Carers, at an Inquiry or an Inquest
Since European Court ruling it now appears the Law recognises immediate family carers - next of kin -
as ' victims' with rights.That now means a grieving family are entitled ...
( stated in a commentary in the Journal of Mental Health Law - Northumbria Law Press ; Issue Jul 2003; Case notes exemplified in Edwards v. UkK2002 35 EHRR 19 )
... 'to a full investigation into an untoward death. Any investigation has to be ' independent, public, prompt, thorough, effective , capable of imputing responsibility for the death, and enables effective involvement of the kin' .
The Edwards case concerned a failure of care in remand in prison which led to a homicide, but the same position of authority responsibility applies to Health Authorities and trusts - any public body of care, and the most likely tragedy is suicide, which will come to a public inquiry - the Coroner Inquest.
The European Court has ruled that in the case of Edwards [ a tragedy that was a homicide ] although there had been an External Inquiry, that the Inquiry had not fully addressed the needs of the family for an explanation, nor had it allowed for questioning by concerned relatives
[ after a Court verdict on a homicide there will not be a Coroner's Inquest. ]
It is now accepted in the UK, the same rights to know now - will apply at a Coroner Inquest - the relatives should have had access to all the information that would give them an explanation sufficent for them to decide whether they wanted to take other proceedings.
The public Authorities must act, once the matter has come to their attention. They should not wait for a complaint.The form of investigation must ensure their accountability.
" Where the deceased was a vulnerable person who lost their lives due to a series of failures by public bodies and servants who carried responsibility to safeguard the welfare,
the public interest attaching to the issues arising was such as to call for the widest possible exposure.
There must be a sufficient element of public scrutiny. There should be some independence from those involved. "
If a Coroner's Inquest does not meet these requirements the relatives are entitled to a full inquiry elsewhere, governed by the same need to satisfy.
Family carers are going to be involved when a family member dies in unexplained circumstances in a situation where someone else was looking after them, and especially if a tragedy occurs in hospital, and maybe especially when a psychiatric patient may have been admitted, partly with a risk of self injury to be prevented. Relatives will likely be carers, and they will be grief stricken, with mixed feelings of anger and self doubt.
They may well want support from people with experience - such as the local carer support worker, or a local carer representative.
When a carer support service is available it will be known, and it should then be an obligation on the Trust involved to let the carer know that they are entitled to ask for and can get support.
They should be informed pro-actively of this by the Health Unit in which the tragedy has occured, and the management of the Trust should put in place a protocol that makes this happen.
They are entitled to be able to find out information which will satisfy their concerns.
[ Article 1. + Article 2. , Article 2(1) + Article 13.set out in the Convention on Human Rights as reviewed in English Law [ jordan v.UK 2001 11 B.H.R.C 1 - and now Paul & Audrey Edwards v.UK - March 14, 2002 35 EHRR 19 before the European Court of Human Rights ]
The effect of Article 13. says there must be an effective action available to a victim or family to find out any liability for acts of commission or omission - to argue a complaint, and ask for redress, even when the act has come about by an official in their office.
If there was breach of
Article 2 .... right to life
or
Article 3 .... right to be free from torture, inhuman and degrading treatment or punishment
then
compensation for non-pecuniary ( other than lossof earnings, say ) should be available a part of a conclusion about redress.
The son in the Edwards family, suffering from schizophrenia, before the Court for some minor offence, had been placed in a cell with another cellmate who also suffered from schizophrenia, and he was killed there.
In the Edwards case there had been many inquiring reviews, but no Inquest, because the cause of death was known to the eventual Court and decided by the Court that found a verdict on the perpetrator.
None gave the family a full opportunity to get at the facts so as to be able to decide what they might do next.
The obligation to provide an account which satisfies that, now clearly lies in any public body where there is a tragedy, and there is likely to be an extension which will say this applies to all serious and untoward incidents which leave 'victims'.
Where the death or serious matter is about a detained patient then the Mental Health Act Commission
should have been informed and they might - should - have obtained a full account. They are likely to help next of kin. They are split up into area visitors but have a central point of access address at Nottingham.
Mental Health Act Commission
Maid Marian House
56 HoundsGate
Nottingham NG1 6BG
tel 0115943 7100
fax 0115 943 7101
They would need your permission to intervene with a local Health Trust on your behalf. As with complaints that the local NHS people have not resolved to your satisfaction.
The most common public examination is at a Coroner's Inquest.
Coroner's may not appreciate the extent to which families are entitled under the recent Convention Law.An Inquest has to have preparation.
That should include a timely and full notification to the next relative, usually by the Coroner's officer who is often someone experienced in the police force.
But it should go further than that; whoever does this notification should ensure that all the family that might be concerned is actually informed. They are entitled to attend and may have questions to ask or to have them asked on their behalf.
The Coroner nay well have already asked that an autopsy be done. The relatives should be informed about that ahead of it happening. It may well be that the relatives have a particular point they want the autopsy to address.
They may want to ask medical witnesses if they were the person in charge of the clinical conduct, whether there was any record of risk, and what measures were taken, and if they were appropriate to any consideration of risk that had been raised.
Was the environment adequately staffed and safe? Was the right treatment in progress? Might there have been side-effects of any treatment, and would these have been noticed.
Most hospitals now have a mechanism for examining the circumstances of a serious incident as soon as possible, largely because there may be immediate alterations to be made in procedures.
The above Court ruling followed a homicide, but the principles can be extended to other serious incidents which carry public concern. Then the public will want an explanation on terms similar to that outlined by the Eurpean Court.
Such serious incidents are usually addressed at a prompt weekly meeting which will gather in experience, and take on any immediate lessons.
Such a meeting may discover matters which could be relevant in a Coroner's Inquest, and they might be matters which the relatives will want addressed and explanations made available.
When relatives are not able to obtain a satisfactory explanation which closes off their worries, they may be affected themselves in adverse ways.
They have the right to be fully informed.
It seems likely in law that next of kin after untoward deaths, inherit by that an entitlement of being next of kin, to examine or have examined the clinical notes, as would the patient whose clinical notes they were all about.
If getting at the clinical notes is difficult and delayed, then a Law Court ( The Court Service ) can be approached and its Office will provide an Application Notice ( N244 for an Order to release documents ) - a little difficult to fill in, and returning the completed Notice to the Law Office will cost 60£ for it to proceed with the authority of the Court - after a Court hearing. You can get as many copies as you want - copies to be served upon the defendant - the Trust who has the clinical notes - to anyone you think may have them.
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E-mail reaction is welcome
mica2@tiscali.co.uk