The ME’s 3 most important determinations: Cause, Manner, and Time of Death
Part I: Cause and Manner of Death Notes
CAUSE/MECHANISM OF DEATH:
Cause of death is why the individual died Heart attack, GSW, traumatic brain injury, diseases
Mechanism-physiological derangement that causes death
One cause—several mechanisms
Example: MI-arrhythmia, cardiogenic shock, rupture
Example: GSW—heart or brain damage, exsanguination. wound infection
One mechanism—several causes
Example: Exsanguination—GSW, ulcer, meds, disease
Just as a cause of death can lead to many different mechanisms of death, any cause of death can have several different manners of death. A gunshot wound to the head can’t be a natural death, but it could be deemed homicidal, suicidal, or accidental.
MANNERS OF DEATH: For what purpose and by whose hand
NATURAL: Natural deaths are due to the workings of Mother Nature in that death results from a natural disease process. Heart attacks, cancers, pneumonia, and strokes are common natural causes of death. This is by far the largest category of death that the ME sees.
ACCIDENTAL: Accidental deaths result from an unplanned and unforeseeable sequence of events. Falls, automobile accidents, and in-home electrocutions are examples of accidental deaths.
SUICIDAL: Suicides are deaths that come by the person’s own hand. Intentional self-inflicted gunshots, drug overdoses, or self-hangings are suicidal deaths.
HOMICIDAL: Homicides are deaths that occur by the hand of another. Note that a homicide is not necessarily a murder. Homicide is a determination of the ME; murder is a legal charge that is determined by the courts. Though each would be ruled a homicide by the ME, the legal jeopardy is much different for a court verdict of negligent homicide as opposed to first- or second-degree murder.
UNDETERMINED OR UNCLASSIFIED: This extra category is used in situations where the coroner can’t accurately determine the appropriate category.
Examples: Car/pedestrian Heroin/Drug OD GSW
Psychological Autopsy
Manner determines whether there is an investigation
Manner not fixed—can change
Proximate cause—cascade of events