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Inquests in England and Wales are held into sudden or unexplained deaths and also into the circumstances of and discovery of a certain class of valuable artefacts known as "
treasure trove A treasure trove is an amount of money or coin, gold, silver, plate, or bullion found hidden underground or in places such as cellars or attics, where the treasure seems old enough for it to be presumed that the true owner is dead and the hei ...
". In
England and Wales England and Wales () is one of the three legal jurisdictions of the United Kingdom. It covers the constituent countries England and Wales and was formed by the Laws in Wales Acts 1535 and 1542. The substantive law of the jurisdiction is En ...
,
inquest An inquest is a judicial inquiry in common law jurisdictions, particularly one held to determine the cause of a person's death. Conducted by a judge, jury, or government official, an inquest may or may not require an autopsy carried out by a c ...
s are the responsibility of a
coroner A coroner is a government or judicial official who is empowered to conduct or order an inquest into the manner or cause of death, and to investigate or confirm the identity of an unknown person who has been found dead within the coroner's jur ...
, who operates under the jurisdiction of the
Coroners and Justice Act 2009 The Coroners and Justice Act 2009 (c. 25) is an Act of the Parliament of the United Kingdom. It changed the law on coroners and criminal justice in England and Wales. Among its provisions are: *preventing criminals from profiting from public ...
. In some circumstances where an inquest cannot view or hear all the evidence, it may be suspended and a public inquiry held with the consent of the
Home Secretary The secretary of state for the Home Department, otherwise known as the home secretary, is a senior minister of the Crown in the Government of the United Kingdom. The home secretary leads the Home Office, and is responsible for all nationa ...
.


Where an inquest is needed

There is a general duty upon every person to report a
death Death is the irreversible cessation of all biological functions that sustain an organism. For organisms with a brain, death can also be defined as the irreversible cessation of functioning of the whole brain, including brainstem, and brain ...
to the coroner if an inquest is likely to be required. However, this duty is largely unenforceable in practice and the duty falls on the responsible
registrar A registrar is an official keeper of records made in a register. The term may refer to: Education * Registrar (education), an official in an academic institution who handles student records * Registrar of the University of Oxford, one of the se ...
. The registrar must report a death where: *The deceased was not attended by a
doctor Doctor or The Doctor may refer to: Personal titles * Doctor (title), the holder of an accredited academic degree * A medical practitioner, including: ** Physician ** Surgeon ** Dentist ** Veterinary physician ** Optometrist *Other roles ** ...
during their last illness *The death occurred within 24 hours of admission to a hospital *The cause of death has not been certified by a doctor who saw the deceased after death or within the 14 days before death *The cause of death is unknown *The registrar believes that the cause of death was unnatural, caused by violence,
neglect In the context of caregiving, neglect is a form of abuse where the perpetrator, who is responsible for caring for someone who is unable to care for themselves, fails to do so. It can be a result of carelessness, indifference, or unwillingness a ...
or
abortion Abortion is the termination of a pregnancy by removal or expulsion of an embryo or fetus. An abortion that occurs without intervention is known as a miscarriage or "spontaneous abortion"; these occur in approximately 30% to 40% of pre ...
outside the exemptions of the Abortion Act 1967, or occurred in suspicious circumstances *Death occurred during
surgery Surgery ''cheirourgikē'' (composed of χείρ, "hand", and ἔργον, "work"), via la, chirurgiae, meaning "hand work". is a medical specialty that uses operative manual and instrumental techniques on a person to investigate or treat a pa ...
of any kind or while under
anaesthetic An anesthetic (American English) or anaesthetic (British English; see spelling differences) is a drug used to induce anesthesia ⁠— ⁠in other words, to result in a temporary loss of sensation or awareness. They may be divided into two ...
both local and general *The cause of death was or was suspected to be an industrial disease *The death relates to public health or the general health or welfare of the public-at-large The coroner must hold an inquest where the death is:''Halsbury'' vol. 9(2) 939 *Violent or unnatural *Sudden and of unknown cause *In prison or police custody *Suspected to be suicide Where the cause of death is unknown, the coroner may order a
post mortem An autopsy (post-mortem examination, obduction, necropsy, or autopsia cadaverum) is a surgical procedure that consists of a thorough examination of a corpse by dissection to determine the cause, mode, and manner of death or to evaluate any d ...
examination in order to determine whether the death was violent. If the death is found to be non-violent, an inquest is unnecessary. In 2004 in England and Wales, there were 514,000 deaths of which 225,500 were referred to the coroner. Of those, 115,800 resulted in post-mortem examinations and there were 28,300 inquests, 570 with a jury. In 2014 the Royal College of Pathologists claimed that up to 10,000 deaths a year recorded as being from natural causes should have been investigated by inquests. They were particularly concerned about people whose death occurred as a result of medical errors. "We believe a medical examiner would have been alerted to what was going on in Mid-Staffordshire long before this long list of avoidable deaths reached the total it did," said Archie Prentice, the pathologists' president.


