The steep increase in the number of deaths occurring outside hospital during the Covid-19 pandemic brings a concomitant rise in the number of deaths requiring verification in the community.

Attending those who have died in the community clearly puts health care workers at increased risk of Covid-19 infection themselves.  In response the NHS has put out guidance suggesting that GPs or another suitably qualified health care professional might now verify death remotely by video, or even by telephone, if family members are happy to support that verification process by, for example, reporting down the phone the absence of movement of the chest wall.

Unsurprisingly that guidance (also now promulgated by other organisations)[1]  has resulted in many calls to coroners and the ambulance service (particularly in London) from GPs and funeral directors who want clarification about the rules or advice about how to pronounce life extinct.

In response, London’s Senior Coroners, who have reservations about the NHS Guidance, have today produced a four-page document setting out their agreed view of the death verification requirements, for the benefit of affected people in the London Area. They acknowledge that different approaches are being taken elsewhere.[2]

The Chief Coroner’s Guidance on COVID-19

The Chief Coroner’s Guidance on COVID-19 (No.34) was issued on 26 March 2020 and reinforced on 27 March 2020 with further guidance (No.35). It is helpful to be read in conjunction with the Chief Coroner’s COVID-19 Note #3. It is intended to be the main piece of guidance for all coroners.

The message overall is that coroners have discretion and judgement to exercise in various respects, which they can be expected to exercise in a pragmatic way taking account of the effects of the pandemic.

However, it also makes clear that a Coroner’s Court should be open for “urgent and essential business only” and further, “absent a coroner a court is not a court”.

The reinforcement of this latter aspect tends to suggest approaches have been made to the Chief Coroner, following his Guidance No.34, questioning the need for a coroner to be physically present in a Coroner’s Court in order to conduct a hearing.

The response is a clear and unequivocal… yes.

The Bishop of St Albans, Dr Alan Smith has introduced a Bill aimed at using the coronial system to record where gambling addiction has contributed to suicide.

If the Coroners (Determination of Suicide) Bill [HL] (HL Bill 32) is passed, then where the inquest’s conclusion is suicide, the coroner or jury will be required to record an opinion “as to any factors which were relevant to the death”[1]

The one factor which the coroner or jury must consider under the proposals is whether the deceased had an addiction to gambling, no other specific factors are identified.[2]

Dr Smith is motivated in bringing forth the Bill having “met far too many families whose lives have been destroyed by the loss of a loved one, often young adults who have their entire lives ahead of them.” Indeed, a quick web search for “gambling” and “suicide” reveals pages of search results detailing a litany of tragic deaths, mostly of young men.

R (Lewis) v Senior Coroner for North West Kent [2020] EWHC 471 (Admin)

A coroner who chooses not to give reasons for a controversial decision may as well hand the aggrieved interested person their acknowledgement of service for the forthcoming judicial review claim along with the record of inquest. Giving reasons is a fundamental aspect of judicial decision making: the person losing an argument in court is entitled to know not only that he has lost but why.

In this case a psychiatrically unwell patient detained in a forensic secure unit had died from malnutrition. The senior coroner refused to leave neglect to a jury without giving any reasons for deciding not to do so. The senior coroner’s decision was flawed on two counts: not only due to an absence of reasons, but, as the Divisional Court found, because it was also not reasonable on the evidence to fail to leave a finding of neglect open to the jury in the “somewhat disconcerting” circumstances of the case.

Namiq v Manchester University NHS Foundation Trust [2020] EWCA

Readers of this blogger’s generation will already know that the answer to the Meaning of Life is 42. The Court of Appeal have now addressed a question too momentous for even Douglas Adams to tackle – what is the meaning of death?[1]

Last month in Manchester University NHS FT v Midrar Namiq (a minor) and others [2020] EWHC 6 (Fam) Lieven J was asked to consider the heart-rending issue of whether ventilation should be withdrawn from a severely brain injured baby (see our related blog here).

The Supreme Court had already confirmed in a number of appeals (including those launched on behalf of both Charlie Gard and Alfie Evans), that the Judge must apply the best interests tests in serious medical treatment cases. However, here the Trust’s position was that the child was in fact already dead and that there can be no best interests assessment of a person who is no longer legally alive. Hence, said the Trust, the Court’s function in Midrar’s case was to assess whether the relevant clinical testing had established that he was brain stem dead. In contrast, in addition to arguing that the brain stem testing had not been properly carried out, Midrar’s parents argued that the Court’s role was to apply the best interests test to the question of whether the intensive care support that was still keeping oxygenated blood circulating his body should be removed.

One difficulty was that, despite clinicians and paramedics regularly declaring life to be extinct, there is no legal definition of death in any statute. Death is clinically and not legally defined. Although the common law position was considered in 1993 when the House of Lords reviewed the position of Tony Bland who had been in PVS for three years after being caught in the Hillsborough crush. Although Tony Bland had no consciousness his brain stem was still functioning, which controlled his heartbeat, breathing and digestion, and as such, said their Lordships, he was not dead. Indeed, the medical consensus that death was to be diagnosed by an absence of brain stem function was expressly endorsed in Bland[2].