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‘Voicing Loss’ before (or without) an inquest

Dr Imogen Jones, Associate Professor in Law, University of Leeds

The ‘Voicing Loss’ project has demonstrated the importance of how the bereaved are treated at inquest, both in terms of their trauma and their relationship with a legal process. In many, although not all, of these cases, the inquest will have been preceded and informed by a post-mortem examination. It is the ability of the bereaved to ‘voice loss’ at this earlier but also traumatic stage of the death investigation process that I focus on here.

In brief, s14 Coroners and Justice Act 2009 gives the coroner the power to order a post-mortem if they deem this necessary to discharge their duty to investigate. A ‘post-mortem’ can mean many things. Among these are a CT scan, a minimally invasive post-mortem, an external examination only, a full invasive post-mortem, and everything between. The majority of these are what is referred to as ‘coronial’, which is short hand for being carried out by hospital hispathologists who are typically focussed on the narrow question of the cause of death. However in suspicious deaths a more extensive, specialist, forensic autopsy will be conducted.

Clearly, it is important that the bereaved understand what is happening, and why. Like at inquest, they may labour under misconceptions about what the process can achieve and what role they can play in it. As always, there is much more to say than can be reflected in a short blog, so I focus here on two examples acknowledging that this excludes many others.

1. Faith and the autopsy

There is increasingly recognition that delays involved in medico-legal death investigation can be especially disruptive to members of faith communities where prompt burial of an intact body is expected. In the UK, this impacts our significant Jewish and Muslim communities. There has been considerable progress, with many areas now working with local leaders to enable the use of CT scanning to, where appropriate, avoid invasive procedures. These have commonly been paid for by the bereaved; however, not least because of the shortage of autopsy pathologists, routine use of CT (with those requiring further investigation then being the subject of more invasive procedures) is increasingly common, with some coroner areas offering this without charge. This is a direct example of how the bereaved are being given ‘voice’ in the pre-inquest process. Clearly, the impact on their experience, trauma and relationship with that legal process can be shaped by this.

2. Care in the mortuary

In some places there are separate bereavement services but, even where this is the case, Anatomical Pathology Technologists (APTs) often interact directly with the bereaved in order to facilitate viewings and explain what will happen to the deceased whilst in the mortuary. When I spoke to APTs about their role in medico-legal death investigation for my own research, one thing which struck me was the importance of care in their values, attitudes and practices.

Care for the deceased and bereaved often intersect, many bereaved people get to voice both their loss and be heard by APTs and bereavement staff. This might simply be being listened to at a time of distress, but can also be about the bereaved informing processes. For example, APTs will often agree to requests to store a deceased person in a way that reflects their lived needs (a child with a teddy for example). It might be facilitating modified viewings even where bodies are disrupted or decomposed.

In both of these examples, we see empathy and process being used to ensure that the bereaved are not unnecessarily traumatised whilst also maintaining the integrity of the legal process. In each of these examples, any difficulties are caused by resource limitations rather than an inherent conflict in the needs of the bereaved and the coronial process. Resources may be finite, but humanity need not be. I would argue that we should prioritise this because it is the morally right thing to do. This involves relatively minimal cost, but has a huge impact on the experience of the bereaved and the legitimacy of the coronial process as a humane one.

Imogen Jones is an Associate Professor at the University of Leeds and researches the role of deceased bodies as objects of law – whether as sites of crime, as evidence of wrongdoing or in order to meet with the needs of the coronial process. Imogen also writes a blog about her research called Dead Bodies and the Law.