Medico-Legal Death Investigation Systems – England & Wales

Suspicious unexpected death is one of the worst events that a family will experience. To allow closure there is the need to identify any underlying medical causes of death. This requires thorough investigation to exclude unnatural causes of death. Death investigations within England and Wales are conducted at local authority level, with the medico-legal systems being a combination of Coroner and Medical Examiner. Post-mortem examinations were carried out on 39% of all deaths reported to the coroner in 2020, with the medico-legal dissection rate for England and Wales being around 13%. Death investigation in England and Wales remained relatively unchanged for decades, but the system has experienced comprehensive revisions allowing a system that is less fragmented with clear supervisory and leadership responsibilities. This paper will outline the death investigation systems, including the legislative framework, key players and their symbiosis.