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(moaning "CON- TINUED"), or tha symbol ▼ (moaning "END"), whichavar applias. IMaps. platas, charts, stc., may ba fllmad at diffarant raduction ratioa. Thosa too larga to ba antiraly includad in ona axpoaura ara fllmad baginning in tha uppar laft hand comar, laft to right and top to bottom, aa many framaa aa raquirad. Tha following diagrama illustrata tha mathod: L'axamplaira film* fut raproduit grica A la gAnArositA da: Medicai Library McGili University ■Montreal Laa imagaa auhrantaa ont «t4 raproduitas avac la plua grand soln, compta tanu da la condition at da la nattat* da l'axamplaira fiim«, at mn conformity avac las conditiona du contrat da filmaga. Las axamplairaa originaux dont la couvartura wx paplar aat imprim^a sent filmis sn commandant par la pramiar plat at an tarminant soit par la darnlAra paga qui comporta una amprainta d'Impraasion ou d'illustration, soit par la sacond plat, salon la eaa. Toua laa autras axamplairaa originaux sont filmte an comman9ant par la pramlAra paga qui comporta una amprainta d'impraaaion ou d'illustration at an tarminant par la darnlAra paga qui comporta una talia amprainta. Un daa symbolos suivants apparattra sur la damlAra imaga da chaqua microflcha, salon la cas: la symbols — »> signifia "A SUIVRE", la symbols y signifls "FIN". Laa cartaa, planchas, tablaaux, ate, pauvant Atra filmAa A das taux da rAduction diff Arants. Lorsqua la documant ast trop grand pour Atra raproduit an un saul cllchA, il aat filmA A partir da I'angia supAriaur gaucha, da gaucha A droita, at da haut an baa, an pranant la nombra d'imagas nAcaaaaira. Laa diagrammas suivanta illustrant la mAthoda. 1 2 3 1 2 3 4 5 6 ■"if ■■ >s.> u % »a»«««i»U«(kVi»lalfc«i«»»-'s»WJt««»i»«iJ.»'*s.-J4»a«.«l.Mfe*# (|si0^ 9a-> ^ ( ^^^^ ^M^k* ^|^^_f,i ,_ - ^ ^MMM^ '«ki ^'^ ' TO AN nitiiiKiis <- >i —OF TfiE— law DBC^MBBR, lAe3, tJ^OK ^- 1 -Vni -»^, .4,'. OORONBltS' nO-QUUSTS. ;>si' M^«iMaairilii*mi*aitof ' ' ' K l' .''^ ^ t ' * -^ Mil V • ■» J L ,4 *v^ \ ' ^ , \ - i ' K 't - / /, -^^1. '' ^w i > ^ i. , " A, 1 , ' 1? » < t •■ «, » .^- ' t ^ \ •J 't \- ;^>-'" 'riK- _-, t ^'-"J, .*; ,i i* i ^ . RETURN -(Mo.82.)~ To an Order of the I/egislative Assembly, dated Decefiil 13th, 1893, for A copy of the Report of Dr. Wyatt Johnston, of Montreal, address* to the Attorney-General, upon Coroners' Inquests ; Also a copy of the Appendix to said Report. LOUIS P. PELLETIER, Secretary of the Proviwx, SaCRETARY'S OPPICB, Quebec, December, 1893. } m^mmmtm^^ £ '-i ^i^^^'MJ^ IM^-^-t^ '•^Itf ■ .afi Jaiifebii«a.^- n-AjJ^iW,:, ■'■ , > t,,^ ., . V'" \ ; \ > ,' JQuEBRc'^-^eith December, 1893. Ths H0N0RABi.1t ThB SECRETAftt* 6f f We' PROVINCE OP QUEBEC. ;';:..< 3i)»,—^In^ reply, to yqvm9,p( the, 13th instant, fonvarding a copy of.an Order of the Legislative Assembly,, the Attorney-General instructs me to enclosie you a ^ J copy of Doctor Wyatt Johnston's report on Coroners' Inquests, with appendix thereto, as required by said Order. ^' . • . I have the honour to be, Sir. Your obedient servant, L. J. CANNON, Assistant Attorney-General. True Copy, JOS. BOIVIN, Assistant Provincial Secretary. h 93- a Order of osie: you a appendix leral. REPORT ON CORONER'S INQUESTS. The H0NOURAB1.K THE Attorney-Generai., Quebec. Sir, — For the sake of convenience, I have placed in an appendix the in! mation obtained during my recent trip to Coroners' Courts in the United StaU and have also added some other statistics, etc., bearing upon the subject of forming the Coroner law, with comments. In the past, the chief complaints in regard to the Coroners' Courts of tl Province seems to have been that (i) deaths were investigated which were in the first instance, strongly suspicious ; (2) that the investigations were ui tisfactory and inconclusive, and (3) that the expense appeared excessive in portion to the results obtained. The various changes in the Coroner law of the Province do not appear tohft^ removed these objections, and the new arrangement made in Montreal, at ' commencement of the present year, of having a lawyer appointed as Corot with an official physician to make all medical examinations, has not, as yi greatly improved matters. In this connection, it must be remembered that the plan of an official m« cal examiner has not had a fair trial during the nine months for which it ' been in force, as the medital c^xpert has only been consulted in less than one-1^ of the inquests ; and in eighty-five of the eighty-eight preliminary enquiJil made from January to May, 1893, was not consulted at all ; owing, no doubt, the absence of definite instructions from head- quarters upon this point, evident that, where the official physician is not summoned, the Coroner ' responsible for the investigation of both medical and legal sides of the case. NUMBER OF INQUE3TS HELD. The number of deaths investigated in the Montreal district by the Cot has been at the rate of 1.3 per annum per i.ooo population, and the number of^ quests at the rate of i .0. These numbers, judging by the experience of cities where, do not appear to be excessive, the number in all parts of the world ra ing between 1 and 3 per i.ooo. New York investigates 3.0 ; Philadelphia London 2.0 • Pittsburg 2.0 ; Buffalo 2.0 ; Baltimore 2.4 ; Washington 2.5 ; Bt minghan 2.4; Liverpool 3.0; Charlestown 4.0; Newark 2.3; Chicaga i.j i'k-t^tmm^. Mr^'H " P.-' |a^d 1.3 ; Wilmington 1.3; St. Louis ..4; Boston 1.2; New Haven i., • ^Stb^r, .1'' ''^'''' ^^»°"°»^' «f the other cities, of which I have -reliable returns, there is not one where less than one death is investigated yearly for every thousand inhabitants. vwnjfBrea ycariy WhUe this, no doubt, shows that about this proportion of deaths may be ex- pected to occur annually in a large city, under circum^ances calling forTinvesU- i^i«rr!r^ all these cases. It seems customary, in most places, to make a pwhm^nary enquiry, in order to see whether the death is really due o violence Wdmg to the thoroughness with which this enquiry is made, the numberTf ^n^^ll^^Y'^'T'''''''''^''^ *° three-fourths. one half, or e" n on^. fourth of the total number reported for investigation. Wo^tdd^n'Ttrhnt '' "''" ^^^^^^ apreliminary enquiry by the Coroner Mfore deciding to hold an inquest ; and. if a careful and satisfactory enquiry ^Iwh"o?tf ;?r''°::i'*^ ^ ^°"°^^ ^°' ^°^<^°^ inquests inloreThan o«.fourth of he total number of deaths reported as suspicious in Montreal b other words, less than 100 inquests would be held in each year. The Queb^ S^b^in ."^'''^'^"^ ^°" that of England, which compels CoronertK |ubhc inquests m all cases of deaths not due to natural cau^s. and in a 1 deaths inpnmn from any cause whatever. 'In Ontario, where the sta ute is the sameas ^^ :;sSr ^" '''' ^° '''-' ^^^^^^^^-^ ^-- -^^^^-- of theVersTd «„ijr^' ^^l"" *^^ ^°'^'^^ °* society that inquests should be held in cases suicide, in order to check its frequency ; as. in countries where this is n^t f^"' ^;f V' ?'