As is pointed out, “28 states still primarily use coroners to determine the cause of death.” (although I disagree with the second sentence in that paragraph) However, Medical Examiners discuss problems with the Coroner System in place around the country (as a member of the National Association of Medical examiners I get to listen in). State and local government officials and regular folks around the country have discussed problems.
Will the coroner system be replaced in this country? I doubt it, but likely it will hybridize into some sort of mixed system as exists in some states. There are not enough Forensic Pathologists to cover the entire country, “there should be 1000 medical examiners, but only half of that are practicing now”. We need to be certain that all areas of the country have access to trained forensic pathologist to lend their expertise to medicolegal death investigations and for autopsy.
But more importantly, we must ensure (and this is indeed where the coroner system comes up short in certain areas of the country) that we have trained and experienced folks in the field. Not just anyone can be a coroner or coroner’s deputy or a medicolegal death investigator. We must be sure that the medicolegal death investigation system is strengthened by any changes that are proposed or occur. We must ensure that a separate death investigation is done in every homicide or questionable death (Coroner’s case), in balance with and in parallel to law enforcement.
As stated on MPR:
“…it's important to have a trained death investigator at every death scene.
Somebody who understands the combination of the forensic issues, the medical issues, the evidentiary issues," .... "Somebody who can address things like the rigor mortis of the body, the position of the body, who can then give those clues back to the forensic pathologist in a way that would be meaningful to him or her."
That is our goal in every case and always will be. We take very seriously our duty of thorough medicolegal death investigation for determination of the cause and manner of death and pursue it professionally in every case, as should every office whether coroner or medical examiner.