Academy Fellow and public health advocate Dr. Stephen Smith (1823–1922).

Complaints about the flawed system of city coroners had been circulating in New York City for years. Problems with the system were numerous: there was no requirement that the coroner be a physician; coroners’ juries had no real power; each borough had its own office of the coroner; autopsy reports and inquests could be medically inaccurate; and the position was ripe for corruption in a patronage-driven system. In 1892, public health advocate and Academy Fellow Dr. Stephen Smith had said, “Social order and public safety demand a complete revision of our methods of inquiry into deaths from unknown causes. No Health Authority can exercise its functions properly which does not thoroughly understand the causes of sickness and mortality among the people.”

For years civic-minded members of the Academy’s Public Health, Hospital, and Budget Committee had worked diligently to research the issue and suggest solutions, feeling it was their duty as physicians to propose a new system and to get state legislators behind their efforts. They felt it was their duty as physicians to propose a new system and to get state legislators behind their efforts. Their undertaking dovetailed with city interests when in June 1914 the Academy was asked by the city’s commissioner of accounts to assist with an investigation into the current system and to evaluate proposals for a new office. Members of the committee, under the guidance of chairman Dr. Charles L. Dana, further researched the topic and made their recommendations. On April 14, 1915, the New York State Legislature passed a bill dismantling the coroners’ offices and setting in place detailed protocols for the new Office of Chief Medical Examiner. When the law took effect three years later (the delay was to enable current coroners to fulfill their elected terms), a chief medical officer, who was a physician and pathologist, was appointed by the mayor—and could be removed by the mayor. A transfer of the legal and investigative duties to the district attorney’s office and the police department, respectively, meant that the examiner could focus exclusively on medical issues. Mayor John F. Hylan appointed Academy Fellow Dr. Charles Norris (1867–1935) as the first official chief medical examiner. The new system, which exists today, proved to be efficient, trustworthy, and cost-effective.

Dr. Charles Norris, New York City’s first appointed Chief Medical Examiner.