^^^'^ "^"^^ '^^"^"* ' ^^t the present Queb^ statute leave it doubtful whether inquests must be held on suicides or not. The idea of the Quebec statute of 1892 seems excellent in principle as the l^lTfiT "^r*"'"' '" i»^--tigating deaths not due to violence. The o^y defect IS that, without a medical examination or inquiry, it isimoossible in moJ cases, to determine whether death is due to violence' or^no^ and^TiL'^^^^^^ the cause of death is. in most instances, the first step necessary. "'''''''^^^^ °^ PRELIMINARY MEDICAL EXAMINATION. In the United States this fact is taken advantage of, and the preliminarv lamination is always made by a medical man. Mosfof tie Am rican aJcaS^ a^an coroners are, on this account, physicians ; and, when such is not the cas^ are provided with medical officers who make the preliminary enquiry The S sul^ bem^, that inquests are only held u|K>n violent deaths sm^ ry AUT0P8!ES. ' , The best results are obtained when an autopsy is permissible at the prdimi ary inquiry. In Massachusetts, in spite of the fact that nearly $40 la paid each autopsy, the average cost of investigating suspicious deaths i& $12.80, or $iO 51 less than in Montreal ; and, in New York, the average cost of each death invoA^*'-^ igated is only $10 ; including all. the expenses of conducting the Coroner's CottrU r ^ The Quebec law, instead of attempting to utilize the medical examination it I a means of reducing expenses, has avoided all medical evidence as much as podkt sible, and has placed so many restrictions upon the performance of autopsies that; the number of these has been reduced to a minimum. This has had the nnde^. sired effect of giving a very unsatisfactory service, without securing the economf^^ aimed at, as may be judged from the fact that, in London, where autopsies ^^ ordered in fifty per cent of all the deaths investigated, the average cost is on^| $15.35 for each case ; which, in Montreal, with autopsies in only 13 0/0 of th^ cases, the cost has averaged $22.28. During the period from January ist, to September 30th, there were 301 death^.j investigated in the district of Montreal. The expense, after deducting $150 al-j lowed for my trip, amounted to $6,705.85, or $22,28 for each case investigated ; fai j spite of the fact that no medical fees at all were paid in 98 cases ; or nearly on««,^ third of the whole. Of this sum, $295, or an average of 98 cents for each case, was directly spent «^ for autopsies ; this amount representing the additional fee of $5 over the cost 0|| an external examination ; and the full fee of $10 in 17 cases, where extemafe^ examination fees were paid to other medical witnesses, and the official physidaiS^^ called simply to do the autopsy. After deducting this $295 and also $300 charg- ed to chemical analyses, arising indirectly out of the results of the autopsies from the total expense ($6,705.85), there remain $6,210.85, or $20.63 spent on an average in each case for coroners' and physicians' fees, constables' fees, clerk hire, transport and care of bodies, rent of rooms, mileage and other incidental ex- penses before the investigation had reached a stage when an autopsy could be legally authorized :— much more than is spent for the entire investigations in I/)ti- don, although autopsies are performed there in 50 0/0 of all the cases. Thisloolcs rather as if article 2689 led to twenty dollars being spent in every ten dollars saved. In 1890-92, the average cost of 240 inquests held yearly was $22.50 each ; of which 37 cents was directly paid for autopsies. 1^1 •M " id On the other hand, the early performance of an autopsy would certainly have shown, in half the cases, that no grounds existed for holding an inquest, and so have saved a large number of inquests ; the average cost of which was 4'f' i-*,^ i„,ilti- ^ii^,i ■' ■MMW^tSi* % than double that of an autopsy, while the verdicts were often absurdlv at twiance with the facts (or absence of facte) elicited by the enquiry. It is evident that too large a proportion of the money spent in Montreal for 4^j)ners' investigations is flittered away in fees and expenses (which may be ^*"^ectly legal and permissible under the law, but are absolutely useless in fur- ring the investigation) and this has led to an undesirable economy in which real objects of the enquiry are lost sight of. As some doubt existed as to the power of the Province to pass a statute, au- lorizing the performance of autopsies as a preliminary means of investigating taths from unknown causes, under suspicious circumstances, I have made care- il enquiries on the subject of the Department of Justice at Ottawa. I was in- formed the Province has a perfect right to authorize this, and that there is no- ting in British or Canadian criminal law to prevent it, or render it inadvisable. I am not advocating the indiscriminate and wholesale performance of autop- [es whsa they are not needed to show whether death was due to violence or not • fent no restriction should be placed upon their being made when really called for! Even without autopsies, a preliminary inquiry and view of the body often Jrteld satisfactory information that death has been natural, in cases which seem suspicious to persons not having a medical training. . In American cities, where official medical experts are attached to the Co- Itoner's Court, no fees are paid to other medical witnesses. In England no fees are paid to medical officers of public institutions in connection with deaths oc- curring in them. In all American cities as large as Montreal the coroner and usually, the official physician are paid fixed salaries. There were no complaints that the work was neglected on this account. MEDICAL FEES. In the Quebec tariff there is no fee arranged for medical evidence apart from that obtamed from examination of the body, and there is no arrangement at all for paying medical fees where inquests are not held. Independent of the examination of the body, the information furnished by physicians who have seen the deceased during life is often of much value. With- out this it is often impossible to give a correct opinion as to the cause of death even after an autopsy, and the testimony of physicians who have attended the case often enables an autopsy to be dispensed with. While some provision is needed to ensure that all medical opinions should be founded on facts which bear them out, and that such opinions are, generally wore correct when given by an expert, it is equally true that all medical testi^ Tj HH JJSM 4 mo^ &t inquffsts, whether of feet or opinion, ii, in a acnse, exp^ evidence, tai is recognized and paid for as auch io our Courts. It has been found elsewhere that proper use of medical evidence forma tht best means of avoiding unnecessary iwiuests without running a risk of aeriotti ;| mistakes, and any arrangement tending to secure such evidence, before an inqueit is decided upon, would certainly lead to economy. . The presence of a medical attendant at an autopsy is often of the greatest ■«• sistance to the expert i -rforming it ; and aflFords the additional security that th» ^^ medical evidence in Court, subsequently, will not suffer in case of absence or death of the official physician. For this reason a special fee is provided in States where the medical examiner system has been adopted for physicians acting a» witnesses at autopsies. In addition, it has been found in the United States that a written statement* of medical fact or opinion by a medical man usually suffices for the purposes of an inquest, so that his personal attendance is seldom necessary. This privilege is highly appreciated by the medical profession, and the legal officials did not con- sider that the interests of justice suffer. Of course, in all cases when the pres- ence cf a physician at an inquest is necessary it must be insisted upon. I think it would be well to provide a special fee, say $2 for a verual or writ- ten statement of medical facts or opinion without examination of the body, and without attendance at an inquest ; also to pay a separate fee of, say, $1 for at- tendance of a physician at an inquest or autopsy, ^he medical examiner would probably be the best judge of when and to what extent outside medical evidence or assistance is necessary. I did not find that the practice of obtaining medical evidence gratis led t«>| any good results. Unless the co-operation of physicians is secured in preliminary | inquiries, unnecessary inquests have to be held at a much greater expense, thaa. is incurred by a medical fee. VIEW OF BODY. '"ft'Sji The view of the body by non-medical persons appears to be a perfectly ttieH?