In Alabama, the amount of training required for coroners to do their job is less time than a high school student spends in class for a week.
When someone dies unattended in Alabama, it is the job of the coroner to first examine the body, decide if there should be an autopsy and declare the cause of death on the death certificate.
It is a complicated job, with potential for a huge impact on family members of deceased individuals, so many experts in death investigation recommend a high level of qualification for those serving in the role.
In Alabama, however, there is little required beyond a high school diploma.
For the vast majority of counties in Alabama, the position of coroner is an elected position and requires no prior training or qualification.
All you need is to be at least 25 years old, be a state resident for at least one day, be a U.S. citizen for at least one day, have a high school diploma or its equivalent, be a registered voter and have no felony convictions on record.
After election, a new coroner is required to complete a 20 hour training course within 180 days in office and to complete 12 hours of training each subsequent year.
“Every coroner’s office is independent of one another,” Evans said. “So there’s not a governing body over them…they’re not overseen by one office or one association.”
Coroners who are registered nurses or EMTs receive 3 credit hours of training each year.
The average high school student spends around 30 hours in class for a single week.
According to Lina Evans, the coroner for Shelby County and president of the Alabama Coroner’s Association, the training that coroners receive isn’t meant to completely train them for their jobs. Instead, it is meant to give them the basic directions on how they should be operating their office.
“Every coroner’s office is independent of one another,” Evans said. “So there’s not a governing body over them…they’re not overseen by one office or one association.”
This means that under the current laws, there is very little that can be done to ensure that a coroner or the people in their office are properly trained for their job.
Which is why Evans and other like-minded coroners want to completely overhaul the coroner system.
Evans compared the current requirements for a coroner to having an untrained pilot fly a plane.
“You wouldn’t want to get on a plane with him,” Evans said. “You want him to have the training. You want him to have the background. You want him to have that education and a certification in flying an airplane and it’s no different with somebody investigating a death of your loved one.”
Unlike any other coroner in the state, Evans is a certified fellow with the American Board of Medicolegal Death Investigation. Fellow is the higher of the two certifications A.B.M.D.I. offers. She has also made sure that all of the staff in her office are certified as well.
“So this office isn’t just doing what it feels like for the day,” Evans said. “I have a set of protocols that I follow for every death investigation. All of the people that work for me follow this set of protocols. We follow protocols and procedures that are consistent with the national accepted protocols for death investigation.”
In total, there are 8 other elected coroners in the state who have been certified by A.B.M.D.I. as diplomats, the first level of certification.
To qualify to take the certification test, applicants must have considerable experience and training in death investigation first.
What does a coroner do?
Primarily, the role of the coroner is to investigate unattended deaths in their jurisdiction. It is up to the coroner to decide the cause of death, determine if an autopsy is necessary and fill out the death certificate.
They also replace their county sheriff if the sheriff is temporarily or permanently removed from office until a replacement is appointed. This happened in Pickens County in 2019.
Coroners do not conduct autopsies, but instead decide if an autopsy is needed to determine the cause of death. So when it is decided that an autopsy is necessary, they send the body to one of the Alabama Department of Forensic Sciences labs. Alabama is broken up into three areas of coverage, with each county either sending autopsies to a lab in Mobile, Huntsville or Montgomery.
With the exception of five counties, the coroners are selected by the residents of their respective counties every four years.
Currently, beyond their yearly training, there is no set standard for coroners in Alabama. Each coroner’s office is completely independent from the other, and the procedures that they use are not regulated by any joint governing body.
Evans considers this inconsistency across county lines to be a problem.
“Everybody in Alabama, all the coroners, should be following the same protocol,” Evans said.
Coroners have the potential to have a large impact on the families of the recently deceased. According to the code of Alabama, it is the job of a coroner to determine the cause and manner of death in cases where the person died unattended by a physician.
Evans explained that Improperly ruling a natural death or homicide as a suicide, for example, could cost a family a life insurance policy that might have been needed to support them.
In addition to the personal impact their work can have, Evans talked about the role coroners play in tracking trends in causes of death. Part of what she and her office do is track the cause of death and file a report each year, detailing how many deaths there were due to suicide, drug overdose, gun violence and other causes.
