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
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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.

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    6339. But you think two guineas insufficient even if he had a considerable number of cases in a day or a week; that the scale is so low that, even assuming he had as many cases as he could properly do, it would not be adequate P—That is my opinion. 6340. What do you suggest ?—I think a fee such as five guineas. 6341. More or less, I suppose, depending on the character of the case. Or do you put that as a minimum ?—I think it would be an adequate fee as a standard. 6342. There might be cases in which a larger fee should be given?—Yes. I can imagine complicated and extremely difficult cases which might occupy a great deal of time. 6343, But in the present state of things, is there an actual want of men who practise forensic medicine and pathology as a separate study?—I think so. I think I am right in saying that there is no teacher at any medical school in London who is an expert purely in forensic medicine. 6344, You say that the teachers at all the medical schools in London, and also the experts of the Home Office, practise medicine or surgery ?’—I think I am right in saying so. 6345. You do not object to their practising medi- cine cr surgery ?—No, I do not object. I should prefer a specialist for purposes of teaching. My point is that his instruction would have probably very much more weight if he were a specialist. 6346. But why would the fact that he practised medicine or surgery detract from the weight that he would carry as a teacher in forensic medicine P—I think that is a general question which permeates the whole of medicine and surgery; but you have specialists in many branches of medicine and surgery. 6347. It is a subject in which you must specialise ; that is what it comes to P—Yes. 6348. What you are ambitious to see is a state of things in which appointments in forensic medicine are full-time appointments ?—Yes. Negotiations have been going on betweei St. Bartholomew’s Hospital, St. Thomas’s Hospital, the London Hospital, and our- selves, with a view to appointing, if possible, a teacher of forensic medicine who could teach at all those schools; but we feel that that is intimately bound up with the institution of a professorship of forensic medicine at the University of London. 6349. A man who shall practise that branch in London ?—Yes. I do not wish to be in any way dero- gatory to the forensic medicine teachers at the present time who have to practise medicine or surgery; I] am merely striving at the ideal. 6350. You suggest in your précis that a great amount of material is wasted at present. What do you mean by that?—It is unorganised. I mean by material, the results of pathological investigations made at the numerous inquests in London. 6351. It is not organised, and therefore as much use is not made of it as might be?—That is what I mean. 6352. You would suggest, of course, that, besides professors and teachers of forensic medicine, there should be a staff of practitioners devoting themselves to that particular branch?—Yes; I think it is the view distinctly of the medical and surgical staff at Guy's, that in many ordinary cases—in fact, in the majority of ordinary post-mortem examinations—the medical practitioner, if properly taught as a student, is competent to make them, but that in cases of difficulty he will require an expert to assist or replace him. 6353. At present, of course, forensic medicine is taken up by every medical student?—Yes. Every medical student is also required—at any rate, for University degrees—to have himself performed post- mortem examinations under his teacher at his medical school. 6354. And that fits him, you think, for dealing with ordinary cases ?—Yes. 6355. But there ought to be a more skilled patho- logist for special cases P—Yes. 6356. In your opinion that is wanting at present ? —Distinetly. . 6357. It is largely a question of fees, is it not P— es. 6358. With regard, further, to the question of fees, do you think it is unreasonable that no fees shouJd be allowed in connection with the cases of persons who are brought into hospital and who die in the hospital ? —Yes. 6359. If a post-mortem is performed in such cases, the person performing it is entitled, in your opinion, to a fee ?—To the ordinary fee. In our opinion, he differs in no way from the ordinary general practitioner. He is attached to a private institution, which pays its own rates as any other house or institution does. 6360. (Dr. Willcox.) And you consider that the medical officers of hospitals should be paid ordinary fees for attendance at inquests P—I think so. 6361. And for the giving of medical reports ?— Yes. It is a great burden on them. The house surgeon in a hospital with a large accident ward, with an inquest being held practically on every accident—that is, on cases which die within a year and a day of the accident —is continually being summoned to make a post- mortem, and to attend at the inquest and give evidence ; and he gets nothing for it. 6362. And they should have a fee, you think, for any medical report they send to the coroner ?—Yes, certainly. 6363. I take it that you regard forensic medicine— I am speaking from the point of view of an expert witness—as medicine applied for the purposes of law ?— Yes. 6364. And it is extremely wide in its application P— Yes, I quite agree. 6365. And very often the expert witness is required to have a very wide knowledge of general medicine as well as toxicology and pathological work ?—Yes, I quite agree with everything you say. 6366. And very often it is an advantage to the specialist in forensic medicine to keep in touch with general medicine ?—We embark there on the difficult question of specialism. JI cannot go the whole way with you. 6367. I am speaking out of my own experience, which is a pretty large one, of this expert evidence. Do you agree with me ?—I must agree, with qualifica- because, as I say, the whole question of specialism and the advantages and defects of specialism is too large to discuss here in a short conversation. One knows that a specialist both gains and suffers by his restricted outlook. 6368. Do you think it would be an advantage for a man to be a specialist in forensic medicine, and not to lose touch with general medicine P—I should, I think, be in favour of special teachers in forensic medicine in the same way as we have special surgeons for diseases of the eye, special surgeons for diseases of the ear, and for other kindred subjects. It is a large and important subject; I think it is the duty of the specialist in forensic medicine to keep abreast of ordinary medicine ; but it is better that he should be a specialist rather than, mm addition, a man who has to spend his life in the rough and tumble of ordinary medical and surgical practice. 6369, Are you aware that in Scotland and on the Continent frequently the professors of forensic medicine have been on the staffs of the hospitals in the places where they have lived >—I am aware of that. 6370. Do you consider the practice of pathological chemistry a subject which would harmonise with toxicological work ?—Yes, distinctly. 6371. With regard to the teaching of forensic medicine in medical schools, is as much attention paid to this subject in the curricula of the examining boards as was the case, say, 10 years ago?—The University of London has abandoned a. practical examination in toxi- cological chemistry. Iam afraid I am not competent to discuss the merits or demerits of that step; but the fact remains. 6372. Do you consider it very important that a medical student should have adequate teaching in forensic medicine ?—Certainly. 6373. (Mr. Bramsdon.) I have just one or two questions upon the subject of practicability, I gather A 4