^ less proceeding. Such persons constantly detect external signs of violence where none exist, or overlook, or fail to understand them when present. This is con- stantly seen under the present regulations which necessitate the jury viewixig all bodies, and brings about so much unnecessary intrusion upon households in* mourning. Doing away with the view by the jury has now become general in the Fnited States, and has the advantage of enabling all inquests to be held at convenient 8 hcmrs m a central locaUty, besides saving the cost of transport in aU cases wher« this is not necessary for the purpose of medical examination, and enablmg the body to b- buned as soon as the medical examination is completed. In addition as the jury do not have to be summoned before the evidence is complete an ad^ joumment is seldom necessary. The establishment of the fact of death and Identity by sworn testimony fulfills everything that is attained through the view by the jury. I Itarried at the Department of Justice that the view by the jury forms no part of criminal procedure, and is not necessary in order to legalize a verdict of homicide in Canada. MEDICAL EXAMINER SYSTEM. Nearly all the difficulties in connection with Coroner's law, arise from the feet that it is attempted to place both medical and legal powers and duties in the hands of one individual, who very often knows little or nothing about either law or medicine. A solution of the problem appears to have been found in the United States by separating as far as possible, the medical and legal sides of the investigation' leaving aJi xl matters to competent physicians, known as Medical Examiners'- and all k. tters,. either to the regular judicial and police authorities in Massachusetts, or to coroners having legal knowledge in Connecticut. It seems sufficiently obvious that, the deciding whether a death is due to viol- ence or not, is a purely medical matter, and deciding whether the violence is criminal or not, a purely legal one. Further, that until death has been shown to be due to violence there is no legal question at all. For this reason, the pre- hmmary investigation is made by the Medical Examiner ; who, if he is satisfied that death is due to violence, or if he is in doubt, refers the case to the leiral authorities for further investigation. I have given, in the appendix, details of the " Medical Examiners' " systems land their results. The Connecticut law, which provides for medical examiners acting under the direction of the Coroners, appears to me the best ; and could be adopted, almost as it stands by the Province of Quebec, with the effect of greatly improving medico-legal investigations ; and, at the same time, materially lessen- ing the expenses. In Massachusetts, Coroners have been aboUshed, with very happy results • and this could be done in Quebec, if desired, as the office is not constitutional in Canada. If the office is retained, it should be so regulated as to give better re- sults than would be obtained without Coroners. It is preferable to make the medical examiner, to some extent, mdependent of the Coroner ; instances have come before my notice where Coroners have tried to CO or hi ever, the! peari cans due do ; deat cum Exa duc< chai whe mig rone med med in n is w biUt ItS( thei gen case tern wot rom be { usu Liv fon to compel the medical deputies to give certain opinions not justified by the facts, or have prevented them from doing their work thoroughly. The Coroner, how- ever, should have the right to investigate any case not considered suspicious by the Medical Examiner, if he sees fit. A joint preliminary examination by the Coroner and Medical Examiner aj> pears to be the best means of proceeding in cases not obviously due to natural causes. As a large number of the deaths, reported as suspicious, are always found due to natural causes, the Cotoner would, in these capes, have almost nothing to do ; and, in many deaths, especially by those from accidents, where the cause of death was perfectly plain, a careful inquiry, by the Coroner, into the outside chr- cumstances might be necessary. On this account, if a joint inquiry were made, either the Coroner or Medical Examiner, would, in many cases, have very little work ; and, therefore, a re- duced fee paid in all cases would be tair to both. One Coroner could easily take charge of a district requiring several Medical Examiners ; and, in the country, where the outside circumstances are readily ascertained, the medical examiner might take entire charge of the preliminary investigation, only notifying the Co- roner when the case proved really suspicious. In the country, we have, already, medical men now acting as Coroners who could be appointed Medical Examiners* It is very important that the Medical Examiner should make inquiry into medical matters, in addition to examining the body, and should aid the Coroner in making any medical enquiries. In any case, the first thing to be established is whether death is due to violence or not, before the legal question of responsi* bility can be considered at all. Juries should only be summoned when their assistance is really necessary. It seems safer to call them, in all cases of homicide and, possibly, of suicide, but their real usefulness would lie in considering cases supposed to be due to negli- gence, especially railway and industrial accidents. The verdicts given in such cases, though they never result in a conviction for homicide, no doubt indirectly tend to ensure public safety. In many parts of the United States inquests are held privately, but this plan would scarcely be tolerated here. Publicity, by juries, is a protection to a Co- roner, as the blame for any mistake, of course, rests with the jury. DEATHS FROM NATURAL CAUSES. » Respecting the large number of natural deaths reported as suspicious, it may be said that the proportion they form in Montreal cases, viz 42 o;o, is not tta- usually high ;— the number in New York being 68 0/0, in Philadelphia 72 0/0, in Liverpool 72.3 0/0, in Charleston 77 c/o and in Chicago 47 0/0. In Boston they form 36.6 0/0. wm. ^it^i "*T^*'^^^^"*"°«^*^^*'«^^« Coronas' Cburts is by cstab- ^il^J^.r'T^lr?'^^'^ °^^^***^'' '^^ enforcing a pr^Uminar^ &^l^^^^°".^^ *^^^^^ Boards of Health into deaths not prt,pcriy 4wh^ ?^ ^' °^ ^^'^ ""'^ °^ ^^^^^^ *^^°S *«^«»d«d in this respect ^^najr the present session. CONCLUSION. l|^«i!JTrn''°"' ^ ^r^ only to state that, in my opinion, what is needed to ^itopiibvft the Coroner's Court of the Province of Quebec is the introduction of a . tlX i i "T '^^'*^"^ ^° Connecticut, providing for coroners with legal '^^^tZT ' examiners, with definite instructions as to the I wouldj therefore, respectfully suggest :— 1. The appointment, in each district, of official medical examiners f« ,1,. termme whether death is due to violence or not ; and^ m2 strltST?;^^^^^ ^rTr^':'' '"'^' -Aether such violence is criminal and^caTfor incjS'S'- 2. A preliminary inquiry and examination of the body in all cases renort -^inoi""*^^ jointly by the medical examiner and coroner in cfties. and by th?me dicg ecammer alone in rural districts ;-the facts obtained to be recorded fn 3- Autopsies to be ordered when the cause of death is unknowi fl«*l ft,o 4. Salaries to be substituted for fees in the case of large cities. f^,-c ^^i^^'^^r ^° ^° ^' ^ ^"^ prepared to frame an Act which will provide for this^stemof mvestigation ; but it appears to me that the Connecticut law is '^uTrfw^if'^^i''-''"^"^'"^' Bven, under the present law.a preliminary in- ^^mry would greatly improve matters. Attempts at economy, by trying to do away with the medical investigation have on^ resulted m producing a system which is so inefficient as to be a con stantsubject of public ridicule ; which makes the average investigatton much m6re expensive than in Undon, Massachusetts or New York, and which has not ye trained in this Provmce any official whose experience in medico-legal exami- nations is sufficient to make his opinion, as an expert, of much value. If the useless fees and expe ses now made necessary by the " pomp and cir- W^Sr" J- T"?!' ^'^""'*' ^''" ^"^"^ ^^*^' * "^^^ efficient service Would be obtained and less money spent. I have the honour to be, ' Your obedient servant, Montreal, November 21st, 1893. WYATT JOHNSTON. Efc.'t'i.Sfc«&lat.