One of the issues that Evans said coroners have had across the state is not properly recording the cause of death in drug overdose cases. Evans explained that there had been issues in the past where coroners had put “multiple drug toxicity” and similar answers on death certificates as the cause of death. This meant that it was difficult to track the specific drugs that were the cause of death.
“The way we were signing them out, nobody knew what was going on,” Evans said.
There have been multiple training sessions to fix the issue, and now Evans says that she believes most counties are signing them out correctly.
Who are the coroners in Alabama?
In systems where coroners are elected, it isn’t uncommon for many of the coroners to also work in funeral homes. In Alabama, there are currently 20 coroners who work in funeral homes.
Coroners who also work in funeral homes will likely have undergone training as part of their job in the funeral service industry, and in Alabama it is required that funeral home directors are licensed. Jefferson State Community College offers an associate degree in funeral service education.
“Our aim and purpose are for funeral directors to understand the working relationship with coroners/medical examiners in order to better service the families in their communities,” said Dr. Jzyk Ennis, a professor with JSCC’s funeral service education program.
“Dealing with death and dying on a daily basis is not for everyone,” said Pinner.
Some funeral service programs do include a class on pathology, but their primary focus is to better prepare students for embalming.
Dr. Kathryn Pinner, the president of the National Association of Medical Examiners, said being both a funeral director and coroner made sense, because it meant you had familiarity with some of the processes for death certificates and were comfortable interacting with grieving families.
“Dealing with death and dying on a daily basis is not for everyone,” said Pinner.
Still, Pinner didn’t consider training in funeral service enough to make an individual qualified for the job, because they still lacked the medical and medicolegal death investigation training. Pinner didn’t view this as an insurmountable obstacle, just one that would require additional training for the coroners.
Of course, working in a funeral home and serving as coroner could easily be seen as a conflict of interest.
In 2006, when Alabama passed the law to form the Alabama Coroner’s Training Commission, one of the laws they added acknowledged that coroners working at funeral homes had a conflict of interest.
“If it’s perceived by anybody as less than honorable, there is a direct conflict of interest,” Evans said.
The law did not ban coroners from working at funeral homes, but it does say “A coroner who owns, operates, is employed by, or otherwise has an interest in a funeral establishment is deemed to have a conflict of interest and shall not direct business to the establishment when performing his or her duties under the laws of this state.”
Bodies can still be taken to a funeral home a coroner is associated with if the family makes the decision on their own.
Sometimes, however, bodies need to be stored for a period of time. Many of the more rural counties in Alabama lack a morgue. In some of these counties, it isn’t uncommon for coroners to store the bodies at funeral homes where they work.
“If it’s perceived by anybody as less than honorable, there is a direct conflict of interest,” Evans said.
Evans believes that every county should have at least one or two drawers for storing bodies in their county to avoid this type of situation.
In contrast to the coroners employed by funeral homes, there are currently a total of 24 coroners that hold some form of medical training. Several of these were elected this year, and in Coffee County, the incumbent without medical training lost to someone with medical training.
This past election saw a total of 10 new coroners elected, and according to Evans, most of them had some type of medical background.
Appointed vs elected systems
While Alabama is hardly alone in electing coroners. There has been a slow shift across the country for years to replace elected coroners with appointed professionals.
Many states have medical examiner systems, where a medical examiner is appointed instead of a coroner being elected.
In Florida, medical examiners are appointed to cover judicial districts, which usually include several counties. The medical examiners in these districts are usually appointed by the governor, though some of the districts that include only a single larger county have their own commission appoint the medical examiner.
No matter who makes the appointment, however, Florida law requires that they are practicing forensic pathologists.
“Everybody has graduated from medical school. Everybody’s gone through a pathology residency and a forensic pathology fellowship,” said Dr. Stephen Nelson, chief medical examiner for Florida’s 10th judicial district and chair of Florida’s Medical Examiner’s Commission.
While it is the governor who makes the appointments, it is the Medical Examiners Commission that is responsible for discipline and handling any situations where medical examiners are not performing their roles.
There are a total of 25 medical examiner offices in Florida, and the staffing of each of them is left to the chief medical examiner for that district. Funding for these offices is decided by a board of county commissioners.
Another example of a state with a medical examiner system is New Mexico. Instead of medical examiner districts, New Mexico has one central office, and several field deputy medical investigators in each county who are called upon when they are needed.
