Introduction

In the majority of cases, a patient's death is from natural causes, and is expected. In these circumstances and where you attended the deceased during their illness, you will need to give the family a death notification form, which includes the medical certificate of the cause of death and which sets out the medical cause of death to the best of your knowledge and belief¹.

In order to complete the death notification form, you must have attended the deceased in their last illness.
If you were the patient's GP or hospital doctor and you saw them within 28 days of their death, and you are confident that you say what the cause of death was, this will be a straightforward process.
If you cannot say what the cause of death was, or if you did not see the patient in the four weeks before their death, you will need to notify the coroner².

The cause of death particulars must be accurately completed, as they feed in to national statistics and can be used in healthcare planning.

The coroner

Coroners are independent officials with legal responsibility for the investigation of sudden and unexplained deaths. They have an important role in determining the cause of death, and enquiring into the circumstances of a death, when it:

was violent or unnatural
was sudden and unexpected
occurred in certain, prescribed circumstances (such as in prison or state detention)³.

When a death is notified to the coroner they will make further enquiries and it is usual for the Garda Siochana to be involved - not necessarily because the death is suspicious, but because they are acting as coroner's officers.

Coroners' enquiries may sometimes result in the cause of death being ascertained, and a post- mortem often is carried out to provide more information. Where the cause of death is natural and an inquest is not required by law, the coroner can issue a certificate to allow the relatives to register the death.

Sometimes the cause of death is natural, but sudden, and the death is notified to the coroner (by the Gardaí, for example). Their inquiries may reveal that the deceased was seen in the 28 days before death by a doctor and that the death, although sudden, was natural. The coroner may then allow the attending doctor to complete a death notification form.

What deaths must I notify to the coroner?

Doctors are in a category of individuals obliged by law to report a death to the coroner⁴ (where they attended the deceased in their last illness, or were present at the death). The list of those deaths that must be reported to the coroner is a long one⁵. The list is probably too long to commit to memory and it may be useful to have it to hand in your surgery or office.

The broad areas are deaths associated with the following:

violence (assaults, etc)
possible suicide
neglect, including when the patient had been dead for a considerable time
accidents
drug reactions or overdoses
occupational or industrial disease
maternal deaths and certain stillbirths and neonatal deaths
certain hospital deaths; patients brought to hospital dead, deaths within 24 hours of admission and those following transfer from a nursing home.

It's also important to be aware of other situations in clinical practice that could mean you have a statutory duty to notify the coroner. One is where the patient may have died as a result of the treatment given them (eg, sepsis following surgery). Another is where "an allegation is made or a concern has been expressed regarding the medical treatment provided to the deceased person"⁶ or where the death may be the result of "an unconventional medical procedure or treatment"⁷.

Reporting a death to the coroner

Practically speaking, you will probably find this easiest to do by telephone as it allows for useful dialogue between the coroner (or their officers) and you.

Contact details for the coroners in Ireland can be found on the coroner service website.

¹ Civil Registration Act 2004, section 42

² Coroners Act 1962 - 2019, section 16A

³ Coroners Act 1962 (as amended), section 17

⁴ Coroners Act 1962 - 2019, section 16B

⁵ Coroners Act 1962 - 2019, Second Schedule

⁶ Coroners Act 1962 - 2019, Second Schedule, paragraph 21

⁷ Coroners Act 1962 - 2019, Second Schedule, paragraph 22

Deaths, inquests and the coroner: an introduction for doctors in the Republic of Ireland

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