What is an inquest ?

An inquest is a legal procedure held by a Coroner to investigate deaths that are sudden, appear accidental or suspicious.

The main purpose of the inquest is to find out the identity of the person who has died, when and where they died and ‘how they came to their death’ (ie the medical cause of death).

Will the Coroner decide who is to blame?

The inquest will not try to establish blame for the death. The Coroner’s verdict cannot blame a named individual. However the Coroner can consider whether failures, gross negligence or neglect on the part of an individual, company or organisation contributed to the death. He can note such failings in his summing up or verdict.

The inquest is a public inquiry that can:

• Help you better understand what happened
• Let you hear from and ask questions of those who have investigated the death (e.g. police, Health and Safety Executive or hospital internal enquiry)
• Allay rumours or suspicions about what might have happened.
• Lead to changes in practice or systems to prevent further deaths or injuries
• Advance medical knowledge

What is the inquest procedure?

Stage one – opening the inquest

In most cases the inquest will be opened soon after the death so that the person’s identity can be recorded. This is a very short procedure normally taking a matter of minutes.

The Coroner will consider if a further medical examination (post-mortem) is needed. In some cases the interested party may wish to request that a second post-mortem is carried out. An interim death certificate will then be issued allowing the family to arrange the funeral or cremation.

Stage two - investigation

The Coroner’s office will then oversee the investigation into the death. They may delegate work to outside authorities such as the Police (where a crime is suspected) or the Prisons and Probation Ombudsman Service (where the death occurred whilst in custody). The Coroner’s Court should advise you as to how their investigation is being undertaken.

It is up to the Coroner to decide who will give evidence but you can suggest to the Coroner witnesses who you think may be important. In most cases you and your family will not be asked to give evidence unless you witnessed the incident. However, you should contact the Coroner in advance if you think that someone in your family can give helpful evidence (perhaps because they were with the person when he died or knew about his state of mind).

The medical examination (post mortem) is prepared by a pathologist. The report is likely to be upsetting, as it gives details of the injuries. There will often also be a toxicological report checking samples for blood and alcohol. The pathologist will give an opinion on the injury that directly caused the death, and will give details of contributory causes such as heart disease.

Stage three - Resumed inquest hearing

In cases where a criminal charge of murder, manslaughter, causing death by reckless driving, complicity in another's suicide or infanticide is brought, the full inquest will not take place until after the full criminal process has been completed. Where the Coroner feels the circumstances were fully investigated at the criminal trial, he may decide it is not necessary to resume the inquest.

Where there is a lesser criminal charge that will be tried in the Magistrates Court e.g. death caused by careless driving, the inquest hearing will be before the Criminal Prosecution.

Can I attend an inquest hearing?

Yes – and you may want to bring a friend or family members with you to support you during the hearing.

On arrival the court usher will meet you and your family. You should ask the usher to show you to a private waiting room where you and your family can wait, avoiding the distress of sitting in the same place as other witnesses. Where time permits, the usher will also be happy to show you the courtroom in advance and explain the seating arrangements.

The dress code is formal. The Coroner and witnesses will usually wear suits. You should wear comfortable clothes, but dressing smartly is recommended.

Who else will be there?

In the court room, the Coroner sits at the top table. Opposite are rows of rows of benches. As an interested party you should ask to sit in the front row facing the Coroner. If you have a lawyer representing you at the inquest they will sit in the front row and advise you where to sit so that you are near to them. It is usually possible for the rest of your family to sit in a row immediately behind you.

If there is a jury, they will sit to the side of the courtroom.

What about the press?

The inquest is a public inquiry that is open to the public. Therefore, reporters from the local press may sit in the courtroom to take notes. They usually sit at the side of the courtroom.

You do not have to speak to or cooperate with the press. However it is a chance for you to prepare some words in advance, perhaps having a couple of copies to hand out to ensure your words are accurately reported. You may also wish to provide a photo.

However angry or upset you may be by the evidence, it is usually best to limit your comments to expressing how much you miss the person who died. In particular, where criminal proceedings have not yet taken place, you will need to avoid saying anything that might prevent a fair trial.

What if the death happened in custody or prison?

The inquest has an additional function where the death occurred while the person was under the care of the state or a Government agency – for instance, a death in custody or prison. Article 2 of the European Convention of Human Rights applies, and the Coroner investigates whether the individual’s ‘right to life’ has been breached by the state failing to protect them.

Such cases will almost always have a jury. The inquest must examine in detail the circumstances surrounding the death. It is for the Coroner to then make any appropriate report to prevent similar occurrences happening in the future.