Juries

A coroner must summon a
jury A jury is a sworn body of people (jurors) convened to hear evidence and render an impartial verdict (a finding of fact on a question) officially submitted to them by a court, or to set a penalty or judgment. Juries developed in England d ...
for an inquest if the death was not a result of natural causes and occurred when the deceased was in state custody (for example in
prison A prison, also known as a jail, gaol (dated, standard English, Australian, and historically in Canada), penitentiary (American English and Canadian English), detention center (or detention centre outside the US), correction center, corre ...
,
police The police are a Law enforcement organization, constituted body of Law enforcement officer, persons empowered by a State (polity), state, with the aim to law enforcement, enforce the law, to ensure the safety, health and possessions of citize ...
custody, or whilst detained under the
Mental Health Act 1983 The Mental Health Act 1983 (c.20) is an Act of the Parliament of the United Kingdom. It covers the reception, care and treatment of mentally disordered people, the management of their property and other related matters, forming part of the men ...
); or if it was the result of an act or omission of a police officer; or if it was a result of a notifiable accident, poisoning or disease. The senior coroner can also call a jury at his or her own discretion. This discretion has been heavily litigated in light of the
Human Rights Act 1998 The Human Rights Act 1998 (c. 42) is an Act of Parliament of the United Kingdom which received royal assent on 9 November 1998, and came into force on 2 October 2000. Its aim was to incorporate into UK law the rights contained in the European Con ...
, which means that juries are required now in a broader range of situations than expressly required by statute.


Scope of inquest

The purpose of the inquest is to answer four questions:''R v. HM Coroner for North Humberside and Scunthorpe, ex parte Jamieson'' 995QB 1 at 23, CA *Identity of the deceased *Place of death *Time of death *How the deceased came by their death
Evidence Evidence for a proposition is what supports this proposition. It is usually understood as an indication that the supported proposition is true. What role evidence plays and how it is conceived varies from field to field. In epistemology, evidenc ...
must be solely for the purpose of answering these questions and no other evidence is admitted. It is not for the inquest to ascertain "how the deceased died" or "in what broad circumstances", but "how the deceased came by his death", a more limited question. Moreover, it is not the purpose of the inquest to determine, or appear to determine,
criminal In ordinary language, a crime is an unlawful act punishable by a state or other authority. The term ''crime'' does not, in modern criminal law, have any simple and universally accepted definition,Farmer, Lindsay: "Crime, definitions of", in C ...
or
civil liability In law, liable means "responsible or answerable in law; legally obligated". Legal liability concerns both civil law and criminal law and can arise from various areas of law, such as contracts, torts, taxes, or fines given by government agenc ...
, to apportion guilt or attribute blame. For example, where a prisoner
hanged Hanging is the suspension of a person by a noose or ligature around the neck.Oxford English Dictionary, 2nd ed. Hanging as method of execution is unknown, as method of suicide from 1325. The '' Oxford English Dictionary'' states that hanging ...
himself in a cell, he came by his death by hanging and it was not the role of the inquest to enquire into the broader circumstances such as the alleged
neglect In the context of caregiving, neglect is a form of abuse where the perpetrator, who is responsible for caring for someone who is unable to care for themselves, fails to do so. It can be a result of carelessness, indifference, or unwillingness a ...
of the prison authorities that might have contributed to his state of mind or given him the opportunity. However, the inquest should set out as many of the facts as the public interest requires. Under the terms of article 2 of the European Convention of Human Rights, governments are required to "establish a framework of laws, precautions, procedures and means of enforcement which will, to the greatest extent reasonably practicable, protect life". The
European Court of Human Rights The European Court of Human Rights (ECHR or ECtHR), also known as the Strasbourg Court, is an international court of the Council of Europe which interprets the European Convention on Human Rights. The court hears applications alleging that ...
has interpreted this as mandating independent official investigation of any death where
public servant The civil service is a collective term for a sector of government composed mainly of career civil servants hired on professional merit rather than appointed or elected, whose institutional tenure typically survives transitions of political leaders ...
s may be implicated. Since the
Human Rights Act 1998 The Human Rights Act 1998 (c. 42) is an Act of Parliament of the United Kingdom which received royal assent on 9 November 1998, and came into force on 2 October 2000. Its aim was to incorporate into UK law the rights contained in the European Con ...
came into force, in those cases alone, the inquest is now to consider the broader question "by what means and in what circumstances". In disasters, such as the 1987 King's Cross fire, a single inquest may be held into several deaths.


