New coroner's system will require two people to verify cause of death
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《英国医生杂志》
BMJ
The biggest overhaul of the coroner's system in England and Wales for 200 years was announced by the government last week, as well as new, more rigorous procedures for certifying deaths.
The new, two stage death certificate process is designed to close the loopholes that allowed the GP Harold Shipman to conceal his murder of more than 200 patients. Reforms to the coroner system will result in a change in the number of coroners from 127 full and part timers to between 40 and 60 full timers, all legally qualified. Each coroner's area will have a medical examiner, who will play a key role in verifying the cause of deaths.
Under the new system a death will be verified by a doctor, paramedic, or senior nurse, who will then complete a verification form. The doctor who had treated the dead person in the immediate past will then issue a certificate of the medical cause of death. After that the medical examiner will seek relevant factual information from the family and elsewhere to confirm the cause of death and authorise burial or cremation, without having to refer the death to the coroner.
The fact that the certificate will be "subject to close subsequent scrutiny by a medical professional" will help to deter "careless or dishonest" practices, says the Home Office paper outlining the reforms.
Home Office minister Paul Goggins said: "No longer would an individual doctor be able to sign a death certificate which would allow someone to be buried without any further scrutiny within the system." He added: "An effective death certification and investigation system is a vital component of a civil society. It is essential for a modern system of public health monitoring as well as for the detection of suspicious circumstances or medical errors. These proposals are an important step towards restoring public confidence and building a better system of death investigation."
The reforms, which will set up a national coroner's service under a chief coroner who will have a medical adviser, are expected to take around three years to implement. Coroners will be given new powers to seize documents from premises such as doctors' surgeries and hospitals to investigate the circumstances of a death. They will continue to have the power to retain any tissue or organs necessary to establish the cause of death, but new rules will govern how long they can keep the samples.(Clare Dyer, legal corresp)
The biggest overhaul of the coroner's system in England and Wales for 200 years was announced by the government last week, as well as new, more rigorous procedures for certifying deaths.
The new, two stage death certificate process is designed to close the loopholes that allowed the GP Harold Shipman to conceal his murder of more than 200 patients. Reforms to the coroner system will result in a change in the number of coroners from 127 full and part timers to between 40 and 60 full timers, all legally qualified. Each coroner's area will have a medical examiner, who will play a key role in verifying the cause of deaths.
Under the new system a death will be verified by a doctor, paramedic, or senior nurse, who will then complete a verification form. The doctor who had treated the dead person in the immediate past will then issue a certificate of the medical cause of death. After that the medical examiner will seek relevant factual information from the family and elsewhere to confirm the cause of death and authorise burial or cremation, without having to refer the death to the coroner.
The fact that the certificate will be "subject to close subsequent scrutiny by a medical professional" will help to deter "careless or dishonest" practices, says the Home Office paper outlining the reforms.
Home Office minister Paul Goggins said: "No longer would an individual doctor be able to sign a death certificate which would allow someone to be buried without any further scrutiny within the system." He added: "An effective death certification and investigation system is a vital component of a civil society. It is essential for a modern system of public health monitoring as well as for the detection of suspicious circumstances or medical errors. These proposals are an important step towards restoring public confidence and building a better system of death investigation."
The reforms, which will set up a national coroner's service under a chief coroner who will have a medical adviser, are expected to take around three years to implement. Coroners will be given new powers to seize documents from premises such as doctors' surgeries and hospitals to investigate the circumstances of a death. They will continue to have the power to retain any tissue or organs necessary to establish the cause of death, but new rules will govern how long they can keep the samples.(Clare Dyer, legal corresp)