Davis explained that part of what makes the course so valuable is how it teaches investigators to focus on the cause of death.
Field deputy medical investigators are essentially part time employees who are paid when they are working to assist the state.
Those deputies are not required to be certified by A.B.M.D.I., but Dr. Heather Jerrell, the chief medical investigator for New Mexico said that they are trained by the central office, and that the medical investigators at the central office are certified by A.B.M.D.I.
Alabama does have its own example of a medical examiner system.
Dr. Greg Davis, the chief medical examiner for Jefferson County, is appointed by a board and has separate death investigators. Davis said that he usually only goes out into the field about once a year, and generally the death investigators, all of whom are certified with A.B.M.D.I., handle the field investigation for his office.
When asked about the value of having A.B.M.D.I. certified investigators in the office, Davis explained that part of what makes the course so valuable is how it teaches investigators to focus on the cause of death.
Davis said that all the death investigators in his office come from a background in law enforcement, which means they were initially trained for emphasis to be placed on determining if a crime had been committed when someone died. He also worked in an office in the past where many of the investigators had backgrounds in the funeral industry, where the emphasis was on comforting families.
“What the death investigation course is teaching people is your focus is really on trying to figure out why death occurred,” Davis said.
The impact of the current coroner system
In Davis’s opinion, the vast majority of cases are relatively straightforward. If it looks like a natural death, then it probably was a natural death. The problem is that it can be difficult for an untrained individual to tell when that isn’t the case.
“Some of those natural deaths, or seemed natural actually turn out to be homicides,” Davis said. “It’s a very small number, but I’ve seen those sorts of cases, like a half dozen times in my career.”
Davis has seen a similar number of cases where the reverse is true: when it seemed like homicide, but was actually due to natural causes.
Davis believes the fact that errors aren’t necessarily common makes it less likely that change will be enacted in the system.
“It’s hard to effect change in a system, when you or most people at any given time don’t perceive that it matters or that they need it or that it’s a problem that would ever touch their lives,” Davis said.
The conversation about the coroner system has been gaining more attention recently in local media due to an old case from 2017 in Marion County.
Jeremy Abbot’s death was ruled a suicide in 2017, and while his mother, Kimberly Mann, initially believed it, she now believes he was killed. While there are multiple details that she says seem out of place, one of the biggest issues is that the coroner’s report from her son’s death is missing.
Not only was the report missing, but the Alabama Department of Forensic Sciences confirmed that no autopsy was requested.
“There is no law pertaining to records of the coroner,” Evans told ABC 33/40’s Cynthia Gould.
Evans explained that there are some coroners who treat the records from their office like personal property.
“Some coroners think they’re personal property, that’s not true. They belong to the office, they should stay with the office,” Evans said.
What would change look like?
Pinner doesn’t believe that the position of coroner can ever be fully abolished. This is mostly because there are not enough medical examiners in the U.S. to replace all of the coroners. This shortage of forensic pathologists was mentioned by Nelson as well.
“Forensic pathology is very much a seller’s market at this point,” Nelson said.
Just because coroners can’t be replaced entirely by forensic pathologists doesn’t mean that coroners can’t be better trained.
“In my opinion, the focus should be on training them to do the job the best they can and offer them assistance if needed,” Pinner said. “Because they perform death investigations, I think they should be required to obtain A.B.M.D.I. certification within 2 years of election to office and maintain it as long as they hold the position.”
Currently, the coroners of Alabama are not held to this standard, but Evans and other like-minded members of A.C.A are pushing to change that.
“Our laws for the coroner system are antiquated, and we need to change and we need standards,” Evans said.
Evans’s goal for 2023 is for legislation to be passed that will require the coroners in counties with over 200,000 people — Madison, Baldwin and Shelby county — to be certified with A.B.M.D.I. or have relevant death investigation experience of five years in order to qualify.
“So we’re thinking let’s start with the big counties since there’s not many of us,” Evans said. “And once we agree on it, maybe the other ones will follow suit.”
Although Evans believes that coroners should be appointed by a governing body instead of elected, she doesn’t think that is a change likely to happen soon because the role of coroners is written into the state constitution. It would require an amendment to the constitution to remove coroners from the ballot.
Regardless, she views the new legislation as an important first step.
“Our laws for the coroner system are antiquated, and we need to change and we need standards,” Evans said.
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