Why do we die? More important, who or what killed us?
“Why did they die?” strikes us as a simple, straightforward, question that deserves a simple and straightforward answer. Yet it is question that turns out to be neither simple nor straightforward when asked. Predictably when one asks a question that is complex and nuanced, one should not be surprised when the answer is vague and deceptive.
Because, at its heart, answering the question “why did they die?” is about assigning responsibility. While we are taught as children that responsibility is a virtue, in practice responsibility is something that no adult volunteers to self-assign.
Particularly when responsibility implicates criminality.
In early civilizations, criminality was the only reason to even ask the question. Did a person die “naturally” or “un-naturally?” If the answer was “naturally” then life was easy. Hold a service, inter the body and move on.
It was God’s Will. God was responsible. God was the murderer. That’s OK because God has a license to kill.
If the answer was “un-naturally” then that’s when the trouble began. Un-naturally implied that man, not God, was responsible. And if man was responsible then man needed to be identified and brought to justice.
Johnny Law
English common law allowed for an appointed “shire-reeve” – literally “King of the Shire”. The shire-reeve being responsible for the administration of justice within the shire. And in the case of death in the shire, the administration of justice started with answering the question “Why did they die?”
Who killed them?
The person empowered to answer the question was the shire-reeve. The shire-reeve not only determined if foul play (homicide) was responsible for the death, the shire-reeve was empowered to bring those who committed the foul play to justice and, once brought to justice, to met out the sentence.
The system placed every imaginable role in the hands of the shire-reeve. The shire-reeve was coroner, he was law enforcement, he was the judge, he was the jury.
What could possibly go wrong?
Coming to America
Congress in its infancy saw no reason to fundamentally alter the English process of determining cause of death — and the administration of justice if necessary. The shire-reeve system was, as they say in Silicon Valley, distributed, autonomous and scalable across a vast untamed landscape. And so, with only a little tweaks here and there, the appointed “king of the shire” (“shire-reeve”) became the elected county sheriff.
There’s only one little problem with that. And that problem is that, unlike back in Jolly Olde England, in the United States the sheriffs were elected, not appointed by the King.
Anyone see a problem with that? I mean, isn’t democracy and officials elected a good thing? Didn’t we learn from Monty Python that “Supreme executive power derives from a mandate from the masses, not from some farcical aquatic ceremony?”
I would say that, yes, in general democracy is a good thing. Where it runs into problems is where the elected official — the Sheriff in this case — holds the power to determine the cause of death of all of those vying for a mandate for the masses.
In other words, his political opponents.
It’s not difficult to imagine the situation in which the political opponents of the incumbent sheriff found themselves. To draw a parallel to modern Russia, citizens running for sheriff against the incumbent suddenly found themselves falling out of windows.
Whereupon the incumbent would duly sign the death certificate listing the cause of death as an accident.
Pretty soon everyone knew that running for sheriff could be bad for your health. But the electorate had a solution. And the name of that solution was: Coroner.
It’s not quite Quincy, M.E. though
Counties in the US recognized the untenable power vested by giving the same individual both the power to investigate deaths and the power to prosecute for wrongful (“un-natural”) death and sought to separate those powers. Going forward the power to prosecute wrongful death would remain with the sheriff. However the power to investigate would be vested in a new, elected, position.
The Coroner would have not only the power to investigate deaths and their causes. But he would have the power, if necessary, to arrest the sheriff. Good old checks and balances — an American institution as old as tax evasion.
Note that, being elected, coroners did not need to have any particular medical training. They still don’t. Getting elected is in and of itself sufficient qualification for the post which is, after all, about assigning responsibility.
Not about precise medical diagnosis.
The only thing the coroner needed to do — and this continues to this day — is determine whether or not the individual died of a natural death or if they died at the hand of another human.
Beyond that, nobody really cared.
Take aways
We started this series with the intention of providing you, the reader, the tools necessary to interpret and understand life in a pandemic. Think of it as Duolingo or a Rosetta Stone that you can use to unlock the cryptic communications from our academic, scientific, media and political mouthpieces.
It is not possible to understand why assigning a cause of death is so difficult and so inexact unless you know the history. And if you know the history you know that assignment of cause of death is not about determining which disease killed you but rather who or what is responsible for killing you.
That makes it a political, not a scientific or medical, process.
And once you understand cause of death attribution as an essentially political process, you can easily understand why it is so inexact.
And who benefits politically from its inexactitude.
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