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96
necessary were accepted. In these circumstances, the Medical
Officer would become practically "Coroner's Officer," as the
St. James's Vestry propose. If suitably remunerated for his
task, he might reasonably be authorised to inquire, in the first
instance, into the cause of uncertified deaths; and to certify in
proper cases, referring those from violence, or otherwise involving
suspicion of foul play, to the Coroner. Any such
change would require legislation to give it effect; but it may
be doubted whether the legislature would entrust to any individual,
powers of such an exceptional nature. In the case of
deaths registered as "not certified," after reference to the
Coroner, it cannot be doubted that inquiry and report by a
Medical Officer of Health would be more satisfactory than that
by a Coroner's 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 patients who have been duly
attended in their last illness by a registered practitioner. I am
of opinion that when death ensues in the case of persons
attended by unregistered practitioners, an inquiry should be
made: 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 the following
resolution, viz.:—
"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 facic ground for holding an inquest, direct such
cases to be investigated by a registered medical practitioner."
* The percentage of uncertified deaths to total deaths in 1889 was 4.2 in Hull,
4.6 in Sheffield, in Hudders field, and 5.6 in Halifax and Liverpool,—corresponding
closely with the percentages in previous years.