Or just a non partisan bureaucrat who works for the state not for any particular political faction. Something that exists in any functioning state (which the US qualified as until recently 
)
Who hires the non-partisan bureaucrat? And who hires them? Keep going up the line, and eventually you get to someone elected. And if that someone is sufficiently partisan, they’ll hire partisans.
Yes, this does not seem to be due to JFKjr-isms.
A Civil Servant? That is how the pathologists are hired.
Which link? I cannot find that in any of them.
The coroner said yesterday, in a TV interview, that an unnamed forensic pathologist gave their opinion. This is whisper down the lane. The coroner is not quoted as saying there was an autopsy, much less who did it. Given that the coroner first said it wasn’t measles-related, and then said it did mention measles on the death certificate, and now claims that’s insignificant because of what an unnamed forensic pathologist said, I think too much credit is being given. Why not credit the Pennsylvania Department of Health?
The World Health Organization definition of a measles-related death, which I quoted, does not require an autopsy. If you require an autopsy to determine that a death in presence of active measles was caused by measles, the whole history of measles-related morbidity and mortality research would have to be thrown out. Maybe that’s what Kennedy wants.
Yeah but this is not some unrealistic utopian vision of a perfect society. Appointing public servants like coroners who can do the job of assigning cause of death without bringing partisan politics into it, is a very low bar. If you aren’t some corrupt post colonial dictatorship (or Donald Trump’s America ) you should be able to pull it off
You do not “appoint” you hire. A job announcement is put out. All qualified applicants are interviewed. The top three are picked for a second level of interviews. The Top person is offered, if they demur, then the #2. See, no appointing. A board of civil servants does the interviews..
You literally quoted that in your post. How can that be construed to be a whisper from someone who didn’t do an autopsy?
FWIW:
neonatal splenic rupture/laceration is very very rare; congenital measles is very rare.
Congenital measles commonly impacts the spleen and can cause easy bleeding. Both of which woukd make a spleen more likely to bleed.
A spleen generally holds a significant volume of blood: it is hard to know how big a spleen that bled out was before the bleeding. Confidently concluding on inflammation or enlargement from gross exam seems … motivated.
It seems highly improbable that the two extremely rare events that have a clear causation path of one increasing the risk of the other are just coincidences. Especially since there is no other proffered explanation for why the splenic rupture occurred (severe birth trauma for example, or a bleeding problem unrelated to the measles.)
It seems there was an autopsy performed by a forensic pathologist. The spleen should have been sent for histopathology analysis. If the spleen was affected by measles there should be multinucleated giant cells present there. Or if not, not.
That’s just quibbling over terminology. The point is electing coroners in a multi-party election is a terrible terrible idea.
I mean I disagree with electing judges or sheriffs, but I see the argument that it’s a check on national political power (I fail to see how local political parties are going to make it less partisan and corrupt, but I get the point)
But a electing a coroner FFS?!?! That’s just dumb.
What you quote doesn’t say there was an autopsy. I agree the coroner gives that impression.
A reporter for the Atlantic contacted the parents and an article on the interview is out tonight, using the pseudonyms of John and Anna for the bereaved parents who:
John says he called the coroner, Stephen Diamantoni, and hasn’t heard back. And Diamantoni admitted to the Atlantic reporter he hasn’t called back. I guess being interviewed on TV, and talking to the Atlantic, is more important.
I wonder if the reporter didn’t have the heart to ask the parents if they thought there had been an autopsy.
I don’t think there’s any political will to change this at this time. Theoretically we could pull it off, but I’m not sure the juice is worth the squeeze.
I mean I think it’s safe to say it’s way down the list of things screwing up the American political system right now. But it doesn’t make it any less stupid though.
I don’t know what to tell you. We elect so many officials due to our history and our culture. I can’t really say much in response to you thinking it’s stupid. There’s just nowhere to go from there.
No, not at all. Some politicians appoint cronies. Civil Service hires the best qualified (in theory).
Okay, there we agree.
Maybe a dumb question but … How would they know about the laceration of the spleen if there hadn’t been an autopsy performed?
For me, the ‘elected v. appointed’ question mostly comes down to: is the general public likely to have much of a clue of whether the officeholder is doing a good job?
I don’t believe my county elects a coroner; I think I’d remember having seen that office on the ballot. But we do elect people to offices like Register of Wills and Recorder of Deeds. Between having been treasurer of my HOA for the past several years, plus some long-ago experience as a paralegal, I probably have a much better idea than most of what these officeholders do. But I still have little idea of whether they’re doing their job well, and it would certainly surprise me if many of my fellow citizens have a better idea than I do.