Procedure

Inquests are governed by the Rules. The coroner gives notice to near relatives, those entitled to examine
witness In law, a witness is someone who has knowledge about a matter, whether they have sensed it or are testifying on another witnesses' behalf. In law a witness is someone who, either voluntarily or under compulsion, provides testimonial evidence, e ...
es and those whose conduct is likely to be scrutinised. Inquests are held in public except where there are real issues and substantial of
national security National security, or national defence, is the security and defence of a sovereign state, including its citizens, economy, and institutions, which is regarded as a duty of government. Originally conceived as protection against military att ...
but only the portions which relate to national security will be held behind closed doors. Individuals with an interest in the proceedings, such as relatives of the deceased, individuals appearing as witnesses, and organisations or individuals who may face some responsibility in the death of the individual, may be represented by a legal professional be that a solicitor or barrister at the discretion of the coroner. Witnesses may be compelled to testify subject to the privilege against self-incrimination. If there are matters of national security or matters which relate to sensitive matters then under Schedule 1 of the Coroners and Justice Act 2009 an inquest may be suspended and replaced by a public inquiry under s.2 of the
Inquiries Act 2005 The Inquiries Act 2005 (c 12) is an Act of the Parliament of the United Kingdom. According to the explanatory notes, published by the Department for Constitutional Affairs, the Act "is intended to provide a comprehensive statutory framework for ...
. This can only be ordered by the Home Secretary and must be announced to Parliament with the coroner in charge being informed and the next of kin being informed. The next of kin and coroner can appeal the decision of the Home Secretary.