-, "#1K**" APPENDIX TO REPORT ON CORONERS' INQUESTS IN "^AMERICAN CITIES, ETC. BY DR WYATT JOHNSTON. The number of cities visited was 17 ; most of which had populations of over ^00,000. They were situated in 15 different states, as follows :— Boston, Mass. New York, N. Y Philadelphia, Pa. Baltimore, Md. Cincinnati, O. Chicago, 111. Providence, R. I. Brooklyn, N. Y. Pittsburg, Pa. Washington, D. C. JeflFersonville, Ind. Toronto, Out. New Haven, Cqtm. Newark, N. J. "Wilmingtou, Del. Louisville, Ky. St. Xouis, Mo. In addition, I have corresponded with a number of coroners and other per* sons interested in the subject, who have supplied information and statistics. An idea of the various systems followed may be seen from the following table, showing the persons employed for investigating suspicious deaths :— England— Coroner and jury. Canada — do Scotland— Procurator fiscal and Police surgeon. France— Magistrate and Medical Expert. Germany — do Massachusetts— Medical Examiner, District Attorney and Magistrate. Rhode Island— Medical Examiner and Coroner Connecticut— Coroner, Medical Examiner and Jury, (xx) New Hampshire — County Solicitor. New York— Coroner, Coroner's Physician and Jury (xx) New Jersey— County Physician and District Attorney. Pennsylvauia— Coroner, Coroner's Physician and Jury. Ohio, (x)— Coroner. Maryland, (x)— Coroner, Coroner's Physician and Jury, (xx) Washington, D. C, (x)— do. Illinois — do. Missouri, (x) — • do. Indiana — do. Kentucky (x)— do. South Carolina, (x) — do. Minnesota, (x) — do. (x) Indicates that Coroner is a medical man. (xx) " " Jury is optional. do. do. do. and Jury, (xx) do. do. do. do. do. do. wum»^Ui'iu_»iruKj'* *:.&fe WW ' 13 ^^Jll^ J^*' '? *^^ ^"**^ ®^*^ "^^ ^" ^"«««^ States, with the ST °^^"1""1: ** ^« *^^ ™J^' «i*l»^'^ to have speciar medical oicers ap- potnted to assist the Coroner, or to have medical men appointed as Coroners. d„ J^?n * I """^f T' ''?^"^ ''^^ ^^^ ^y**""* °^ °»^i^ examiners, intro- «^ in? '^ILT, ^.^^^^^^'^^tt^ '• a°d adopted since, with certain modifica- tiona mto Rhode Island and Connecticut. I have given a synopsis of the stS- ut^ ^n these three States, as the system, especially that of cLnLUt, api^a^ to have removed all the difficulties that exist in the Province of Quebec ; and at the same time, to be perfectly adaptable to British and Canadian criminal law.' My attention was chiefly directed to the medical part of the system • but I r^.i?^«l'V°-°''^'w'"^"^ ^^'"'^"" ""^ j"^^^^ ^ to how it worked, from ot^rlrr. J'^7' ^^'^ "." ^^"^ ^" pn>nouncing it highly satisfactoi^, and itr^^rV I trf"'"^^ '^" ^"^^ °P^°^^"- '^^^"^h the Massachusetts !ri« T- ^"''^l ^'^"^^^ '°°*' ^^^" y^^'' ^g«- it has never needed se- ^^S^rrrrP "^^^ ^"^"" dissatisfaction. I have not.been able to find any State under the Coroner system where legislative attention of some sort was the ^ut ^^^"^ ""' '^'"' ''"'"' '"^ "° °^" "^"^ "PP""^^ *° ^ ^^tisfied with The whole beauty of the Massachusetts system is that it leaves all medical trtr " "5' hands of medical men. while aU legal matters are attended to by the regular judicial and police authorities. The composite character of the co- roners duties, partly medical and partly legal, appears to be the only real reason why the coroner's system does not work well. In Connecticut, where the co- roner IS retained, but only charged with the legal side of the investigation, things go quite as smoothly as in Massachusetts. ^ frJ"" ^r ^""J"^' f^^^'S^"" ^°d New Hampshire, it has been attempted to in- trodu^ the medical examiner system, but without success, owing to the fact that the office of coronet is part of the constitution and cannot be abolished without revising the Constitution. u wnaom MEDICAL EXAMINER SYSTEMS. The following are the chief points in the medical examiner laws of Massa- chusetts, Connecticut and Rhode Island. MASSACHUSETTS SYSTEM. The office of Coroner has been abolished. Medical Examiners are appointed by the Governor for a term of seven years goodTeraro"'"'' '" """" '''"°* ^''^ '^"^ '^"^^^ °^- ''' "^^ '^ ^W ^5 J:^ They give bonds of $5,000. In Boston, two Medical Examiners receive a salary of $4,000 each. In other - districts $5 is paid for each view and enquiry and $30 for view and inquiry with antopsy. No medical fees are paid at inquests. " Medical Examiners shall make exammations upon the view of the dead •• bodies of such persons only as are supposed to have come to their death by '• violence." •' When, after view and personal inquiry, he deems a further investigation '• necessary, he shall, after being authorized, in writing, by the distict attorney or " mayor, make an autopsy ; and report, in writing, every fact and circumstance " showing the cause and manner of the death." A copy of this view and inquiry or autopsy is sent to the District Attorney. If death is thought due to violence, it is reported for inquest before a Judge of the district who received a duplicate copy. In any case, the Medical Examiner certifies the identity and cause of death, if known, and orders the body to be buried. Two witnesses must be present at an autopsy, one of whom may be a physician, who receives for this five dollars. The Justice holds an inquest, which may be private, examines witnesses summoned by subpoena and makes a finding and draws up a report. The Judge's fee is $5 for each day of inquest and $5 for report. The District Attorney or some one appointed by him, may be present at the inquest and examine all witnesses. In cases of homicide, the evidence is taken in shorthand and paid for by the District Attorney's o£&ce, where a copy of the re- cord is filed in all cases. In railway accidents, except those to trespassers, the stenographer's fees are paid by the Railway Company. Medical Exammers ?re rarely needed at inquests, as their report furnishes all necessary information. If the Medical Examiner finds death aot due to violence (i. e. the criminal act or negligence of another person) the District Attorney or Attorney-General may, notwithstanding, order an inquest. Inquests must be held in all railway accidents. The medical examiner may employ a chemist to aid him in investigating the cause of death. He takes charge temporarily of property found on the deceased and is responsible for it. The District-Attorney's approval of an autopsy report is required before payment is made. Expenses are all borne by the city or county where the body was found. Records of all deaths '.. :stigated are sent once a year to the Secretary of the Commonwealth for statistical purposes. 'm -.