So people should be appointed to these offices rather than elected. Sure, the county executive or the county commissioners could fill those jobs with their political buddies, but OTOH they could take their jobs seriously and learn enough about what these offices entail to hire good people. But when these offices are filled by elections, getting a competent person in the job is a matter of plain dumb chance.
Imaging? Death certificate filled out by a normal doctor at Lancaster General?
But autopsy may well be part of it. Context is that the Republicans in Lancaster County tend to be pretty far right and you cannot take what they say at face value. My guess is that the whole reason they mentioned the spleen – in a way that would mislead the average uninformed TV viewer into thinking it wasn’t measles – but did not mention that the mother had a severe case of measles – was because of the political goal of minimizing the local measles outbreak.
I do think this:
There are a lot of Pennsylvanians who have not gotten the measles vaccine (actually MMR) because they think childhood illnesses are minor. So when people here die of measles, with the death meeting the WHO criteria for a measles-related death, it is the duty of the Pennsylvania Department of Health, working with the governor, to publicize that death. While death is not the only possible serious consequence of getting measles, it is the one that will most impress those on the fence with being vaccinated. As for the fact that MAGA and MAHA types will resist this narrative, of course they will. No Democratic Party messaging, or strategy for timing the announcement, is going to mitigate that.
I’ll offer some context, because either I’m missing it or it’s missing in OP/linked article. Full disclosure, I did not read the linked SD thread, maybe the context is there.
Very generally, because anything above State/County is just going to be different, this is how the cause of anyone’s death is determined. One of three people:
- Doctor (physician)
- Coroner
- Medical Examiner
Most causes of death are determined by a doctor.
Meaning, most never get referred to a Coroner or medical examiners. Doctor certified cause of death is for all natural deaths (ie, got sick n died). Coroner or ME get involved when it’s unnatural, unexpected, etc. (completely healthy got sick n died, suicide, homicide, accidental death, etc). Most referrals to the cororner or ME or done via a rule/reg somewhere versus somebody deciding something. Meaning, making this up, die in hospital within X hours = auto ME referral. Gun death = auto ME referral. You can also request one because you feel like it.
Most referrals are rejected by coroner or ME. Because they are auto-generated and usually not necessary (a doctor can determine it just fine), the coroner would reject the request.
For clarity/not accuracy: All said, in a made up year, if 3million people die in the US, 2million causes of death are certified by the doctor, 1 million get referred to coroner/ME, and 60% rejected / 40% accepted, so 400,000 causes of death, out of 3M, are determined by a coroner/ME. To be clear, I’m making those numbers up to show the proportion of COD between doctor/ME/coroner (ie mostly doctors) and because they are roughly correct, but it is verifiable if I might be way off.
So full circle, I’m not sure how politized it could get. Certainly a case is/does, but not US deaths in general.
f/u to above because I didn’t make the point re: my problem with the linked article***. It’s the first sentence:
In the United States, cause of death is recorded and filed by Medical Examiners and Coroners, locally at the county level.
If this means, cause of death of an individual person is initially determined by ME/Coroner, then no, that’s not right at all. I don’t think the researcher means this, but I could see how it could be interpreted that way, hence my explanation above.
I think it means, after the cause of death is determined by a doctor (or coroner/ME in some cases), the coroner or ME, depending on the county, goes through them all to get them into more systematic reportable information to feed up the chain to the national level. In doing that job, you are usually taking written words on a death certificate ( eg, Acute liver failure), and matching them with an ICD code for national reporting purposes (eg, K72.0). In doing that job, sometimes there’s no perfect ICD code for every situation and judgment needs to be used; or there are many ICD codes depending on the kind of liver failure. It’s best judgment. It’s a messy ad hoc system in the best of circumstances.
The researcher wonders if we should rely on elected officials to do this job? It’s a fair point, but no idea what the data shows re whether bias affects the judgment enough or if it evens out across political parties, etc.
***I couldn’t find the actual research paper, just the article/brief intro of it.
That almost exactly how I got all of my state civil service jobs ( I specify “state” because people have a tendency to assume federal if I don’t and the details aren’t always excactly the same). Differences are that it’s not a board of civil servants that interviews - it’s a panel of managers that interviews. Usually there is only one interview and it’s usually more than three people, as everyone who ties for third on the initial test (and there is always a test of some sort) is interviewed - I was on a panel that interviewed 38 people for a single opening once. Every single document , including the publicly available eligible lists , uses the word “appoint” as a synonym for what you are insisting is “hire”.