Commission raises questions over Northern Ireland's death certificates
http://www.100md.com
《英国医生杂志》
The system for investigating deaths in Northern Ireland抯 hospitals has failures, according to a report by the province抯 Human Rights Commission.
The report, written by Tony McGleenan, professor of law at the University of Ulster and a practising barrister, criticises the absence of an automatic requirement for an investigation into a death in hospital. "The system of death certification can conceal the presence of individual or systemic errors which have contributed to the death," the report says.
A total of 14 462 people died in Northern Ireland in 2003, of whom 7464 died in hospitals, 3042 in nursing homes, and 58 in psychiatric hospitals.
The Human Rights Commission, which is charged with ensuring that human rights are fully protected in law, asked Professor McGleenan to examine hospital deaths in the context of Article 2 of the European Convention on Human Rights. The chief commissioner, Professor Brice Dickson, said the commission has received a number of complaints from people concerning alleged medical negligence in hospitals in Northern Ireland and that the report was one method by which the commission was trying to address people抯 concerns.
According to Professor McGleenan the key question he set out to answer was "whether there is currently in place an effective system of ensuring that life is protected in hospital systems."
In concluding that there is not he criticises the practice whereby a coroner retains wide discretion as to whether a postmortem examination should be carried out when a hospital death is reported to him. He is also critical of coroners combining investigative and judicial roles when holding an inquest.
While recognising the role of clinical audit, postmortem examinations, and investigations by the General Medical Council into hospital deaths, the report states: "In the light of the obvious shortcomings of the current mechanism for investigating healthcare fatalities in Northern Ireland ?there is an obligation upon the state to establish investigative procedures which will address that need."
Among specific recommendations the report calls for an independent review of each death in hospital to be carried out by "an appropriately qualified external scrutineer as soon as is practicable." Where this review concludes that a death may have been the result of negligence a mandatory inquest should take place. Professor McGlennan also recommends an extension of inquest verdicts to include an examination of the circumstances surrounding a death.
Inviting comments on the report, Professor Dickson said the commission would especially welcome views on the practicability of the recommendation that the circumstances of every death in hospital should be subject to an independent review.(Galway Muiris Houston)
The report, written by Tony McGleenan, professor of law at the University of Ulster and a practising barrister, criticises the absence of an automatic requirement for an investigation into a death in hospital. "The system of death certification can conceal the presence of individual or systemic errors which have contributed to the death," the report says.
A total of 14 462 people died in Northern Ireland in 2003, of whom 7464 died in hospitals, 3042 in nursing homes, and 58 in psychiatric hospitals.
The Human Rights Commission, which is charged with ensuring that human rights are fully protected in law, asked Professor McGleenan to examine hospital deaths in the context of Article 2 of the European Convention on Human Rights. The chief commissioner, Professor Brice Dickson, said the commission has received a number of complaints from people concerning alleged medical negligence in hospitals in Northern Ireland and that the report was one method by which the commission was trying to address people抯 concerns.
According to Professor McGleenan the key question he set out to answer was "whether there is currently in place an effective system of ensuring that life is protected in hospital systems."
In concluding that there is not he criticises the practice whereby a coroner retains wide discretion as to whether a postmortem examination should be carried out when a hospital death is reported to him. He is also critical of coroners combining investigative and judicial roles when holding an inquest.
While recognising the role of clinical audit, postmortem examinations, and investigations by the General Medical Council into hospital deaths, the report states: "In the light of the obvious shortcomings of the current mechanism for investigating healthcare fatalities in Northern Ireland ?there is an obligation upon the state to establish investigative procedures which will address that need."
Among specific recommendations the report calls for an independent review of each death in hospital to be carried out by "an appropriately qualified external scrutineer as soon as is practicable." Where this review concludes that a death may have been the result of negligence a mandatory inquest should take place. Professor McGlennan also recommends an extension of inquest verdicts to include an examination of the circumstances surrounding a death.
Inviting comments on the report, Professor Dickson said the commission would especially welcome views on the practicability of the recommendation that the circumstances of every death in hospital should be subject to an independent review.(Galway Muiris Houston)