Clinicians are to receive new guidance on how best to prepare patients and their loved ones for the legal process that follows a death from mesothelioma, which can be especially traumatic for relatives. The advice has been produced by the British Lung Foundation and is supported by the British Thoracic Society.
The guide is being published to mark Action Mesothelioma Day on 27 February and was developed after the British Lung Foundation highlighted families’ experiences in a report launched in February 2007. An Unnatural Death detailed how relatives can receive distressing visits from uniformed police officers investigating the death shortly after their bereavement.
The key recommendations for clinicians are:
- Discuss the inquest procedure with the patient and family members at an appropriate time so it does not come as a shock. Seek permission from the patient as to which relatives would be most capable of understanding the situation.
- Review or complete a work history of the patient - this should include any occupations that may have caused or contributed to the illness, or any other information that may be helpful to the coroner in his/her inquiries.
Dame Helena Shovelton, Chief Executive of the British Lung Foundation, says: “It can be incredibly traumatic for bereaved families to have to endure a formal and often lengthy investigation after losing their loved one to mesothelioma, but clinicians are ideally placed to help alleviate some of this distress. By following these new guidelines and explaining to relatives what to expect from the legal process they will hopefully be able to do so.”
Dr DavidBaldwin, Chair of the BTS Lung Cancer & Mesothelioma Advisory Group, says: “We believe that the implementation of this guidance by clinicians will be of great benefit to the families of people with mesothelioma. Many clinicians already try to prepare patients and their families and this initiative will help to disseminate best practice.”
The guidelines will be sent to clinicians as part of the BTS newsletter and will also be available on the British Lung Foundation website www.lunguk.org as well as The Coroners’ Society and BTS websites.
The Coroner’s procedure
A doctor called to a family home or hospital to issue a death certificate following a mesothelioma death should report it to the local coroner immediately. A formal investigation into the death then begins.
The coroner will make inquiries, often through a coroner’s officer, with a view to answering four key questions at the subsequent inquest:
(1) Who has died?
(2) When did s/he die?
(3) Where did s/he die?
(4) How did s/he die, i.e. the cause of death.
Some coroners work alone without the support of coroner’s officers.Most will have the benefit of one or more coroner’s officers, but in some areas they will be serving police officers, usually in uniform. This is why some families will be visited by uniformed police officers shortly after a loved one has died of mesothelioma.
Relatives may be asked to formally identify the body and many wish to do this, but some coroners will allow a healthcare professional to carry out the identification if the family does not wish to.
The coroner must hold an inquest to determine both the cause of death and whether it was due to a naturally occurring disease or occupational asbestos exposure. If it is not clear an open or a narrative verdict may be returned. On average an inquest takes around three months to complete, but in some cases it can be longer. Clinicians should try to ensure that families are prepared for this.
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