Verdict or conclusions

The following conclusions (formerly called verdicts) are not mandatory but are strongly recommended:''Halsbury'' vol.9(2) 1030 *Category 1 **
Natural causes In many legal jurisdictions, the manner of death is a determination, typically made by the coroner, medical examiner, police, or similar officials, and recorded as a vital statistic. Within the United States and the United Kingdom, a distin ...
** Industrial diseases **Dependency on
drugs A drug is any chemical substance that causes a change in an organism's physiology or psychology when consumed. Drugs are typically distinguished from food and substances that provide nutritional support. Consumption of drugs can be via inhalati ...
or non-dependent abuse of drugs **Lack of attention at
birth Birth is the act or process of bearing or bringing forth offspring, also referred to in technical contexts as parturition. In mammals, the process is initiated by hormones which cause the muscular walls of the uterus to contract, expelling the f ...
**Lack of care or self-neglect *Category 2 **
Suicide Suicide is the act of intentionally causing one's own death. Mental disorders (including depression, bipolar disorder, schizophrenia, personality disorders, anxiety disorders), physical disorders (such as chronic fatigue syndrome), and ...
**Attempted or self-induced
abortion Abortion is the termination of a pregnancy by removal or expulsion of an embryo or fetus. An abortion that occurs without intervention is known as a miscarriage or "spontaneous abortion"; these occur in approximately 30% to 40% of pre ...
**
Accident An accident is an unintended, normally unwanted event that was not directly caused by humans. The term ''accident'' implies that nobody should be blamed, but the event may have been caused by unrecognized or unaddressed risks. Most researche ...
or misadventure ** Execution of sentence of death ** Lawful killing (formerly "justifiable homicide") **
Open verdict The open verdict is an option open to a coroner's jury at an inquest in the legal system of England and Wales. The verdict means the jury confirms the death is suspicious, but is unable to reach any other verdicts open to them. Mortality studies c ...
(cause of death unknown or unstated) *Category 3 – Unlawful killing **
Murder Murder is the unlawful killing of another human without justification or valid excuse, especially the unlawful killing of another human with malice aforethought. ("The killing of another person without justification or excuse, especially the ...
**
Manslaughter Manslaughter is a common law legal term for homicide considered by law as less culpable than murder. The distinction between murder and manslaughter is sometimes said to have first been made by the ancient Athenian lawmaker Draco in the 7th ce ...
**
Infanticide Infanticide (or infant homicide) is the intentional killing of infants or offspring. Infanticide was a widespread practice throughout human history that was mainly used to dispose of unwanted children, its main purpose is the prevention of resou ...
*Category 4 **
Stillbirth Stillbirth is typically defined as fetal death at or after 20 or 28 weeks of pregnancy, depending on the source. It results in a baby born without signs of life. A stillbirth can result in the feeling of guilt or grief in the mother. The term ...
In 2004, 37% of inquests recorded an outcome of death by accident / misadventure, 21% by natural causes, 13% suicide, 10% open verdicts, and 19% other outcomes. Since 2004 it has been possible for the coroner to record a narrative verdict, recording the circumstances of a death without apportioning blame or liability. Since 2009, other possible verdicts have included "alcohol/drug related death" and " road traffic collision". The civil standard of proof, on the
balance of probabilities In a legal dispute, one party has the burden of proof to show that they are correct, while the other party had no such burden and is presumed to be correct. The burden of proof requires a party to produce evidence to establish the truth of facts ...
, is used for all conclusions. The standard of proof for suicide and unlawful killing changed in 2018 from beyond all reasonable doubt to the balance of probabilities following a case in the courts of appeal.


Modernisation

Owing in particular to the failures to notice the serial
murder Murder is the unlawful killing of another human without justification or valid excuse, especially the unlawful killing of another human with malice aforethought. ("The killing of another person without justification or excuse, especially the ...
committed by Harold Shipman, the
Coroners and Justice Act 2009 The Coroners and Justice Act 2009 (c. 25) is an Act of the Parliament of the United Kingdom. It changed the law on coroners and criminal justice in England and Wales. Among its provisions are: *preventing criminals from profiting from public ...
modernised the system with: *Greater rights of bereaved people to contribute to coroners' investigations; *A new office of chief coroner to lead and supervise practice; *Full-time coroners with new district boundaries; *Broader investigatory powers for coroners; *Improved medical support for coroners' investigation and decision making; *Vesting of treasure jurisdiction in the new office of treasure coroner with national responsibility.


See also

*
Committal procedure In law, a committal procedure is the process by which a defendant is charged with a serious offence under the criminal justice systems of all common law jurisdictions except the United States. The committal procedure, sometimes known as a preli ...
* Fatal accident inquiry, Scotland *
Grand jury A grand jury is a jury—a group of citizens—empowered by law to conduct legal proceedings, investigate potential criminal conduct, and determine whether criminal charges should be brought. A grand jury may subpoena physical evidence or a p ...
*
Immunity from prosecution Legal immunity, or immunity from prosecution, is a legal status wherein an individual or entity cannot be held liable for a violation of the law, in order to facilitate societal aims that outweigh the value of imposing liability in such cases. Su ...
*
Preliminary hearing Within some criminal justice systems, a preliminary hearing, preliminary examination, preliminary inquiry, evidentiary hearing or probable cause hearing is a proceeding, after a criminal complaint has been filed by the prosecutor, to determine w ...


References


External links

*
This act extends to England and Wales only. *


Bibliography

* *   * *   *— (2003b)  , Cm 5854 *— (2004)  , Cm 6159, * * * * {{DEFAULTSORT:Inquest (England And Wales) Civil procedure Death in England Death in Wales Juries in the United Kingdom