Death and the law

Question 1

What is the role of medical examiners?

Answer 1

• contacted by doctor who writes death certificate in all cases
• conducts independent review of patient’s circumstances
• Doctor must raise concerns known about the care
• Doctor and medical examiner discuss wording and decice on the cause of death
• Medial examiner discusses cause of death with the family
• then doctor can write the MCDD (death certificate)

MCCD - medical certificate of cause of death
In GP - doesnt have to speak to medical exmainer? And can go straight to coronor

Question 2

Can you refer to the coroner directly?

Answer 2

No, need to go through medical examiner who discusses the case with you before the case goes to the coroner

Question 3

Indications for referring to the coroner

Answer 3

• died from a recognised complication of a procedure
  
  • *obviously if not recognised complication then doesn’t need to be referred*
• Allegation of medical negligence
• medical intervention that appear to have played a role in causing/ accelerating death
• Any case that has occurred on the background of **trauma **or violence
  
  • eg a fracture in an elderly lady - could have been pushed etc.
• Any element of suspicion/ unusual factors
• Death whilst being detained by the state - MHA, prison, young offenders institution, police cells

Question 4

DO coroner’s need to have a medical background?

Answer 4

no

Question 5

Do most cases involving the coroner go to court?

Answer 5

tend not to go to court “inquest”

Question 6

Do coroners have to investigate if families raise concerns about healthcare?

Answer 6

Nah- only depending on the level of the concern

Question 7

Does post mortem require the consent of the family?

Answer 7

No

Question 8

Who appoints a coroner

Answer 8

Local coucil

Question 9

Would coroner investigate if “uncertain” cause of death, but doctor has proposed a cause

Answer 9

Sometimes wont investigate…

Question 10

What does the human tissue act advocate for?

Answer 10

You need consent for examination, removal, storage and ANY type of use – teaching, research, audit, clinical governance etc

Hierarchy of consent:

Partner/ spouse

Parent/ Child

Sibling

Grandparent/ grandchild

Niece/ Nephew

Step-parent

Half sibling

Friend of longstanding

Question 11

Hospital vs coroner post mortem - which one needs consent?

Answer 11

Hosptal needs consent - either from person before they died or from their next of kin

Coroner does not need consent

Question 12

Part 2 of a death certificate

Answer 12

Significant conditions that may have contributed to 1
(eg. Diabetes)

Question 13

Is Organ donation opt in or out?

Answer 13

Opt out system
(if opted in - means it can procede but doesnt have to procede)

If opted out - as long as competent decision - cannot be overridden

Question 14

Wing may kong has slides need to read before path