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124
expense to the rates, if his decision that inquest was unnecessary
were accepted. In these circumstances, the Medical
Officer would become practically "Coroner's Officer," as the
St. James's Yestry 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 eases, 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.:—
* The percentage of uncertified deaths to total deaths in 1890 was 4.9 in
Sheffield, 5.5 in Halifax, and 6.1 in Liverpool—corresponding closely with the
percentages in previous years.