Why Do Elected Coroners Underreport Suicide?

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The WSJ reports on a new study that finds that elected coroners report 15% fewer suicides than do appointed medical examiners. The researchers looked at 1,578 counties with elected coroners, and 1,036 with appointed medical examiners, adjusting for poverty, marriage, household income, education levels and gun ownership.

Their reasoning for the difference in reporting? Stigma and politics:

“Elected coroners would feel pressure because they are elected by the public at large and would be worried about antagonizing local community stakeholders who might badmouth them,” said Joshua Klugman, PhD, first author of the study and assistant professor of sociology at Temple University in Philadelphia. “For medical examiners, we think the pressure is still there, but it’s to a lesser degree. They feel insulated from that.”

In addition, the researchers looked at 174 appointed coroners and found that their reporting rate matched the medical examiners, instead of the elected coroners.

In general, suicide is a taboo subject. But not too taboo for us — if you haven’t already downloaded our latest podcast, do so and find out about  “The Suicide Paradox.”

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COMMENTS: 15


  1. AaronS says:

    While I tend to agree with the Klugman’s reasoning, there just might be more to it….

    First, an elected coroner likely finds it much more necessary to be involved in the community. Thus, instead of thinking of votes, he/she might be thinking of not hurting someone’s feelings…or perhaps helping a needy family collect on an insurance policy that would be invalid otherwise.

    Or it might be as simple as “I know this guy well–he would not have committed suicide.”

    In other words, though I’m pretty cynical myself, it might not be for purely cynical reasons that this is being done.

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  2. BL1Y says:

    They “would be worried about antagonizing local community stakeholders who might badmouth them?”

    That seems to miss the mark. My guess would be that it’s easier on the families to have a death reported as an accident rather than a suicide, even if they family knows what actually happened. Friends, family, and coworkers will all ask what happened, and being able to say “the coroner ruled it was an accidental overdose” will be easier on the family than saying it was a suicide or having to lie about what happened.

    Elected coroners may report fewer suicides to help secure votes and reelection, or they may just feel more connected to their communities and want to save them a bit of grief.

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  3. JP says:

    Did you think maybe that appointed examiners may, in fact, be better medical examiners? Most locations do not have any requirement for elected coroner except that they run and get elected. My guess is that maybe appointed coroners are more qualified. Was that taken into account?

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  4. Scott from Ohio says:

    How do we know that elected coroners under-report suicide, as opposed to appointed coroners & medical examiners over-reporting?

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  5. Mike B says:

    This should be no surprise as this is the very reason we have elected coroners in the first place. Back when medicine was as much art as science, ruling a death the result of foul play could almost be thought of as a political decision if the facts were not clear cut. For example if the community held the view that a specific person was violent or no good and then that man’s wife suddenly died in a suspicious manner, the elected coroner would represent the community’s interests and declare the death a homicide. Likewise suicide not only held many social stigmas, but also would result in real world penalties such as the payout of insurance claims and burrial in the church courtyard. The responsibility of an elected coroner would be to weigh the community impact of a death being ruled a suicide vs the actual facts at hand and if the facts weren’t clear cut, which they frequently were not, the coroner had leeway to rule the death accidental. Finally I can see how the two combined with eachother would lead a coroner to err on the side of caution and rule potential suicide deaths as a homicide and let things get sorted out at trial. An elected coroner will always get more blame for allowing a killer to escape than sending an innocent man to trial.

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    • Kevin P. says:

      Even now, the job of a coroner is an art, since the facts don’t automatically tell the story. The coroner always asks about the circumstances and sees if the facts and evidence agree with them. Shows like CSI mislead us into thinking that the facts are always clear cut and describe the story immediately. There is always room for interpretation and disagreement in good faith.

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  6. robyn ann goldstein says:

    Reminds me of a study that I worked on years and years and years ago. One large company had around 37 office subsidiaries. They paid out money. Kept records and were compared. Monthly statements were printed. And every office got a record of where they stood relative to the others. IF that is not a reason to pad (as in keeping up with the Jones’s) or maintain one’s place on the list, I don’t know what is. And especially since the larger offices appeared to be more efficient. Seems that elected coroners have a reason to be a little more rigid when it comes to deciding who did and who did not commit suicide. the lower the rate, the better things look.

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  7. Eric M. Jones says:

    Not much of a mystery. Many suicides, like motoring into a bridge-abutment or tree, require a certain amount of guesswork; was there a note?, was the person threatening suicide?…etc. So an elected coroner might give the benefit-of-the-doubt to “probable accident”, thereby not depriving the survivors of the insurance nor suffering the social-condemnation and shame issues.

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  8. Clancy says:

    My question is: Does anyone care at all about elections for coroner? Follow-up question: Why is coroner even an elected position? (Mike B suggests an historical reason)
    I voted for a coroner once and my only reason for making my choice was the guy’s name: Scott Grimm.

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    • RPM says:

      Also, I wonder if the study’s author, Joshua Klugman, PhD, was influenced in his field of study by Jack Klugman, aka Quincy M.E.

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  9. TelliameD says:

    By not reporting a suicide, an elected coroner is helping a family (and hence a community) financially to collect on a life insurance policy. This in turn ensures their re-election.

    By reporting a suicide, a professional coroner is only helping an insurance company.

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  10. AMC says:

    My only expreience with the term of an elected coroner was living in a small town in the southern US (until then, I had never heard of an elected coroner; I’d always lived in metro areas in the US where there is an appointed medical examiner) The notion seemed odd to me (it was my understanding that a person running for/elected coroner need not have any medical training or background). I suspect that most areas with elected coroners are smaller jurisdictions, and possibly in areas that could be considered more religious (I know that was the case in my expreience; small town in the so-called bible-belt). Since suicide is not only a [secular] cultural taboo- but also a religious one, there might be less reporting of suicide because of cultural/religious reasons in smaller jurisdictions (which also happen to have elected coroners). Or it could be there are fewer actual suicides in these smaller, more religious areas (so it might not be underreporting, but cultural difference).

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  11. Longtime Lurker says:

    Just have to clarify something about life insurance benefits. In the past, yes, if it were a suicide life insurance would not pay out, no matter how old the policy was. Today, all states have what is called a “contestability period” of no more than two years (some are shorter) after policy issue. After that time, even if you kill yourself, your policy will pay out as long as there wasn’t egregious and blatant fraud that rendered the contract invalid from the start (and sometimes even if there IS egregious and blatant fraud the court favors the family over the insurance company anyway). So unless it is a new policy, your family will collect even if you kill yourself.

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  12. Drumm says:

    While I agree some Coroners may feel some pressure to adjust the death rates where possible, consider the large city with an extremely high murder rate and very low conviction rate. Classifying murders as accidential deaths or Suicides decreases both and gains them the political support of the elected politicians for making the city look safer. The problem is they give murders a free pass, but with the low conviction rate, not really.

    If I remember correctly this happened in Washington DC, probably under the control of Marion Berry. However, I don’t doubt it has happened elsewhere.

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