the coroners service of northern ireland
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The Coroners Service of Northern Ireland. Dr Gillian Clarke Medical Advisor. Presiding Judge 3 Coroners 1 Medical Advisor Solicitor 3 Coroners Liaison Officers Support staff. Each year there are approximately 14,500 deaths in Northern Ireland 26\% are referred to the coroner

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the coroners service of northern ireland
The Coroners Service of Northern Ireland
  • Dr Gillian Clarke

Medical Advisor

slide2
Presiding Judge
  • 3 Coroners
  • 1 Medical Advisor
  • Solicitor
  • 3 Coroners Liaison Officers
  • Support staff
slide3
Each year there are approximately 14,500 deaths in Northern Ireland
  • 26% are referred to the coroner
  • 3,600 per year
  • Over 300 each month
  • Approximately 75 per week
the medical certificate of cause of death mccd
The Medical Certificate of Cause of Death (MCCD)
  • Registered medical practitioners have a legal duty to provide without delay a certificate of cause of death if, to the best of their knowledge and belief, that person died of natural causes for which they had treated that person for in the past 28 days
slide5
This is a statutory legal duty on all doctors based on the Births and Deaths Registration (Northern Ireland) Order, 1976, independent of any employment contract
the reporting of deaths to the coroner
The Reporting of Deaths to the Coroner
  • Coroners Act (Northern Ireland) 1959
  • The duty of medical practitioners and others to report a death - Section 7
  • The duty of the police to report a death- Section 8
section 7 of the 1959 act provides
Section 7 of the 1959 Act provides;-
  • “Every medical practitioner , registrar of deaths or funeral director and every occupier of a house or mobile dwelling and every person in charge of any institution or premises in which a deceased person was residing, who has reason to believe that the person died, either directly or indirectly…..
slide8
….as a result of violence or misadventure or by unfair means, or as a result of negligence or misconduct or malpractice on the part of others, or from any cause other than natural illness or disease for which he had been seen and treated by a registered medical practitioner within 28 days prior to his death…..
slide9
….or in such circumstances as may require investigation (including death as the result of the administration of an anaesthetic), shall immediately notify the coroner….of the facts and circumstances of the death”
the 5 categories of reportable deaths
The 5 categories of “reportable” deaths
  • As a result of violence or misadventure or by unfair means
  • As a result of negligence, misconduct or malpractice on the part of others
  • From any cause other than natural illness or disease
slide11
From natural illness or disease for which he had not been seen and treated by a registered medial practitioner within 28 days prior to his death
  • In such circumstances as may require investigation
the coroner s decision
The Coroner’s Decision
  • The coroner must make an assessment each time a death is reported and this calls for complete candour on the part of the clinicians concerned.
  • 1) direct that the doctor should issue a MCCD
slide13
2) allow the death to be processed under the “pro-forma” system

(An extra-statutory scheme developed to facilitate the coroner receiving evidence of the medical practitioners opinion of the cause of death)

the inquest
The Inquest
  • In Northern Ireland, unlike England or Wales the holding of an inquest “for inquiring into the death of a person” is discretionary rather than mandatory
nature and scope of the inquest
Nature and scope of the Inquest
  • 1) to determine the medical cause of death
  • 2) to allay rumours or suspicion
  • 3) to draw attention to the existence of circumstances which, if unremedied might lead to further deaths
slide17
4) to advance medical knowledge
  • 5) to preserve the legal interests of the deceased persons family, heirs or other interested parties
inquisitorial investigation
Inquisitorial Investigation
  • WHO?
  • WHERE?
  • WHEN?
  • WHY?
rule 16
Rule 16

“Neither the coroner nor the jury shall express any opinion on questions of criminal or civil liability or on any matters other than those referred to in the last foregoing rule”

slide20
CSNI open 364 days per year
  • A coroner is on call 24/7/365 days per year (and can be contacted OOH by a reporting doctor e.g to discuss organ donation)
slide21
www.coronersni.gov.uk
  • Best Working Practice Guidelines
slide24
IN HER MAJESTY’S COURT OF APPEAL IN NORTHERN IRELAND

________

BETWEEN:

THE ATTORNEY GENEAL FOR NORTHRN IRELAND

and

SIOBHAN DESMOND

Appellants;

-and-

THE SENIOR CORONER FOR NORTHERN IRELAND

Respondent.

________

Before: Morgan LCJ, Girvan LJ and Coghlin LJ

_______

slide25
Conclusion
  • [36] For the reasons given the appeal is allowed. It has not been necessary for us to address the Convention points and we decline to do so since consideration of these points may in due course be informed by further decisions of the European Court of Human Rights.
  • [37] We consider that there is great force in the submission by the Royal College of Midwives that the Guidance on Stillbirths issued by the DHSSPS should be reviewed and reformulated as a matter of urgency. If there is likely to be any delay in the final formulation of revised guidance practitioners would doubtless benefit from interim guidance.
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