Inquest Representation for Doctors
Inquests raise particular difficulties for doctors who have to attend them to explain the care and treatment decisions they made in relation to a patient. Coroners frequently call hospital doctors (general and psychiatric) and General Practitioners (GPs) to attend an Inquest to give evidence about how a patient was cared for, as part of the inquiry into the cause of a patient’s death.
Bereaved families and other interested parties are permitted at an Inquest to question medical doctors they and will often have their own barrister to ask the questions. Relatives on many occasions seek to blame a doctor for causing or contributing to a patient’s death. It is wise therefore for a doctor to attend an inquest with a legal representative, to protect their interests, where there is a risk of such questioning.
Coroners in our experience, while polite and on many occasions helpful to witnesses, are not on the side of any particular witness. They are independent, tasked with the role of establishing the cause of death, and must do so fearlessly in the public interest. It is therefore important to have regard to the coroner’s position, and their responsibilities, as any reassurance given by the coroner or the coroner’s officers may carry little meaning, as the inquest inquiry progresses and the evidence is heard. Clinical witnesses who feel that they have nothing to worry about can suddenly find their past clinical conduct (as it related to the deceased) being scrutinised and challenged. An act or omission that contributes to death more than minimally can lead to an adverse finding against a doctor.
Coroners have a statutory duty (an obligation pursuant to Article 2 of the European Convention on Human Rights) to inquire into the deaths of all patients, whether death occurred in a hospital, other clinical facility, or in the community (even at home), who may have died an unnatural death. A Coroner also has a statutory duty to make recommendations to doctors and healthcare providers on the steps that they might take to reduce the risk of repetition, where an error or accident has occurred.
Article 2 inquires by way of an inquest will also apply to informal mental health patients (see our case law update, below).
Inquest verdicts can include a rider that a doctor caused or contributed to death by way of neglect – a failure to provide basic medical care. Even a finding that a doctor contributed to death in some way (without there being a Neglect rider) can still be damaging to the doctor’s reputation and standing. At the end of an inquest, a coroner may report a doctor to the General Medical Council (GMC) or CQC or other public authority, leading to further and prolonged inquiries.
On occasions a Coroner will be assisted by a jury. Inquest juries must be empanelled where there is a pressing public interest for a patient’s death to be examined by a jury – because of the added independence that a jury brings to the inquiry into matters that may concern employees of the State or the State’s obligation to protect human beings from harm.
In some instances, a coroner may be tasked with looking into the causes of a number of patients’ deaths, and a large number of clinical, lay and expert witnesses may be called to give evidence. Some inquests last for several months, while others may be as short as half a day.
It is recommended that doctors attend an inquest with legal representation where their own acts or omissions (0r those of their employees or colleagues) are being scrutinised, that relate to the care and treatment of a patient. A failure to attend can lead to fines and imprisonment, as well as a referral to the GMC for misonduct.
Under the code of conduct for doctors, Good Medical Practice, a doctor must, pursuant to paragraph 73:
‘…cooperate with formal inquiries and complaints procedures and must offer all relevant information while following the guidance in Confidentiality*.’
*a GMC publication.
Doctors Defence Service provides legal advice and assistance to doctors who are appearing at coronial inquests (with or without a jury) in the UK and some international jurisdictions. Call us on 0800 10 88 739 to discuss any matter concerning an inquest or the unexpected death of a patient.
Recent DDS Articles on Inquest Law: