The Role of the Procurator Fiscal and Forensic Pathologist in Sudden Natural Death

The Role of the Procurator Fiscal and Forensic Pathologist in Sudden Natural Death

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The World Health Organisation (WHO) describes sudden natural death as ‘death within twenty four hours of the onset of symptoms’ (Payne-James et al. 2011, 54). However in reality sudden death can occur within minutes or even seconds of many symptoms. The investigation of sudden natural deaths is vital to establish the cause is due to natural causes rather than criminal or medical negligence where a trial and prosecution may be necessary. This essay reviews the roles of the Procurator Fiscal and the forensic pathologist in relation to sudden death and looks at two common natural causes of sudden death; pulmonary embolism and cerebrovascular disease and how they might be identified by post-mortem investigation.

The role of the Procurator Fiscal is to oversee the investigation of all deaths deemed sudden or unexpected, occurring under suspicious circumstances, in a violent manner, or in custody (Medical Protection Society 2013). The main objective is to find the cause of death through examination of all the collected evidence. The Procurator Fiscal can then decide whether a criminal prosecution or Fatal Accident Enquiry should be carried out (Medical Protection Society 2013). However, if the sudden death is due to natural causes then declaration of sudden death avoids wrongful prosecution and brings the case to a conclusion providing closure for the family and friends of the deceased.

Deaths are reported to the Procurator Fiscal usually by either the police or by doctors who are unable to issue a death certificate, henceforth further investigation is required (Medical Protection Society 2013). The Procurator Fiscal then decides if a post-mortem is required to identify and confirm the cause of death. Seventy percent of deaths report...


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...der to detect any blood clot within the blood vessels of the brain. If found then this would most likely be described as the mechanism of death. Figure 2 shows a cross section of a brain that has suffered from CVD.

To summarise, sudden death arising from natural causes must be carefully investigated in order to identify the precise mechanism of death and to eliminate any suspicion that the death may have been caused unnaturally. The investigation usually involves a post-mortem which is performed by a forensic pathologist in order to reveal the exact cause of death. This process is important in that it should inform the family of the deceased with the cause of death and perhaps significant information relating to hereditary disease. The role of the Procurator Fiscal and forensic pathologist are vital to ensure the issue of a correctly completed death certificate.

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