■f^^s, rt*\tjS^; 1:^ :f'^ No body may be buried without a certificate ftom the Board of Health or from the Medical Examiner. No body shall be cremated without an order from « Medical Examiner. Persons charged with homicide are publicly examined be- fore a Magistrate, who may dismiss the case. The case, if not dismissed, is pie- aented before a Grand Jury by the District Attorney. Only these cases are tried where the medical and legal proof both appear satisfactory, as may be judged by the feet that, out often trials annually for homicide, in Boston, there are, usual- ly, ten convictions. A special police officer collects the evidence in cases reported for inquest, The system has, in my opinion, the effect of throwing too much responsibil- ity upon the Medical Examiner for matters not strictly medical. Also, inquests are often delayed. It would not be applicable here unless the duties of the office of Crown Prosecutor are materially modified, or the Coroner made to act under him. It has, however, the great advantage that one individual, the District At- torney, follows the legal case from beginning to end, and is responsible for every step taken. There appears never to have been any complaint of too many cases being en- quired into. In every case, men of high standing in the profession seem to have been selected as Medical Examiners. RHODE ISLAND 'SYSTEM.-Chapter 420, April 30th, 1884. Medical Examiners are appointed by the Governor, and hold office for six years, and give bonds to the amount of -^i.ooo. They " make examinations " upon the bodies of such persons only as are supposed to have come to their " death by violence, " and must examine and view all such bodies. If, upon view and personal enquiry, the Medical Examiner deems a further examination of the body necessary, he performs an autopsy after being authorized, in writing, by the Mayor of the city or town, and makes a written report of every fact and circum- stance tending to show the cause and manner of death. The presence of two wit- nesses at autopsies is required, as in Massachusetts ; and one may be a physi- cian who receives five dollars for acting as a witness. A Coroner is elected in each town who holds office for three years, and has exclusive jurisdiction in his district. He may appoint deputies and suspend or discharge them. The Coroner and deputies shall take the prescribed oath of office. Coroners may take ante-mortem statements. If, upon view, personal inquiry or autopsy, the medical examiner is of opinion that the death was caused by the act or neglect of some person other than the deceased, he shall, at once, notify the Attorney-General and the Coroner of the town where the body lies and shall file a duly attested copy of his autopsy or view, %% ^i of Health or an order from • examined be- missed, is pre- cases are tried be judged by ere are, usual- )r iuquest, ih responsibil- A.lso, inquests ;s of the office ; to act Under lie District At- iible for every ases being en- seem to have office for six examinations come to their If, upon view ination of the writing, by the ;t and circum- ce of two wit- 1^ be a physi- ears, and has d suspend or ribed oath of iris of opinion :her than the Coroner of the topsy orview, With the Coroner, and a Uke copy with the Attomey-Oeneral, ahd »J;»»^^ the feet of death and, if possible, the identity and the cause of death ytm rm Registrar of the town. The Coroner shaU, thereon, hold an inquest, which may be private, andat which the Attorney-General, or some person designated by him may be pr^ and examine all witnesses. The Attorney-General may direct an f ^^^"^ 7, held in the case of any casuality. Witnesses may be summoned by subpoena,^ and are allowed the same fees as in a criminal prosecution. ' The Coroner, after hearing the evidence, shall draw up and sign a report, , certifying when, where and by what means the deceased came to his death, mSf nam^, if known, and all other material circumstances. If it appears that d^tnj tesulted, wholly or in part, from the unlawful act of any other person, he shal^ state the name of such person, if known to him. The testimony is filed with ttt| Clerk of the Court where the indictment is found. The Coroner may tniKlwe- witnesses, or commit them to jail if they yefuse to recognize. Or shail mrtni tiiake a complamt against the person accused, in writing and on oath, it suen complaint be not already made ; and shall, forthwith, notify the Attomey-General that he may appear personally or by deputy to present the complaint If the Coroner reports that death was not caused by the act or negligence oi some person other than the deceased, the Attorney-General , may, notwithstand ing, order an inquest to be held, at which he may be present, or represented, an^ may examine all witnesses. Bodiesof strangers shall be decently buried, if necessary, at the pabUc e» pense, the expense of burial to be recoverable from the estate of the deceased. Reasonable compensation is allowed for bringing bodies to land, but not for searching for them. • ♦*, The Medical Examiner to take charge of all property or moneys for sixty days, and be punished for fraudulently refusing or neglecting to deliver them. FEES OF CORONERS For receiving and filing copy of autopsy • • $o-5o " each page of 200 words of autopsy testimony • -3^ " " day's attendance at inquest 5-oo , •' filing and drawing up report 5-0o j ^j •' recognizance of witnesses 35 FEES OF MEDICAL EXAMINER For view without autopsy • • ^'°° " '♦ and autopsy 30-oo " travel per mile •'^ ** Qlerk per day actual service , . i , . , ♦ 3'°^ 16 Itwiswl BtatiitM Coun. •003 9004 •005 All accounte are paid only after approval by the SUte Attditor. Thia system, aa wiU be seen, is ti foe-simile of the Massachuaett. «r«**.«. ., CONNECTICUT SYSTEM, 1M3, Ch. 118. The Judges of the Superior Court shall appoint for each county a Co- roner, who shall be an attomey-at-taw. residing in such county, Miliar ri™^ r' ''""'" *"'' n-edical jurisprudence, who shaU hold office lor fcr^,5? '""«• """'^ *°°" •*"'"'«» fi^" ««« by the .aidTudges .ho«^n"TC '° '"'"'' ""• '=""""' '""" "^^ '""'^ ««« tv an^hlf"^"? *"■ '"'' """'^ **" '«*"* ^' "'='• «»™ in *•» «>»»- ^ri^ndT'' J r?'" ''»'<»'^»«« •'"ri-8 the pleasure of the Co- roner, and give bonds for one thousand dollars. When any one shall come to a sudden, violent or untimely death or when any person shaU be found dead, the manner of whose dLttsn" known, any one who shaft become aware of such death shall forthwith re- P»t the same to the Medical E=.aminer of the town in which the d^ ^tT' "^"ff P^yttei*^ first reporting such death fifty ^u iner swr.^r;t^ !f " ^'^ '"^ immediate enquinr the Medical Bxam- «mssion. or carelessness of another or others, and that there are no sus^ p^e.o„s^:rcumstances attending the same, he shall, forthwith, make, si^ ^ifi?r Ti" '^^^^^'^ of Wrths, deaths and marriages if the t^™^ ^cate of death m U.e fonn required by law. and he shall also. irZe^ Core^ of h'- "'^""r ""'^ '«'""^' "^^ °"' "" "»" « "'liver to ttt ito S ' '''^ "^"'^ "^ ""•• "^ *' '■"'"'"'"8 or Sim. death 'o^c"^^"^^'^' '^ "•■ ""^'"^ ^^"^'^' '"'™8 "<>«« of tie death of CD.. male. years old. late of the town of in (OT. If an unknown person, stating that fact and carefully describing the body. ,ts clothmg and articles found on or near it, which may be of s^ m.ts identification, always stating sex, colour, apparent a«.hl^c^ lour and cut of hairrb.ard.-coldur'^f e^^TIdlirfesSi^llg acofi aoo7 17 I system, ex- liave no legal county a Co- ity^ familiar Did office lor ; said Judges perform the Is for three in thecoun- le to be Me- e of the Co- y death, or leath is not )rthwith re- :h the dead •■ fifty cents rge of such ical Sxam- Iminal act, ire no sus> nake, sign the town a lIso, imme- ver to the ngor sim- tice of the in ribing the of service leight, co- sordefor- iii - i i- i ift i M ii - i T»' • • 'TrTi i iffitril mitiesofbody) who, onthe day of A. D., il (waa dead or died) in the town of , having visited the body of ^ said deceased, and made immediate enquiry concerning the death, do htrt* by cettify that the said C. D. died in on the day of A. D. i8 , firom natural causes, suicide, or accident, as fht case may be, stating manner of suicide of nature of accident) and I am »- tisfied *-hat the said death was not caused by the criminal act or omisidoni of any other person or persons, and that an inquest is unnecessary. In accordance with the statute, I have delivered the body of the said deceased to (his friends or the town authorities) for burial. 