Citation

Studdert DM, Cordner SM. Med. J. Aust. 2010; 192(8): 444-447.

Affiliation

Melbourne Law School and Melbourne School of Population Health, University of Melbourne, Melbourne, VIC, Australia. d.studdert@unimelb.edu.au.

Copyright

(Copyright © 2010, Australian Medical Association, Publisher Australasian Medical Publishing)

DOI

unavailable

PMID

20402607

Abstract

OBJECTIVE: To evaluate the changes in the understanding of the manner and cause of death occurring during the course of coronial investigations. DESIGN: Retrospective analysis of deaths reported to coroners in Australia between 1 July 2000 and 31 December 2007, using the National Coroners Information System. MAIN OUTCOME MEASURES: (i) Manner of death (natural, external, unknown); (ii) intent classification (eg, unintentional injury, suicide, assault) among deaths with external causes; and, (iii) changes in the manner of death and intent classification between the presumption made at case notification and the coroner's final determination. RESULTS: The coronial investigation changed the presumption about manner of death or intent classification in 5.2% (6222/120 452) of cases in which a presumption was made. Among deaths with a change in attribution from natural causes to external causes, unintentional falls (442/1891) and pharmaceutical poisoning (427/1891) each accounted for 23%. Among deaths with attribution changing from external causes to natural causes, the leading medical causes of death were cardiovascular compromise (551/842; 65%) and infection (124/842; 15%). Of deaths understood correctly at notification to be due to external causes, but the wrong external cause, 34% (206/600) were ultimately judged to be unintentional injuries, and 22% (133/600) were judged to be suicides. CONCLUSIONS: Coronial investigations transform basic understanding of cause of death in only a small minority of cases. However, the benefits to families and society of accurate cause-of-death determinations in these difficult cases may be considerable.

Language: en