Statutory reform of the death certification process in England and Wales

A number of inquiry reports into poor practice and misconduct by health bodies and health professionals have recommended reform of the death certification process in England and Wales (Smith, 2003; Francis, 2013; Gosport Independent Panel, 2018).

The third report of the Shipman Inquiry (Smith, 2003) found that the system of certification of cause of death in England and Wales was open to the concealment of a crime and other wrongdoing by the doctor providing the certificate. It was also open to the risk of a certifying doctor who knows that a death may have been caused by poor practice or misconduct by a professional colleague choosing not to take the matter further.

Such situations could arise because there is no statutory definition of death (Grubb et al, 2010). Generally, the Triad of Bichat (Griffith and Tengnah, 2008) is used to determine whether a person has died: this defines death as ‘the failure of the body as an integrated system associated with the irreversible loss of circulation, respiration and innervation’.