Doctors are under an obligation to co-operate with any coronial investigation, including attendance at an inquest if called to give evidence. Rachel Parker, case manager at Medical Protection, looks at the consequences of failing to attend an inquest
The recent case of R v Lawrence [2019] Wimbledon Magistrates Court was notable for being the first case of its kind under the Coroners and Justice Act 2009, as it saw the prosecution of the clinical lead of a residential home for failing to attend an inquest. Lawrence was subject to a fine of £650 and was sentenced to four months’ imprisonment. The case puts the spotlight on the obligations of healthcare professionals to comply with a coroner’s request to provide evidence.
The coroner has the power to call any witness they feel will assist in their investigation. As a witness, you play an important role in helping the coroner establish the circumstances of a death, to enable them to reach a conclusion at the inquest hearing.
Being called to give evidence does not automatically indicate that you are going to be criticised for your involvement. You may simply be called to assist the coroner in establishing the facts leading to the death. Clinically complex cases are more likely to have clinical witnesses give oral evidence, as coroners are generally not medical professionals.
Submitting a detailed and comprehensive statement can often negate witness attendance, if that person has very limited or peripheral involvement. However, if a person is centrally involved in the circumstances leading to death, or their evidence is contentious, the coroner is likely to call that individual to give oral evidence.
Legal framework
A coroner has the power to call a person to give evidence at an inquest under Schedule 5 of the Coroners and Justice Act 2009. It is the same power that compels a person to produce evidence to a coroner if requested and this is usually by way of a written statement, or documents in the custody of a person.
It is an offence to do the following:
- Fail to attend an inquest when summonsed (without a reasonable excuse)
- Give false evidence
- Distort, alter or prevent any evidence or document being provided for the purpose of a coronial investigation
- Intentionally suppress, conceal or destroy any document a person knows or believes to be relevant to such an investigation.
Such offences amount to contempt of court and under Schedule 6 of the Coroners and Justice Act 2009 are punishable by a fine up to £1,000, imprisonment of up to 51 weeks, or both.
Obligations under Good Medical Practice
Paragraph 73 of Good Medical Practice sets out a doctor’s obligations with regards to co-operating with a coroner’s investigation and attending an inquest if they are requested to do so:
You must co-operate with formal inquiries and complaints procedures and must offer all relevant information while following the guidance in Confidentiality.
Consequently, failure to comply with a coroner’s investigation could also result in a referral to the GMC.
Do I have to go?
Yes. Attendance is compulsory. Failure to attend without a ’reasonable excuse’ will leave you open to either (or both) of the sanctions set out above. If you have a genuine unavoidable commitment that would prevent you from attending (for example, a pre-booked holiday abroad), then it is advisable to make contact with the coroner’s office to discuss this. It may be that alternative arrangements could be agreed, such as attendance on a different date, or the submission of a supplementary statement.
Case study
By Alicia Hayes, Medical Protection legal adviser
The possible ramifications for failing to comply with requests or summons of the coroner were highlighted at a recent inquest. The inquest was opened following the suicide of a patient.
In the two weeks before his death Mr A had made two suicide attempts. He sought medical attention after both attempts but was not admitted to hospital for treatment. After the second attempt, he was seen and assessed by a home treatment (mental health) team in the community. The decision following this assessment was to discharge him from the home treatment team service. Mr A was provided with crisis contact details and crisis access, and was encouraged to contact the local primary care psychological therapies service. He did not contact any of the services and a week later made another attempt to take his own life, which was unfortunately successful.
It appears the trigger for Mr A’s deterioration in mood and mental health was a recent diagnosis of an eye problem. Mr A understood (erroneously) that he was at risk of losing his sight as a result of this condition. Though he did have an eye problem, it could be easily corrected with surgery. Shortly before his first suicide attempt, he was seen by an ophthalmologist, Dr B, during which his diagnosis and treatment plan was discussed. Statements obtained as part of the inquest suggested Mr A left this consultation shaking and distressed. The coroner felt Mr A’s ophthalmology history was relevant and so a statement was requested from Dr B. We assisted Dr C, who was a locum consultant psychiatrist. Dr C had assessed Mr A shortly before his death and was consequently an Interested Person at the inquest. As a result, Medical Protection provided legal representation for Dr C, to ensure his interests were protected at the hearing.
Dr B, who was not a Medical Protection member, failed to provide a statement. The coroner then summonsed Dr B to attend the inquest to give live evidence. However, she did not provide a statement and did not attend court in answer of her summons. On the morning of the inquest, the coroner’s officer called Dr B to ascertain why she had not attended court and Dr B apparently put the phone down. As a result of this, the coroner referred Dr B to the GMC. It is not clear whether a prosecution for failure to answer her summons will also follow.
In my experience, a doctor rarely fails to co-operate with a request from the coroner. Nevertheless, this case is a good example of the implications for doctors where they do.
Further support and assistance
If you have been called to give evidence at an inquest but feel that you have an unavoidable commitment, call the Medical Protection advice line on 0800 561 9090 for further advice and guidance.
For more information about inquests, read our factsheet.