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79
Officer. Presumably, the deaths " not certified " in lone and
mountainous districts, are not even referred to a Coroner.
In some of the manufacturing towns there is much so-called
" medical " practice by unregistered persons, upon whose information,
probably, many deaths are registered : registration
being required by law, which medical certification is not—
excepting in the case of persons who had been duly attended
in their last illness by a registered practitioner. I have long
held the opinion that when death ensues in the case of persons
attended by unregistered practitioners, an inquiry should be
held : the dread of inquisition would tend to limit irregular
" medical " practice, which, as a very general rule, must be to
the public detriment.
The subject of uncertified deaths has engaged the attention
of the Society of Medical Officers of Health on more
than one occasion, and some years ago the Society passed
a resolution to the effect:—
" That all cases of uncertified deaths should be reported by the local registrar
of births and deaths to the Coroner, who should, when there is no prima
facie ground for holding an inquest, direct such cases to be investigated by
a registered medical practitioner."
It had been suggested that the duty of making the proposed
investigation should devolve on the Medical Officer of
Health as a part of his ordinary work, but the Society did
not approve this view.
Of all the unsatisfactory arrangements connected with
uncertified deaths, it was felt that the least defensible is that
which makes the Coroner's Officer tie facto judge, in a doubtful
case, whether an inquest should be held, and the Society,
at my instance, adopted the following resolution on the
subject :—
* The percentage of uncertified deaths to total deaths in 1893, in the thirty-two
large provincial towns, was 2.4 per cent. It was 4.3 in Halifax, 4.5 in West Ham,
and 4.9 in Birmingham.