Death Certification – The new Coroners Bill

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    The Coroners and Justice Bill overhauls the law on the coroners’ service, creating a post of chief coroner for England and Wales to be held by a High Court judge, new national standards for coroners’ investigations and powers to transfer investigations into deaths from one area to another to prevent the backlogs that occurred in the hearing of military inquests arising from deaths in Iraq. It also brings in a new death certification system in the aftermath of the Shipman murders.

    Currently there is no statutory requirement or provision for confirmation or certification of the cause of death although a doctor is usually summoned to confirm that death has occurred.

    A doctor who has attended the deceased during their last illness can issue a Medical Certificate of Cause of Death (MCCD) which is a standard form used throughout England and Wales. The completed MCCD is handed to a relative or other appropriate person (“the informant”) and that person attends the local registry office to register the death.

    The sealed envelope is passed on to the registrar who can then issue a disposal certificate to enable the body to be buried or cremated.

    If the circumstances of death are obviously suspicious the police will mount an investigation and the death will be reported to the coroner. If the death appears natural the deceased’s GP is contacted. If he/she intimates that they are in a position to issue an MCCD the police undertake no further investigations. Local protocol dictates whether the coroner would be notified in these circumstances.

    If the doctor is unwilling to certify cause of death the coroner is informed. The coroner then undertakes his/her own enquiries after which a death registration is authorised (either with or without post-mortem) or an inquest is held. The statutory requirement to report a death to the coroner is imposed only on a registrar although, in practice, doctors who are unable to issue an MCCD report most deaths. Most coroners have legal rather than medical qualifications.

    The purpose of this Bill is to “deliver an improved system of death investigation for families, so that they can be assured that the cause of death of their relative has been properly established and that, where possible, lessons can be learned to prevent future deaths”.

    The main elements of the Bill are as follows:

    • create a new national coroner service, moving towards whole time coroners working to national minimum standards

    • create a new system of secondary certification of deaths that are not referred to the coroner, covering both burials and cremations

    • establish a new group of medical examiners to scrutinise independently the causes of death given by doctors on death certificates

    • introduce new powers of investigation for coroners, including improved procedures for post mortems and inquests

    • establish a new Chief Coroner as head of the coroner service

    • establish new and accessible rights of appeal for bereaved people against coroners’ decisions

    • introduce a Charter for the Bereaved outlining a full range of rights for bereaved people to be informed and consulted about case progress by coroners.

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