1 M08 aoio aoii Dated, A. B. Medical Examiner. .« If the Medical Examiner sees reason to suspect that death was caused by the criminal act, omission or carelessness of another, he shall, as speed- ily as possible, by telephone, telegraph or otherwise, notify the Coroner of the county of such death, and of the place where such dead body is lying. Whenever the Coroner has such notice, he shall, at once, and on other notice may proceed to view and take charge of the body and make all pro- per enquiry respecting the cause and the manner of the death ; and, if from such inquiry and view he be satisfied that the death wa» not caused by the act, omission or carelessness of another or others, the Coroner shall make and sign the certificates required in like cases of Medical Examiners by the preceding section. *o°9 If the Coroner sees reason to suspect criminal violence or aq^ligence, he may cause an autopsy to be made by the Medical Examiner, who shall record, in writing, every fiact and circumstance to show the time, manner and cause of the death, which writing he i^all subscribe, under oath, and deliver to said Coroner. The taking of such testimony firom such Medical Examiner, and any other person whom the Coroner may find it necessary to examine, shall constitute an inquest (or preliminary inquiry.) If necessary, the Coroner may summon a jury of six men of the coun^ try to assist him in his investigation. This inquest may be private. If the verdict or finding charges any one with having caused tl death, the Coroner shall communicate, without delay, the import of said verdict to a Grand Jury or Prosecuting Attorney (Magistrate or Justice) of the town or city in which said death happened or was caused, and shall file with said Magistrate or Justice a record of the evidence taken by him. ' tf- m mmmum M13 ••14 •••I •016 MI7 M18 The Coroner shall keep a record book, into which he shall copy all the certificates sent to, or made by him, with the names and addresses of witnesses, the time and place of the view and inquest, the cause and man- ner of death, as found, the disposition and place of burial of the dead body, and a careful description of all dead bodies not identified before burial. The Coroner shall take, or cause to be taken the ante-mortem state- ment of persons thought to be dangerously wounded by the fault of an- other. The Medical Examiner shall take into his possession all property found upon, or near the deceased person, which, in his judgment, will aid the investigation of the death, and, when such articles are no longer re- quired, for the purposes of justice, the Coroner shall return to the persons, entitled to their custody ; or, if they are not claimed by such persons with- in sixty days thereafter, then such articles or property shall be adminis- tered upon according to law. After the termination of the proceedings of the Medical Examiner and Coroner, the body shall be forthwith delivered to the friends of the deceas- ed for interment ; or, in case there are no friends or relatives who will take charge of and bury it, then to the proper authorities of the town in which such dead body shall be lying, whose duty it shall be to bury it. Whenever the deceased person shall not have left property suflScient to pay the expenses of burial, then the same shall be paid by the said town. The Coroner may subpoena witnesses, and take testimony under oath ; $Uo may order, arrest or bail suspected persons, or may commit without bail. Persons bailed may be re-arrested and committed without bail, when the presumption is great that they are guilty of a capital oflFence. The Coroner may order the release of such persons after the finding, or at any time before such finding, when the grounds on which the person is arrested cease to exist in the opinion of the Coroner. Any proper person shall serve orders, papers and processes, as directed by the Coroner, and remain 'in attendance on such Coroner, and issue his lawful orders during any inquiry or inquest. Any officer wilfully violating any of the provisions of this Chapter, and every person who shall wilfully reject or refuse to report a case of death as prescribed in sections 2005 and 2020, and who shall wilfully and unnecessarily touch, remove or disturb any such dead body or any article on or near the body shall be fined not more than five hundred dollars, or imprisoned for not n^ore than one year, or both, Mf9 M«I 9009 •093 Bvery Conmer mfty appoint a Deputy, who shall oiHy act aa atieh kf] case of the aickneaa , aboence or the inability of the Coroner ; and, so acting, and for such time only, shall have the same pow^ and dtttiea as are by this Chapter given to Coroners, and shall, while so acting, re- ceive the same fees as the Coroner in like cases. In case of absence or inability of the Medical Bxaminer, it shall b« the duty of any persons becoming aware of the death of any person, under the circumstances mentioned in section 2005, to report the same to th« nearest accessible Medical Bxaminer of another town ; who shall, there- upon, proceed to perform the duties and shall have the powers of the local Medical Examiner so absent and unable to act. In case the attendance of the Coroner or his Deputy cannot be pro- cured within thirty-six hours after the Medical Examiner has taken chargtt of the dead body ; and sooner, in case of the known inability of the Coro- ner and his Deputy, the Medical Examiner [or a Magistrate of Justice of the District] shall have the powers to hold an inquest ; but the Corona- of his Deputy may, at any time, enter and take control of such inquest ; and thereupon, such Medical Examiner [Magistrate or Justice] shall be relieved from all other powers or duties therein. If it shall be necessary to have a medical or microscopical analysis or other scientific investigation for the purpose of ascertaining the cause of the death of the person upon whose body he is holding an inquest, the Co- roner shall so report to the State Attorney [Attorney-General] who may order such analysis or investigation to be made, and who shall certify the expense thereof, and shall order it to be paid. Every Coroner shall return to the Clerk of the Court for his comity [Attorney-General], at the end of each month, a full account, signed and sworn to by him, of all the lawful fees, expenses and payments in each view [autopsy] or inquest ; which account, after being audited, shall be paid, if found correct. CORONERS' FEES. For each day of inquest $500 " report of inquest 5«oo MEDICAL EXAMINERS' FEES. For view and inquiry • • $ 4'00 *♦ " " aut<^y 25-00 *' each mile travelled o.jo aid in 96 ;^e Massa- exclusive it fifty in- h inquest of $1000 tiomicide, I pv?! J- violence, r enough, f inquests •ed, with "" ■ ?