December 08, 2017
Area(s) of Interest: Scope of Practice
Today, the California Medical Association (CMA) and the San Joaquin County Medical Society (SJCMS) called on San Joaquin County to immediately separate the Coroner’s Office from the Sheriff’s Office in order to guarantee the autonomy and independence of forensic pathologists and other physicians for the interest of the common good of the people of San Joaquin County.
San Joaquin County’s longtime Chief Medical Examiner, Bennet Omalu, M.D., and forensic pathologist, Susan Parson, M.D., recently resigned over what they describe as a “routine practice” of interference from Sherriff-Coroner Steve Moore. Moore, according to Dr. Omalu, regularly interfered with death investigations and used his political office to protect law enforcement officers in cases of persons who died while in custody or during arrest.
“Physicians have a professional and ethical obligation to place the patient’s interest foremost, even in death,” says CMA President Theodore M. Mazer, M.D. “Allowing non-physicians to influence the practice of medicine in any way, shape or form, puts all patients at risk, and greatly diminishes the quality of care we can provide to our patients.”
From medical staff independence to the corporate bar, CMA and its county medical societies have long stood for and protected physician autonomy and independence because medical decision makers should be insulated from influence by laypersons who may not have patients’ best interests at heart.
"Physician independence is paramount to avoid improper influence on the practice of medicine," said R. Grant Mellor, M.D., SJCMS president. "We urge the proper authorities to conduct a full investigation. What is happening at the San Joaquin County Sheriff-Coroner’s Office is eroding the trust the public, every patient and every family place on the physician to provide the highest standards and quality of care without any perceived or real influence, bias or control of professional judgment.”
The issue of diminished public trust in the autopsy process is not new.
Following another high-profile case in Ventura County, State Senator and physician Richard Pan, M.D., and State Senator Hannah-Beth Jackson jointly authored a bill in 2016 to ensure autopsies are conducted only by licensed physicians and that forensic autopsy reports are accurate and unbiased. The original bill language would have required licensed physicians to review and sign their approval for any post-mortem examination or autopsy conducted by a coroner or deputy coroner. If there was a dispute between the coroner and the reviewing physician, the original language would have required a separate qualified pathologist to make these determinations.
The final legislation (signed by Governor Jerry Brown) was amended, however, to remove language that would have explicitly prevented coroners and law enforcement officials who are not medical professionals from overruling a manner of death finding by a medical examiner or forensic pathologist. The new law, which took effect January 1, 2017, upheld the sheriff-coroner’s authority to decide the manner of death, but added a requirement to do so “in consultation with” the forensic pathologist who performs the autopsy.
“The facts in this latest case demonstrate that the law has to be fixed so that law enforcement officials cannot interfere with the professional judgment of medical examiners and forensic pathologists to further their own agenda,” says CMA General Counsel and Senior Vice President Francisco Silva.
Additionally, Dr. Omalu and Dr. Parson have said once the autonomy and independence of the San Joaquin County Coroner’s Office can be guaranteed, they will both consider withdrawing their resignations and returning to their jobs.
# # #
The California Medical Association (CMA) represents the state’s physicians with more than 43,000 members in all modes of practice and specialties. CMA is dedicated to the health of all patients in California. For more information, please visit cmadocs.org, and follow CMA on Facebook, Twitter, LinkedIn and Instagram.