In recent years, Ghana has been marked by a troubling rise in suspicious and unexplained deaths, many of which have ignited intense public outcry, media scrutiny, and protracted litigation. Families, friends, and civil society continue to ask painful questions--what truly happened, who investigated, and whose voice speaks for the dead?
Unfortunately, these deaths are still investigated under the Colonial Coroner's Act of 1960 (Act 18), a legal framework conceived in an era long before modern forensic science, human rights jurisprudence, and contemporary medico-legal standards.
The deficiencies of this outdated law have resulted in inconsistent death investigations, limited use of scientific evidence, weak inquest procedures, and outcomes that often leave families without closure and the public without confidence. In the absence of an independent, modern medico-legal death investigation system, suspicion festers, trust erodes, and justice is perceived--rightly or wrongly--as compromised.
As the father of modern forensic science, Edmond Locard, famously demonstrated, every contact leaves a trace, yet Ghana's current system often relies on the colonial Act rather than rigorous scientific interrogative Medico-Legal Death Investigation System (MLDIS).
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A comprehensive review and reform of the Coroner's Act, aligned with contemporary forensic, legal, and human-rights standards, is therefore, not optional--it is imperative if Ghana is to uncover the truth that lies beneath what the naked eye alone can see.
History of Medico-Legal Death Investigation System (MLDIS)
The roots of medico-legal death investigation date back to 44 BC, when the Roman physician, Antistius, examined Julius Caesar's body and scientifically determined the single fatal wound among 23 stab injuries, earning recognition as history's first medical examiner.
In 1302 AD, judicially ordered post-mortem examination emerged in Bologna, Italy, where a panel of physicians investigated a bizarre death under a magistrate's directive.
Ancient Ceylon later developed an independent death investigation tribunal known as Sakshi Balanda, which examined suspicious deaths, though without documented medical involvement, before British colonial influence introduced a modified English coroner's system in 1883.
By 1958, the United States advanced the field by passing the Model Post-Mortem Act, clearly defining categories of deaths requiring investigation and empowering states to modernise their systems.
Globally, medico-legal death investigation frameworks have continued to evolve in step with advances in forensic science, underscoring the necessity for laws to adapt to contemporary investigative realities.
Overview for Medico-Legal Death Investigations Systems (MLDIS) in the world
Medico-Legal Death Investigation Systems worldwide differ mainly by the authority responsible for investigations, though autopsies are predominantly conducted by trained forensic pathologists.
Ghana inherited the coronial system from Medieval England through colonial rule, yet unlike jurisdictions such as England, Wales, and India, the system has remained largely unchanged for over six decades.
Under the Coroner's Act, 1960 (Act 18), Ghana adopted the English medico-legal death investigation framework, albeit with notable deviations from the modern system currently practiced in England.
Elsewhere, the Scandinavian model employs a concurrent investigation led by both the Prosecutor General and a state pathologist, ensuring strong legal-scientific collaboration.
In contrast, countries such as India, parts of the Caribbean and the Middle East rely primarily on police-led investigations, while the Russian Federation, Continental Europe, and Scotland utilise prosecutorial authorities such as the Procurator Fiscal or district attorney to investigate deaths.
Objectives and discussion
Medico-legal Death Investigation System (MLDIS) is an administrative office that is essential in a given country. It is a process in which there is an interconnection between few components shown in the diagram below;
Most aspects of medico-legal death investigation are medically complex and require the expertise of specially trained physicians, particularly forensic pathologists and scientists, rather than lay coroners.
In Ghana, opinions issued by coroners are often misrepresented as medical opinions, leading to inaccurate and unpopular determinations of the cause and manner of death over many years.
A 2023 preliminary study at the Department of Pathology, KNUST/KATH revealed that out of 378 inquest cases, the manner of death could not be determined in 97 cases at the initial proceedings, reflecting systemic deficiencies similar to findings from a Sri Lankan study.
Ideally, forensic pathologists and scientists should play a central role in death investigations, as their involvement would significantly improve the accuracy, reliability, and scientific credibility of the system.
The primary deficiencies of the Ghana Coroner's Act 1960
The primary deficiencies in the coroner's system are structural, professional, and operational in nature, undermining confidence in medico-legal death investigations.
There is a lack of standardised training and consistent professional medical expertise required to conduct credible death inquiries. Accountability mechanisms and quality assurance systems are largely absent, allowing errors and poor practices to persist unchecked.
Chronic insufficiency of resources and funding further weakens the system's capacity to conduct timely and thorough investigations.
Political influence remains a significant concern, as many coroners are elected officials who cannot be easily dismissed for incompetence, making them vulnerable to political pressure and, in some cases, unrelated misconduct such as fraud.
There is also a marked lack of medical and forensic expertise, as many jurisdictions do not require coroners to be physicians or trained forensic scientists and pathologists, with some drawn from law enforcement or non-medical backgrounds.
This gap increases the risk of misinterpreting medical evidence, overlooking injuries, or missing critical diagnoses.
Poor communication with public health services and the bereaved--as reflected in Section 5 (2a, b (i)-(iii) of the Act--results in a fragmented system with no formal integration for disease surveillance or epidemic detection.
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Public confidence and transparency are further eroded under Section 4 of the Act, which mandates that the police initiate death investigations and advise whether an inquest is necessary.
In cases of deaths occurring in police custody, this arrangement raises serious concerns about impartiality and fairness.
Moreover, although Section 7 (1a) requires assistance from a registered medical practitioner for post-mortem examinations, the Act does not mandate that such examinations be conducted by a forensic scientist and pathologist, thereby diminishing their scientific, epidemiological, and public-health value.
Conclusion
When amended, the Coroner's Act must operate synergistically with a National Forensic Authority, which will regulate and oversee the practice of the Chief Forensic Scientist and Pathologist as well as all other relevant forensic experts necessary for thorough death investigations.
This integrated framework will ensure scientific rigor, professional accountability, judicial oversight, and restore public confidence in medico-legal findings.
Ultimately, Ghana's current Coroner system requires a complete review and transformation into a professional, medically and scientifically driven death investigation system staffed by qualified forensic scientists and pathologists.
