GENERAL-PRACTITIONERS KNOWLEDGE OF WHEN TO REFER DEATHS TO A CORONER

Background. In 1992 about 179 000 deaths were reported to coroners in England and Wales and these represented 32% of the total number of reg istered deaths. Many of these cases were referred to coroners by gener al practitioners who certify the vast majority of deaths which occur o utside hospitals. The safeguards to society which are provided by the coroner system in England and Wales are undermined if doctors fail to recognize those deaths which should be reported for further investigat ion. Aim. A study was undertaken to assess the ability of general prac titioners to recognize deaths which require referral to a coroner. Met hod. A postal questionnaire consisting of 12 fictitious case histories was sent to all 323 general practitioners in Sheffield and the senior staff of the local coroner's office (two coroner's officers and two d eputy coroners). Ten of the case histories contained a clear indicatio n for referral to the coroner. Results. A total of 196 general practit ioners (61%) and all the coroner's office staff returned the questionn aire. General practitioners correctly identified whether or not referr al was indicated, with reasons, in a mean of 8.5 cases (range 4-12). O nly six general practitioners (3%) were correct in all 12 cases. All o f the coroner's staff were correct in all cases. Conclusion. General p ractitioners may be failing to bring certain categories of cases to th e attention of coroners because of misconceptions or ignorance of thei r medico-legal responsibilities. General practitioner education in thi s area, and a closer working relationship between general practitioner s and coroners may improve the situation.