* ' In Connecticut, the effect has b«en the aame af ia MaaaachtuKCti, the office of Coroner haa been retained. In New Haven, only 35 iaqt annually are necessary, with a population of 83,000. No one in the States mentioned seems to be of opinion that crime ii looked which would have come to light under the Coroner's system. The retention of legal Coroners appears to me to be an ad^watage, •• ensures the investigation being conducted in accordance with the law. U relieves the Medical Examiner of all responsibility apart from the medical side the case. It often happens that while the cause of death is very plain, the ^mil tion of criminal responsibility depends entirely on outside circumstances; bttfc» without a medical examination, it would be impossible, in many cases, to dbd($t the rftspoii'ibllity. Medical evidence, obtained by the medical enquiry of m i^'Tedr .al ivxaminer, is safer than that taken by a non-medical Coroner, who haa ton« ept, without question, all statements of medical fact and opinion made to him by persons who may be interested in deceiving him, or be themselves d t c d vd. NEW HAMPSHIRE. There are no Coroners,— the investigation being made by the County S^- citor, who calls in any physician he may think fit, to aid hhn. The system i» stated to be unsatisfactory, as there are no skilled medical examiners trained under it. NEW JERSEY. There is a medical examiner, called the County Physician, who investigates all suspicious deaths, and makes autopsies when he consider;) it necessary. Ini Newark, with a population of 350,cxx), over 800 deaths are investigated annually|| at a cost of $3,500 salary, besides expenses. » In appropriate cases a Jury is called by a Coroner, and the case is tiius in- vestigated, or andnquest may be conducted by the District Attorney. Abottt 35 cases afe annually investigated by inquest. This system appears to throw too much responsibility for non-medical mAttexs upon the Physician. It is, however, thought very highly of by the judges andj lawyers, and seems to work well. NEW YORK. There are four Coroners, each of whom has one Medical Deputy, known aai Coroner's Physician. The medical deputies make all autopsies, and examinat.. of the body, and report the result, in each case, to the Coroner, afto: signii^ ft| death certificate when the medical examination is completed. The deputy has 32 t 'authority to make autopsies, when necessary, and these are held in about 25% of all the cases. Inquests are held in public, before a Jury, when the death is due to other than natural causes. All cases must be investigated by the Coroner or Deputy which have not been attended for 24 hours previous to death by a physi- cian, or when the cause of death is not known. Coroners are paid $5,000 per year each, and deputies $3,500. The total number of deaths investigated annually is 5,600, and the cost, is $55,000 in all, making about $10 for each case, or less than one-half what is paid in Montreal. This system appears to be good in prin- ciple. A good deal of dissatisfaction is expressed at the delay in holding inquests when death is accidental, in order to bring about incriminating verdicts, upon the strength of which claims for damages may be based. This seems due to the fact that officials are over-worked, and the labours not equally divided, there being too many Coroners and too few Deputies. PENNSYLVANIA. In Philadelphia there is one salaried Coroner, with four salaried Deputies and two salaried physicians to make autopsies. The deputies are detectives and have power to take sworn depositions, which may be admitted as evidence, if approved of by the jury. No medical fees are paid. The grounds of investigation are the riii iiiiM ■tJ.r.i OMSJa 23 WASHINGTON, D. C, There is a salaried Medical Coroner, with a salaried medical Deputy, to pet* form autopsies. All deaths not due to known causes are investigated. Juries are summoned in all cases of unnatural death, except accidents and suicides. OHIO. In Cincinnati there is a salaried ($3,500) Medical Coroner, who investigates 700 cases annually, and holds inquests in public when death is not due to natural causes. A fee of $20 is paid when a complete autopsy is necessary, or $10 for a partial autopsy. An attempt is being made to secure a salaried medical officer, to make the autopsies. KENTUCKY. In lyouisville there is a Medical Coroner, who performs his own autopsies. Juries are summoned when death is shown to be due to violence. The disadvan- tage of this system is that all medical and legal responsibility rests with one man. MISSOURI. In St. Louis there is a salaried Medical Coroner with a Coroner's Physician | to perform autopsies, the fee for which is $10. Juries are only called in cases ot-% homicide, but all inquests are held publicly. ILLINOIS. In Chicago there is a salaried Coroner with a salaried Coroner's Physician to'^ make medical inquiries and perform autopsies. Inquests are held before a jury of six, when death is not due to natural causes. Deputy Coroners are appointed, who may hold inquests. ONTARIO. In Toronto there are 28 Medical Coroners appointed by the Province, and paid by fees, from the county treasury. Inquests are held only when there is strong suspicion the death is due to violence, the Statute being the same as that subsequently adopted in Quebec. The grounds for holding an inquest must sa- tisfy the Crown Attorney for the district, and inquests are not held in suicide or accident from unavoidable causes, or from negligence of the deceased. I am informed that it is proposed to appoint a Medical Officer, who shall per- form all autopsies. Autopsies are held in almost every inquest, and are ordered by the Coroner, without consulting the jury pbut other medical evidence is only paid for when demanded, in writing, by the jury. About 100 inquests are atinu< ally held in Toronto and the entire county of York. (Population 200,000.) '1 M ix : I*- i.. What is most striking in the Coroner's system throughout the United States lis that (i) special medical officers are provided in larger cities and (2) the salary "system is almost universal in cities of 200,000 and over, both for Coroners and ^niysicians. It is difficult to judge of the merits of the various Coroner Systems, owing to the fact that ward politics regulate all the appointments. Without, in any way, wishing to reflect upon the gentlemen holding positions, it must be admitted that owwe really good medico-legal work is done every year by the handful of men acting as Medical Examiners in Massachusetts, Rhode Island and Connecticut than by the hundreds of Coroners and coroner's physicians throughout the re- maining States. Medical Examiners have, as a class, much higher professional standing than coroners' physicians. The only reason I can assign for this diflFereuce between the two systems is that, unless a life study is made of this special clasr of work, sufficient exper- ience is not obtained ; and, unless occupied personally in making medico- legal studies, and especially autcpsies, scientific interest in the cases is soon lost. I see no reason why the coroner's system should not work well ; but, for some reason or other, it does not appear to do so. I found very few men who had anything better to say of the Coroner system than that " it was a farce : " (those who thcught otherwise beibg, in all cases, themselves Coroners), and many Coroners said that they found their work very imsatisfactory. On the other hand, every one appeared to be enthusiastic about the Medical Examiners' system ; more especially judges and lawyers. Where special medical officers were appointed to Coroners' Courts, no other medical fiees were paid, or expected to be paid. In most cases the written depo- sitions of medical men wore accepted as evidence ; and their presence at inquests was seldom necessary. When opinions were wanted, the experts were usually asked to decide upon the facts given by the medical witnesses. This was found to prevent opinions being given which were not justified by the facts. Some check upon indiscriminate medical opinions, not justified by any facts, is greatly wanted ia Montreal. The old custom, which compels juries to view the bodies, appears to have jnractrkally been done away with in most States. SCOTLAND. In Sci>tland there are no Coroners or Juries, and investigations are all made by the procurator-fiscal [Investigating Attorney] and the Police Surgeon for the district. The proceedings are absolutely secret. The system is cheap and effi- cient ; but some agitation is, at present, being made for public inquests before juries, in cases where deaths appear due to negligence. 