Death certification reform in England

The 11 June announcement from England’s Department of Health and Social Care heralds a new phase, though not a final one, in the long slow saga of death certification reform.1 New local “medical examiners”—different from North American forensic pathology services with the same title—will from April 2019 start checking all death certificates issued by treating doctors for accuracy and compliance with coroner notification obligations.

The reform originates in the 2000 conviction of Harold Shipman, an English family doctor, for murdering 15 patients. The judicial Shipman inquiry found that he had probably murdered 250 patients during his career,2 certifying most deaths as natural. It recommended major reform of death regulation,3 as did a government appointed policy review.4

The Coroners and Justice Act 2009 empowers government to create medical examiners as statutory office holders appointed by English local authorities. In 2016, the health department consulted on impressively thorough details of the statutory scheme prepared with professional and service partners.1 A pilot projects report said, “Death certification is usually done …