A longstanding character’s death in BBC Radio 4’s ‘The Archers’ gives Freeman Brothers’ Manager, Abi Pattenden, an opportunity to talk about unexpected deaths.
As regular readers of this blog will know, I am a fan of the radio drama The Archers, and a member of several enthusiastic online groups where storylines are discussed. Recently, Jennifer Aldridge, a longstanding character, died supposedly unexpectedly (it later transpired she had been unwell). It was interesting to me that many of my fellow online ‘Archers Appreciators’ didn’t know a lot about what happens when someone dies unexpectedly in England or Wales (rules are different in Scotland), so I thought I would take this opportunity to answer some questions that I have seen in the last few days.
What is an unexpected death?
Someone dies unexpectedly when there is not a doctor who has seen them recently who feels able to give their cause of death on a document called the Medical Certificate for the Cause of Death. This therefore means that someone who is under the care of a doctor for one condition can still die unexpectedly if the doctor feels that condition was not responsible for their death. If a Medical Certificate is completed, that is deemed sufficient to know what the person has died of- which is a legal requirement in the UK. Therefore, if there is no-one to complete one, further investigations need to take place. In England and Wales, this duty falls to Coroners, who are appointed by Local Authorities and have usually been medical or legal professionals. Coroners delegate the initial stages of an enquiry to their Coroner’s Officers, who establish whether the death is really unexpected, order whatever investigatory procedures are needed to determine the cause of death, and liaise with the deceased person’s representatives over the progress of all of this.
All deaths which are not of natural causes – including accidents, suicides, and any case where there is suspicion of foul play – are automatically considered unexpected.
What is different about an unexpected death?
The main difference is in the involvement of the Coroner and his or her Officers. There are also procedural differences. In unexpected deaths, there is no Medical Certificate, which is usually used to register the death, so this has to happen differently. The Coroner’s Officer will advise when the death can be registered and will give the relevant authority the information required in the absence of the Medical Certificate. For cremation funerals, they will also provide permission for the cremation by issuing a document called Form 6 (Certificate of Coroner). This replaces Form 4 (Cremation medical certificate), which is completed by the relevant doctor in expected deaths.
Will the person who has died need a post mortem?
Probably. It may be possible to determine the cause of death using histology (analysis of tissue samples) or haematology (analysis of blood samples). However, most investigations usually result in a post mortem examination being carried out.
Will the funeral be delayed?
Not necessarily. Many Coroner’s Offices conduct investigations and determine the cause of death quickly. However, because a cause of death has to be found, cases which are not straightforward can take longer to proceed. It’s worth noting that there is no requirement to register the death before the funeral where someone has died unexpectedly and the Coroner’s Office has issued the relevant paperwork. Waiting for an appointment to register is one of the key factors that affects when a funeral can take place in expected death cases, so omitting this part of the process may actually mitigate any delays the Coroner’s investigation has caused and the timeframe may end up being similar in either case.
Any death where there is suspicion of foul play is usually subject to delays, because any prospective defendant in criminal proceedings is entitled to request an investigation independent of the initial one. In such cases, the funeral often has to be delayed until it is certain that every interested party has had an opportunity to examine the body of the person who has died and gather evidence.
Can the person who has died still be cremated?
Usually, if that is what is wanted. There may be some circumstances in which the Coroner would only permit the person to be buried, such as if they think there may be a need to re-examine the body in future. These would be very carefully discussed with the person’s representatives, and there would probably be the option to choose to wait until a cremation was permitted if a burial was not suitable.
Do we have to have a post mortem?
There is little you can do to prevent one if it is deemed necessary by the Coroner’s Officer. You could ask for it to be avoided and perhaps suggest medical professionals who might either be prepared to certify the death- mitigating the need for a Coroner’s investigation altogether- or give information which would help the cause of death be determined by other means. However, because there is a need for every person to have a cause of death, if a post mortem is the only way to establish this, then it will go ahead in spite of any objections.
There is a UK company called iGene which offers non-invasive post mortems through producing CT scans of bodies. These can be analysed to establish a cause of death. However, it is for the allocated pathologist to decide whether these results satisfactorily explain the cause of death to an acceptable standard, and not all Coroners will accept them in lieu of more traditional techniques, so it should not be assumed that this procedure is possible.
Will there be an inquest?
This largely depends on what the Coroner’s investigation determines. Unexpected deaths which are attributed to natural causes will not usually require an inquest. However, there are some exceptions to this. For example, someone who dies in custody will automatically require an inquest, no matter what the cause. Some causes of death always require an inquest, such as in cases of mesothelioma or other asbestos-related lung diseases. Anyone whose death is thought to be unnatural (for example, in an accident or as a result of violence) will require an inquest.
Theoretically, a funeral cannot take place before an inquest, but to prevent delays in this taking place, the inquest will be opened and then immediately adjourned. This means the funeral can happen but that investigations can continue if needed. The inquest will be reopened and heard in due course- this can be some time after the event, depending on the complexity of the situation.
If there is an inquest, the death cannot be registered until it has concluded and so the Coroner’s Office will provide an interim death certificate to prove the death has taken place and enable the deceased person’s affairs to be settled in the meantime.