Book Review: A Clinician’s Brief Guide to the Coroner Court and Inquests,Gabrielle Pendlebury and Derek Tracy (eds)

Reviewed by: G Spoto, Consultant Psychiatrist, Medico-legal Society, UK

Medico-legal education is a neglected part of medical education. Supervised experience is rare and training if at all available is largely didactic.

Consultants are usually self-taught and privately they are often heard saying that they learnt their trade in the Coroner’s Court.

Whether this explains the dearth of expert witnesses in the medico-legal system is unclear, but it is certainly the case that to attend the Coroner’s Court is for many doctors a very daunting experience.

This timely little book does much to assist witnesses due to attend the Coroner’s Court and at the same time alleviate any anxieties thereof.

The book is edited by Dr G Pendlebury, a Child and Adolescent Psychiatrist and former Medico-legal Advisor, and Professor Derek Tracy, Chief Medical Officer of South London and Maudsley NHS Foundation Trust.

The book is part of the series produced by the Royal College of Psychiatrists and Cambridge University Press known as the Clinician’s Brief Guides.

The series takes complex medico-legal topics and breaks them down into accessible handbooks for the busy clinician.

The book amounts to a total of 101 pages. There are 18 chapters and 116 references. Most chapters have useful key points. There are three appendixes and templates. The book is written with the psychiatrist in mind.

Multi-author books run a risk of suffering from inconsistencies. However, the editors, who are themselves contributors to several chapters, have been successful in making this book a coherent whole.

All chapters are written concisely and always take the clinician as their starting point. In one chapter the reader is even addressed directly.

In terms of the knowledge base the book is comprehensive, covering everything from trust policy to managing emotions.

There is an interesting historical chapter providing information which is not readily available elsewhere and where I learned a very considerable amount.

The Coroner’s Court sits outside the criminal and civil courts, also adopting a model which is inquisitorial rather than adversarial. To this extent this jurisdiction has much in common with the Mental Health Tribunal Service.

Since 2013 coroners appointed to the role have been lawyers rather than doctors, however as the book makes clear the role of the coroner is to find facts, always abstaining from making a judgment of culpability. Indeed, the coroner is strictly forbidden from having a view and providing an opinion.

There is also always an expectation, which is again made clear in the book, that this must be made explicit to the parties, the coroner also providing the parties with words of reassurance when doing so.

I have personally only been called once during my career as a consultant psychiatrist to attend the Coroner’s Court, several years ago in a case of suicide. I can confirm that the kind words of the coroner before the hearing were very helpful and did a great deal to reassure me.

As an Educational Supervisor in a large training scheme in Psychiatry I also later had the opportunity to supervise a trainee in similar circumstances, when I attempted to follow the same approach. The trainee did not need to attend court on this occasion and the report was sufficient in this case.

True to its title this is an eminently practical book which is designed to support the witness during an inquest and the book certainly does so very successfully every step of the way.

The advice provided in any chapter of this book is always very detailed, but contributors are at pains to explain that the book is no substitute for independent legal advice, which is normally available from the employer’s legal department or a medical indemnity provider.

This incredibly useful little book thoroughly succeeds in making a very large amount of essential medico-legal information readily accessible in a single volume, which is extremely easy to carry. It will prove useful to newly appointed consultants but also experienced consultants preparing for an inquest.

If the Royal College of Psychiatrists were to be minded to include medico-legal subjects in the membership examination then I think there is much in this book that could readily translate into MCQs and be used as examination material. The book is strongly recommended.