In most cases, a GP or hospital doctor can certify the medical cause of death and the death can then be registered by the Registrar of Births and Deaths. However, in certain circumstances, deaths must be reported to the coroner, for example when a death is sudden and of unknown cause, due to injury, soon after an operation or when a doctor does not know the cause of death.

Coroners are independent judicial officers in England and Wales (procurator fiscal in Scotland). They are usually lawyers and may be doctors,and are appointed by the local authority.They inquire into deaths reported to them and seek to establish the medical cause of death.

Coroners' Officers, who are usually police officers, work under the direction of the coroner and liaise with bereaved families, police, doctors and funeral directors.

The coroner may order a post mortem examination to be carried out, and while the consent of the next-of-kin is not required for a coroner's post mortem, the family may have a representative of their choice attend the post mortem. If a post mortem reveals that the death was due to natural causes, the coroner will release the body. The death can then be registered and the funeral can take place.

If the cause of death remains in doubt following a post mortem, an inquest will be held. An inquest is an inquiry into who has died and how, when and where the death occurred. It does not consider who is to blame for a death. Inquests are open to the public and journalists are usually present. In circumstances where there is to be an inquest, the coroner will usually issue a burial order or cremation certificate after the post mortem is completed to allow the funeral to take place. When the inquest is completed, the coroner will inform the registrar. A death certificate can then be obtained.

In cases referred to the coroner, if families are contemplating organ donation, the coroner must be informed and give his/her agreement before organs can be removed.

Coroner reform

The Ministry of Justice is responsible for the law and policy governing coroners. The Government is committed to strengthening and improving the coroner service. A programme of reform was established in 2003, and proposals presented in a position paper in March 2004. Further plans were announced in February 2006 and a draft Coroners Bill was published in June 2006.

The Draft Bill [1]aims to modernise the coroner service by providing a better service for bereaved people. It seeks to do this by creating a good national framework and leadership, while ensuring the service remains firmly grounded locally, and by making sure that investigations and inquests are more effective. The bill will be introduced as soon as parliamentary time allows