Sola Ogundipe & Chioma Obinna
18 July 2008
In 2007, the Lagos State Government promulgated The Coroner's System Law that established a new system of investigation of death in the State. The Coroner's Law which imposes specific civic responsibilities on individuals in both private and official capacities, is intended to strengthen the security of human life by investigating suspicious or questionable deaths, and enabling the state take action necessary to forestall the repetition or continuance of circumstances capable of bringing about avoidable loss of human life.
It is a specially designed law aimed at curtailing deaths caused by extrajudicial killings in all ramifications as well as deaths from medical negligence. But even though the Coroner's System Law was enacted to provide a regulatory framework for the investigation of deaths occurring in certain questionable or suspicious circumstances provided for under the law, doctors under the aegis of the Nigeria Medical Association (NMA) Lagos Sate branch are crying foul over the new law and have threatened to stop the issuance of death certificates should the State government go ahead with plans to effect the law.
Saturday Vanguard is on top of the development and reports that doctors have been at loggerheads with the Lagos State Government over the issue.
Different reactions from doctors have been trailing the passage of the law. Many claim that the process that led to the law was fraudulent. But the State government says the Coroner's System Law is here to stay. The law has been enacted but the controversy lingers ......
Issuing the threat at a press conference in Lagos, State chairman of NMA, Dr. Babafemi Thomas called for urgent suspension and withdrawal of the law establishing the corner system of Lagos state for purposes of holistic review.Thomas who alleged that the whole exercise was a travesty of due process said the law lack advocacy abinitio.
According to him, "We are inferring that the system and the law contravenes federal and international status and constitute an affront to moral justice in that certain pertinent key stakeholders in the health system development were neither consulted nor co-opted in the deliberations."
Continuing, he alleged that "the enactment exercise relied squarely and solely on the office of the forensic pathologist of the Lagos State for its bank of information. No impact was sourced from the medical and dental council of Nigeria which is the primary regulatory body for ethical practices within the medical profession in Nigeria.By this convert or avert omission, are further emphasising that the process that generated the document was not due.
As it stands and if the law is enforced to the letter, the average medical practitioner incurs the risk of being put in jail for issues as basic as issuing a death certificate." He further state that the law exposes the practicing medical professional, particularly those in private practice, to persons who may want to exploit its loopholes for the purpose of extortion.
Drawing attentions to some sections of the law, Thomas cited a sub-heading under sections 7 (1,23) 8,9 (1(a), b, 2) stating that it is a gross abuse of discretion for an attorney-general of a city, state or federation to be seen as appointing the chief medical examiner within his jurisdiction.He further argued that the legislation empowering his office to do so, is in the same vein grossly defective adding that the act is an affront to the medical community in Lagos.
The doctors also disagree on the issue of one man acting as the only forensic pathologist in the state. According to them, a forensic pathologist cannot play God as the final and sole determinant of the cause of death but can only be a contributor. They also demanded that a forensic institute must defer to the medical and dental council of Nigeria for purposes of accreditation, otherwise all its activities shall be deemed irregular and unlawful.
What the Coroner's Systems Law is all about
The law establishes a Coroner's System for Lagos State under the control and administration of a Chief Coroner of the State - section 1(2). A Judge of the High Court of Lagos State appointed by the Chief Judge of Lagos State shall be the Chief Coroner of the State - section 2. The overall administration of the Law is vested in the Chief Coroner - section 3.
The Law also provides for the designation of a Magistrate to be a Coroner in each District in the State - sections 4 and 5. A Subsidiary Legislation attached to the Coroners Systems Law designates four Districts as follows: Lagos Coroners District; Ikeja Coroners District; Yaba Coroners District; and Apapa Coroners District. The Magistrate in charge of each Coroners Court should however not be below Magistrate Grade 1- section 4(1).
The Law makes provision for the appointment of Chief Medical Examiner and District Examiner sections 7 and 11. The responsibility of the Chief Medical Examiner and District Examiner is to generally conduct medical investigation into the cause of death of any person referred to them amongst others. The implication of designation of four Districts is that only four District Medical Examiners can be appointed. In the event that there is the need for more Districts the Chief Judge may by a Subsidiary Legislation create more Districts pursuant to section 5.
The availability of a well equipped forensic laboratory is a sine qua non for the smooth functioning of a Coroners' System. Consequently, the Lagos State Government is committed to establish a first class forensic institute pursuant to the provision of section 8 that will be able to conduct all kinds of investigations that are required to enable the Medical Examiners and the Coroners to effectively discharge their responsibilities under the Law.
Reportable Deaths under the Law
The Law imposes a legal duty on any person to make a report of death to the Police, Local Government Authority, or Office of the Medical Examiner or the office of the Coroner and such deaths shall be subject to post-mortem examination where there is reasonable cause to believe that the cause of death was:
Unknown; sudden or unexpected and unnatural; violent, unnatural and suspicious; accidental or misadventured; due to self neglect or negligence of others; an industrial disease accident at work or industrial poisoning; due to negligent medical intervention, misconduct or malpractice; due to neglect during surgery or before recovery from anesthesia or diagnostic or therapeutic procedure; as a result of non-conventional medical procedure or medication; suicide, suspected suicide or assisted suicide; a known or unknown cause while in custody or shortly afterwards; due to ailment within twenty four hours of hospital admission; a maternal death occurring during or following pregnancy or that might be reasonably related to the pregnancy; as a child in care; an infant death as in Sudden Infant Death Syndrome (SID) and non- accidental injury; unnatural still birth and intrauterine death; and an ailment in a nursing home or hospital - section 14.
When information has been given to any of the agencies in respect of reportable deaths, such agency or a person authorised in that behalf by the agency shall proceed to the place where the body of the deceased person is lying and shall take full responsibility and carry out investigations in accordance with the functions of such agency - section 25(1). The agency shall without delay cause notice of the death to be sent to a Coroner in whose district the body was found. The agency shall arrange for the removal of the dead body to the office of the District Medical Examiner - section 25(3).
Investigation of Cause of Death
The basic duty of Coroners under the Law is the investigation of death occurring in questionable circumstances. Section 15 provides for circumstances when it is mandatory for the Coroner to hold an inquest. The circumstances with minor differences are similar to circumstances when a report of death should be made. It appears that in circumstances listed in section 15 (1) - (8) an inquest is mandatory while in other circumstances listed in section 14 it is mandatory to make a report of death.
It is only mandatory to hold an inquest under the circumstances listed in section 15. The only thing that is mandatory with respect to the circumstances listed in section 14 is that deaths in section 14 must be subject to post-mortem examination, but may not be subjected to an inquest except for cases falling also within section 15 unless the Coroner so decides under section 15(9). In addition it also mandatory for a Coroner of a district where a death occurs in custody to hold an inquest- section 18. Section 19 empowers a Coroner within whose jurisdiction a body is found to hold an inquest on it, notwithstanding that the cause of death arose elsewhere.
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