25 ted States the salary oners and owing to any way, litted that 111 of men )nnecticut ut the re- 'ofessional iystems is ;nt exper- :dico- legal >st. ; but, for men who I farce : " lers), and On the xaminers' no other tten depo- t inquests re usually Tfas found :s. Some is greatly s to have : all made a for the and effi* sts before FRANCE. All deaths are investigated separately, by two official physicians, whether suspicious or not ; and no certificate is accepted from the physician in charge of the case. In medico-legal cases the investigation is made by a magistrate and a medical expert. There are no juries, except in the regular Court. GERMANY. The system is practically the same as in France, and is conducted by a police magistrate and two medical experts. Detailed official instructions exist, as to how views and autopsies shall be performed, and how reports shall be drawn up. These reports are examined by a special Court of medical exi)erts [super-arbi- trium] in case their accuracy is called into question, and it is officially decided whether the conclusions agree with the facts established. The system works well, but involves a great deal of labour. No one is allowed to perform medico- legal autopsies, unless he has passed a severe special examination. AUSTRIA. In Vienna, besides medic(/-legal autopsies directed by the Magistrates, in every case of sudden death from unknown causes, an autopsy is performed by an official expert. In this work a fixed salary is paid. Over 800 autopsies in such cases are annually made in Vienna. ENGLISH CORONER'S LAW. In England, Coroners had, formerly, practically unlimited authority for in- vestigating deaths, whether these occurred under suspicious circumstances or not. In Manchester, in 1867, three thousand cases of deaths from natural causes were investigated. The Coroners' Act of 1887, in England, was largely intended to prevent un- necessa,ry inquests, but still compels Coroners to summon Juries wh^ there is reasonable cause to suspect that death was due to (i) violent or unnatural causes, (2) sudden cases, of unknown nature, (3) deaths in prison or (4) under circumstances calling for an inquest in pursuance of any act (intended especially for all cases where the death certificate is unsatisfactory.) This obliges the Coroner to hold an inquest in all cases where death is not known to be natural, and to deaths of all kinds occurring in prisons. No provision is made for medical expert testimony ; the law, in this respect, being retained verbatim from a statute passed iu 1826, whereby the physician in attendance, or any other physician, is called upon to testify and perform autop* sics, if necessary. ':t- .*?! '-'li 26 It may be stated, in this connectioii^ that the leading English medical journal has pronounced the system of having an official medical officer to be " a decided improvement in the matter of Coroners' inquests and evidently a step in advance." (British Medical Journal, October, 1893.) The English system appears to offer no guarantee that the medical work will be well done. The medical fees paid are $10 for an autopsy, and $5 for other evidence. In England autopsies are very frequently performed ; being held^ in from 50 0/0 to 70 0/0 in all inquests in I in I & (A I 1-3 2.0 30 1.2 1.2 i.o 1.6 1-5 0.3 O go V 4> 20 60 80 80 M O ct n V 0^ 55 60 6S 36 •3 a I o u $22.28 15-35 10.00 16.90] 12.80 The cost given for Massachusetts does not include the inquests. The fees for these are [$io] ten dollars in each case, and they are ordered in about 25 0/0 only of all the deaths investigated. As autopsies in Massachusetts cost $40 each, the figures given represent fairly what the whole cost of the Massachusetts sys- tem would be with our fees for autopsies. In I^ondon the cost of each death investigated is really only $12.35, if those cases are taken into account where no inquests are held. ai^^i^, S- 'P^dt-4S' t***" TABLE SHOWING ANNUAL NUMBER OF HOMICIDES TO 10,000 POPULATION. Locality. Population. Annual number of Homicides. Annual rate of Homicides per 1 0,000 living. Remarks. London. C ■• 1,500,000 1,356,000 2,450,000 550,000 1,200,000 250,000 300,000 1,600,000 480,000 200,000 550,000 1,500,000 300,000 480,000 500,000 190,000 75,000 23 26 47 12 27 6 56 21 10 28 98 30 45 69 . 30 15 0M| 9'i8 b'i9 0'22 0*24 0*24 o'33 o*35 0-43 0-50 0-51 0-65 066 ?5 1-58 2'0O Vionna •• Parii. Liveroool Philaaelohia Montreal City and Suburbs. Buffalo New York Boston Toronto Pittabunr Not including homicides ChicafifO at the Homestead strike. Cleveland Birminffham 1 ■St. Louis iS^uifviUe pharleston These include murder, manslaughter and infanticide, and represent the find- ings of inquests, not of trials. %l TABLE SHOWING THE RELATIVE PROPORTION OF DEATHS FROM' OirrRRBMT CAV9IS 111 EVERY lOO CASES INVESTIGATED. ' *' Locality. Montreal Toronto. Kinffston London, C .... Liverpool Birmingham ... Parii. Vienna Boston State of Mass... New York Buffalo Newark Milwaukee Cleveland Cincinnati Phdadelpbia .. Pittsburg Chicago ~ Charleston Sute. Quebec Ontario u England France Austria Mass. M N.Y. M N.I. Wis. Ohio. Pa. Pa. lU. S.C. Homicide. 2"0 lO'O 6-6 07 07 3*9 51 4-6 3"26 I'D 1-6 1*2 ri S'o 0-8 17 4*2 6-2 Suiade. 60 13*4 S'5 £1 253 23*0 i8'i io'i6 12'0 3-0 6-6 12*3 4'3 Accident 38-0 40*0 20*0 48*0 19*0 41-3 4706 37*0 45-5 25*0 67-6 365 13'5 Natural Causes. 43'o 40*0 72*3 57 54-0 366 37'94 68-0 37-5 71-8 SCO 47-0 77-0 Unknown Cinscs. 13*0 'U ' 1*58 04 41 u RemariuL ' " I . ! ' • ' * % • i' h'' "t^M .'1 Morgue.. 'I • •■ ■ ■■ ■•>»[• c ■ ,: f •,'{ Note.— Where the number of deaths from unknown causes is ndt speoW !it i«ju||(ifl|i^||4 ^d with the natnal causes. I'u "W^ t ' -Ml.-, V 'I J ' ''I', ii'y; " TABLE SHOWING THE RELATIVE PRELIMINARY INQUIRIES, INQUESTS AND AUTOPSIES TO POPULATION. IpOCAUTT. Statb. atreal uo ^Itmiltoo Kingston Kaiau .St John ;V{ctorm London London, W . LoadooK^.... London, S.W Liverpool .••■ BinninghamJ Paris iyienna ■ton. idence-.. Mow Haven . New York ... Brooklyn .... Bui&do Newark Philadelphia: .Ciqcinnati ... 'CWl^tnd..... Wilmington;. Baltimore . ... Washington;. Louisville . . Charleston . StlLouis .... Chtcagol.... St Paul ... Milwaukee i?. Que. P. Ont N.S. N.B. B.C. England. « France. Austria. Mass. R.i. Conn. N.Y. 4( PoratATIOM. N.J. Pa. "I Ohio. Del. Md. D.C. Ky. SC.3 Mo.1 111. Minn. , I Wis.| DMlht tnvMCilaMd ;jp«rT««r.. Tout p«r inoo pop. 300,000 200,000 50,000 20,000 40,000 40,000 25,000 4,232,000 1,250,000 1,500,000 480,000 550,000 480,000 2,450,000 1,356,000 480,000 132,000 82,000 1,600,000 900,000 300,000 350,000 1,200,000 550,000 500,000 300,000 100,000 500,000 240,000 190,000 75,000 500,000 1,500,000 160,000 245,000 X 400 or I'i 100 " 20 20 ? 40 30 x8,569 600 2,300 730 1,660 1,140 911 xi,4g6 600 X 150 X 80 X 5,600 1,800 600 810 3,300 1,100 750 400 130 550 c 600 t 369 300 1,200 " 2,300 ;; 200 " 3,792 " 05 0.4 10 Aaaual inquMit. Totkl par looo pop. 300 or ro 60 " 20 " 10 " Vo 1*2 2.0 05 '•5 17 30 3.4 0-37 VI V2 II 10 30 20 20 2'3 27 2'0 1-5 I '3 1*3 1*3 2*5 1-9 40 2-4 1-25 1-5 10 12 30 6,848 610 1.743 464 800 421 X278 1,006 150 24 35 2,400 1,800 60 X 35 2,500 900 520 300 X 100 X200 X200 150 60 69 ,757 20 Anniwl •nl«pilM orderwi, and perc«nt«(< .M p< toll oquMtt. eantai* or •UtoptiM to daathi invanti- x6o 0/0 X20 226 03 04 05 0*25 03 1*2 1-6 05 1*2 09 1*5 09 O'll 078 0.35 0*17 0-4 14 20 0'2 0"I 2.0 r8 ro4 i.o ro 0*4 I '2 1*26 0-9 013 1-15 0'12 0-8 l< 60 12 I 10 10 22 22 400 1,200 300 ? 300 294 1,066 120 X32 ? xi,5oo X900 5° 120 440 150 25 50 X20 80 c 100 c 36 80 250 260 3 12 It 14 U »< tl IC « t( tl (t t( I* l( « t< T3ftf^ !^f^p^ ^.m m p 9 ^H^^WP*H ^fp ^ wjim fliw^J • '■--^m^^ ^7 "*?■? , ^ 'IS * -V - V ' ^ ^^ - -'■i^- i i 1 ■• ''; •i ■ '7' ■":" '-■ ■ l. ■■■ . <:;-,t r-/ ' \' . _ ' ■-' ■ ■ ■P m * ' ) '- ■" , /. f- -, ««^5 iV: m A-;-- {.r::^jr^!MM^ ■•»«;'4W»*