News Professional Discipline 6th Oct 2019

New Notification of Death Regulations: Filling A Lacuna in the Law

On 1st October 2019 the new ‘Notification of Deaths Regulations 2019’ came into force. 

Long anticipated, these guidelines set out a roadmap for when the medical profession will be under a duty to notify a senior coroner of a death. 

A new set of written obligations with the force of law behind them may initially seem a daunting prospect for those that must work within them. However, the Regulations will bring welcome clarity to doctors in a previously uncertain area.

A “LACUNA IN THE LAW”

The lack of statutory or other clear criteria setting out when to report a death created a void of uncertainty for medical practitioners. 

Local guidelines had emerged to fill the void, but these left an uneven and potentially confusing landscape for practitioners, particularly those who worked across different areas as locum doctors.

Doctors were left in a precarious position, and there could be no guarantee of consistency in how deaths were treated. Local coroners were deprived of a clear framework to handle referrals

It was this “lacuna in the law” that was lamented in Report of the Chief Coroner to the Lord Chancellor, Fifth Annual Report: 2017-2018. It is this lacuna that the Regulations seek to fill.

WHEN IS THERE A DUTY TO REPORT A DEATH?

The Regulations set out the circumstances in which the duty to notify the coroner arises.

In a nutshell, the core obligation arises where the death is “unnatural”. Nine specific scenarios are identified, which include deaths from poisoning, neglect and medical treatment. A catchall provision creates a duty where a death is “unnatural” but doesn’t fit within that list.

Deaths which occur in custody, where the cause is unknown and where the deceased can’t be identified all trigger the reporting obligation too.

The full list of circumstances is set out in Regulation 3: a brief but essential read for medical practitioners.

RESIDUAL GREY AREAS

Regulations and guidelines can only go so far. Residual grey areas inevitably remain, and indeed can provide the necessary flexibility to ensure that the regulations are workable.

Determining whether a death is “unnatural” inevitably has an element of subjectivity. Even within the nine point list, determining whether a death was “due to…self-neglect” for example, may be more difficult in practice than on paper.

Doctors and other medical practitioners are likely to find reassurance through becoming thoroughly familiar with the Regulations, erring on the side of caution and even seeking legal advice in more difficult cases.

THE PRACTICALITIES 

Where there is a duty to report, it must be done “as soon as reasonably practicable after the duty arises”. 

Except in “exceptional circumstances”, notifications must be in writing.

The information required ranges from the straightforward – a name, to the onerous – the name of “any consultant medical practitioner who attended the deceased person during the period beginning with the fourteenth day before death and ending with the person’s death”. The full list is set out in Regulation 4.

THE SIGNIFCANCE OF THE CHANGE

The Regulations bring welcome clarity and uniformity. However, they also carry with them greater weight.

Practitioners who fail to notify a death as required could risk a referral to their professional body or disciplinary action by their employer. Intentionally failing to report a death could amount to an offence under coronial law.

However, the Regulations are clearly intended to help rather than hinder. Medical practitioners should familiarise themselves with the brief and important Regulations and should consider seeking legal advice if they find themselves facing difficult decisions.


Grace Forbes


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