Second report of the Departmental Committee appointed to inquire into the law relating to coroners and coroners' inquests, and into the practice in coroners' courts.

  • Great Britain. Committee on Coroners.
Date:
1909
Catalogue details

Licence: Public Domain Mark

Credit: Second report of the Departmental Committee appointed to inquire into the law relating to coroners and coroners' inquests, and into the practice in coroners' courts. Source: Wellcome Collection.

    32/232 (page 2)
    _~ 25 May 1909.] [ Continued. County Council list, I suppose there was no need for my employment at the time. 6210. It was particular to you ?—I have no reason to suppose so. 6211. There were the post-mortems to be per- formed ?—Yes, but the system of using a special pathologist to do these cases had not come so much into vogue then as it has now. That will be perhaps the best explanation. I think a fixed salary would probably meet the question of expense, and would probably lower the expense entailed by the employment of such skilled pathologists. 6212. What is the practice with regard to the dead bodies of persons who are brought into hospital ’—I can only speak from experience in the district in which Tam situated. The practice there is in cases of bodies brought in dead to employ only those pathologists whose names stand upon the list submitted by the London County Council as being prepared to do such work, to make the examinations on such dead bodies. The result is that if a body is brought into a hospital whose pathologist’s name is not on the list, or who has for some reason withdrawn his name from the list, such body is taken away to the public mortuary in the district, and some other pathologist is asked to logist, I feel that that is not right. Anyone holding the office of pathologist at a general hospital is most highly skilled and competent to make such examina- tions. The only point is that, where such a patho- logist is employed, I think he ought to attend the inquest and give evidence. At present, as I daresay you have heard, what happens in ordinary hospital eases is that the pathologist makes the examination and the house physician or the house surgeon goes to the inquest to give evidence; and a young house officer, however skilled in naked eye appearances, and what he sees, may not have sufficient experience to be able to answer some of the more expert questions depending upon these appearances which he may be asked. 6213. The practice of removing the body when it obtains is, I understand, due to the fact that the pathologist of the particular hospital is not on the London County Council listP—I understand that is the reason. 6214. That difficulty would be removed if the London County Council list were amended ?—Yes, that difficulty would, I think, be removed if such pathologists were on the list available for this work. 6215. At your hospital they are P—Yes. 6216. And you think they ought to be ?—I think the pathologists ought to be available as a body. It is their work. 6217. How is it that they are not put on the list in some hospitals ?—I think they were at one time. There were a great many names submitted to the London County Council; but, for reasons which it is difficult to go into at this precise moment, a good deal of -pressure was brought to bear in certain quarters of the medical profession, and they withdrew their names from this list. At our hospital the names of the hospital pathologists are on the list only as a temporary measure pending some alteration in the law, inasmuch as it was thought that the fees paid for expert work were quite inadequate. 6218. I do not follow that?—We were placed temporarily on this list because the hospital authorities felt that for the employment of hospital pathologists the ordinary fee of two guineas, which is for the post- mortem and for giving evidence at the inquest, was not a suitable fee and compensation for this special work which such pathologists might give. 6219. You think the fee is not sufficient P—I think it is not sufficient unless one is in constant work. It is obvious that if you are doing these cases three or four times a day, the annual profit would make it worth while. 6220. We have had a great deal of evidence about it, and we have heard that the two-guinea fee is very often exhausted in expenses ?—It is in my own case. I always take my own assistant with me for the reason not at all what it should be in my experience; and by the time one has paid one’s assistant and other people, it does not leave much profit. 6221. You desire, I think, to refer to the want of freezing chambers in this connection ?—It is compulsory at present for an identifying witness to go and see the body on the day of the inquest, and sometimes a mother is forced to go and look at the body of her child in summer time, perhaps some four or five days after death, when the body has reached such a stage of putrefaction that itis a most distressing and unpleasant spectacle, and the poor mother comes into court ina condition that is most sad and distressing. I think that some system might be evolved to make this a little less painful. yi ' 6222. That could be cured by means of a freezing chamber ?—Yes, I think so by some proper freezing arrangement. I have been accustomed always to work in our hospital with a freezing chamber, and I can speak most cordially of the benefits to everybody con- cerned, It is left to the private and general hospitals to instal such freezing chambers; I think most of them ~ have them now. © 6223, And it is not impracticable that they should be general, not of course all over the country ?—Not all over the country, but in big towns I think it is certainly most important; you have then a means of preserving material for medico-legal inquiries which may be most important ; and, when properly supervised, it could be utilised for other purposes as well. I believe, for instance, that at one London hospital the freezing plant is used to produce cold storage for the hospital larder and so on, and-also to make ice for consumption on the premises. So that it can be utilised in that way. 6224. With regard to deaths under anesthetics, you are of opinion that there should be an independent enquiry in all such cases. You mean independent of whom ?—Of any of the medical men concerned in the case. I think there is a feeling now at a good many institutions that it is better for the institution, for the medical men, and for the public, that an inde- pendent inquiry should be made. , re 6225. You refer to cases which occur in hospital or outside a hospital in private practice P—I include both. 6226. Do you mean an independent pathologist ?— Yes, an independent pathologist to make the exami- nation. 6227. Do you suggest that the pathologist should be a witness, or should be in the nature of an assessor ? ——I think it would be better if he was to give evidence as a witness; and I suggest (although I admit the difficulty of the suggestion) that the coroner might have the assistance of an expert anesthetist to help him in the inquiry. Of course one realises the rather invidious position which that would place such an expert anesthetist in; but I believe myself the ques- tions which an expert anesthetist, who alone appreciates the difficulties of each case, could suggest would fre- quently help to make these inquiries complete, and in a good many cases would help also to place the difficulties of the case clearly before the jury, and some- times prevent the rather unnecessary blame which is thrown upon the anesthetist in some cases. It does not often occur, but in some cases they are blamed when nobody can quite realise the difficulties, and when everything has been done that could be done. On the other hand, the anesthetist would be able to direct the inquiry in such a way as to bring to light any error which had been committed, and so to prevent another mishap in the future. 6228. At present we understand—we have heard from a good many witnesses—that when the anesthetist or other medical witness is called, the coroner uses his services not only as a witness but as an adviser in the case, and keeps him in court practically through the sitting. Perhaps that is not your experience P—My experience has been, of course, that; most of the medical men are kept through the sitting at the inquest; but it is only under rare circumstances that the coroner makes use of them out of the witness box as assessor. It has fallen to my lot to be asked questions by the coroner when I have been sitting in the body of the