在1348年至1350年间，天主教会的首脑，教皇克莱门特六世，下令对黑死病的受害者进行尸检，试图找到瘟疫的原因——尸检，而不是审讯。美国医学协会的第一部章程（AMA， 1847年）专门用了一整个章节来讨论法医学和医生在死亡调查中的责任。1857年，美国医学协会（AMA）的一个委员会建议彻底废除验尸官办公室，将刑事案件中的医疗和法律职责分开，取消验尸官的调查，并停止对验尸官的政治任命。1860年，马里兰州成为美国第一个要求验尸官必须是医生的州。1877年春，波士顿律师西奥多·H·廷代尔在美国社会科学协会卫生部门发表演讲，呼吁废除波士顿的验尸官。他认为验尸官办公室既陈旧又腐败。在当时关于验尸官的抱怨中（直到今天仍然如此），“验尸官经常以微妙或不那么微妙的方式施加影响，从而决定陪审团审议的结果。”1889年，斯奎尔·斯普里格写了《托马斯·韦克利的生平与时代》。有一章讨论了老式的英国验尸官的审讯，这些审讯通常在“酒馆”（酒馆）举行，其中包括以下描述。
“客店的色调破坏了证据，破坏了陪审员的判断力，有损验尸官的尊严。这一场合的庄严气氛被酒精冲淡了，或者被法官的无能完全破坏了。简而言之，爱德华一世所设计的，在他的王国中最重要的法庭之一……已经普遍沦为一场沉闷的闹剧，……成为众所周知的笑料，死亡的威严随着陪审团的杜松子酒的烟雾而蒸发。”
In 1904 the Elsberg Bill passed the New York state legislature, abolishing the office of coroner and creating an office of medical examiner.
In 1911 a special committee of the Chicago Bureau of Public Efficiency made a comprehensive examination of Chicago’s government offices. The committee recommended that “the coroner ought not be an elected official.”
In 1928 the National Academy of Sciences through the National Research Council’s (NRC’s) Committee on Medical Legal Problems addressed the state of death investigation. Committee members included Roscoe Pound, Dean of Harvard Law School, and John Henry Wigmore, Dean of Northwestern Law School. The NRC released a harshly critical report entitled The Coroner and the Medical Examiner. In its first four recommendations, the 1928 committee suggested the following: (1) that the office of coroner be abolished. It is an anachronistic institution which has conclusively demonstrated its incapacity to perform the functions customarily required of it; (2) that the medical duties of the coroner’s office be vested in the office of medical examiner; (3) that the office of medical examiner be headed by a scientifically trained and competent pathologist, selected and retained under civil service, and compensated by a salary which will attract men of genuine scientific training and ability; and (4) that the office of medical examiner be provided with the services of a staff competent in toxicology, bacteriology and other sciences necessary in the scientific investigation of causes of death.
The committee found that coroner inquests “frequently did not follow the required legal procedures, often used quasi-professional witnesses, and many cases reached unrealistic, politically influenced conclusions.”
In 1947 the City and County of Denver (Colorado) converted from a coroner to a coroner-medical examiner system and coroner inquests stopped. In the 1990’s, following a series of police-involved shootings in Denver, a commission was formed to examine the problem. The Erikson Commission published a report in 1997 making no mention of “coroner inquests,” but reached the conclusion that “The criminal law, by its very nature, can never be as effective a mechanism for shaping police behavior and limiting the use of deadly force in law enforcement as internal policies, administrative regulations, and training programs that reflect the values and priorities of the community.“
In 1954 the National Conference of Commissioners on Uniform State Laws issued the Model Post-Mortem Examinations Act (the Model Act). The Act stated the following: The purpose of the Post-Mortem Examinations Act is to provide a means whereby greater competence can be assured in determining causes of death where criminal liability may be involved. Experience has shown that many elected coroners are not well trained in the field of pathology, and the Act should set up in each state an Office headed by a trained pathologist, this Office to have jurisdiction over post-mortem examinations for criminal purposes. The Office would supersede the authority of Coroner’s Offices in this field.
In 1958, the American Board of Pathology formally identified Forensic Pathology as a subspecialty. The Board began issuing certificates of special competence in Forensic Pathology (i.e. “Board Certified”) to qualified pathologists in 1959.
Between 1960 and 1979, 12 states converted from coroners to medical examiners. Also during that time, Texas Code was change to include: “Subject to the provisions of this Act, the Commissioners Court of any county having a population of more than one million and not having a reputable medical school as defined in Articles 4501 and 4503, Revised Civil Statutes of Texas, shall establish and maintain the office of medical examiner, and the Commissioners Court of any county may establish and provide for the maintenance of the office of medical examiner.”
During the period of 1969 to 1987, the Washington State counties (in chronological order) of King, Whatcom, Pierce, and Snohomish converted under “Home Rule” from coroner to medical examiner.
1999: Spokane County and Clark County convert by popular vote of the people each county from coroner to medical examiner under RCW 36.24.190.
2009: The National Research Council published the report of its Committee on Identifying the Needs of the Forensic Sciences Community titled Strengthening Forensic Science in the United States: A Path Forward. Included in the recommendations is the statement “Congress should authorize and appropriate incentive funds to the National Institute of Forensic Science (NIFS) for allocation to states and jurisdictions to establish medical examiner systems, with the goal of replacing and eventually eliminating existing coroner systems.”
In 2012, the U.S. Department of Justice identified only Clark County Nevada, King County Washington, and the counties of the State of Montana as jurisdictions that routinely held coroner inquests in cases of fatal officer-involved shootings. That represented only 58 of 2,342 death investigation jurisdictions in the U.S. It is of note that King County has a medical examiner system that replaced the coroner in 1969, but the coroner inquest authority was given to the elected County Executive, not to the medical examiner, making the inquests political, not investigatory.
In 2013, Nevada’s Clark County (Las Vegas) Commission voted to do away with the county’s controversial coroner’s inquest process (legal challenges went all the way to the State Supreme Court), introducing a new fact-finding process into fatal officer-involved shootings. The board approved a new “police fatality review process” that streamlined the incident review process, including doing away with a panel of members of the public that had acted as a “jury” during inquests, and moved the hearings out of courtrooms.