When a loved one dies, it can be the hardest thing. But when the circumstances surrounding the death require an investigation or an inquest, it’s not surprising that the relatives of the deceased may be both confused and worried. What exactly is an inquest and what purpose does it serve?

1. What happens when a relative has died?

When a person dies, the doctor who treated them will issue a medical certificate stating the cause of death. However, in some situations the doctor will need to inform a coroner about the death, so that it can be investigated. Family members, the police or the registrar of deaths can also report the death.

2. When is an inquest needed?

If the post-mortem examination of the body shows that death is not the result of natural causes, or the cause of death cannot be established beyond reasonable doubt, an inquest will need to be held. In certain cases, the coroner is obliged to hold an inquest even when a natural death has occurred, for example when someone has died in custody or state detention. This includes immigration detention centres as well as secure mental health hospitals.

3. What exactly is an inquest?

An inquest is a unique form of legal investigation to establish the identity of the deceased, as well as when, where and how the person died. Unlike criminal or court cases, its purpose is not to determine fault.

There are 3 different types of inquest hearing:

Inquest Opening

The inquest is officially opened but then adjourned so that more enquiries can be made

Pre-Inquest Review

A meeting that takes place in open court after an inquest is opened, and where details and arrangements (e.g. for witnesses) are discussed for the final court date

Documentary Inquest

An inquest where no witnesses are called to give evidence; only evidence on paper is considered

4. Where are inquests held?

Inquests are held in a court of law and are conducted by a coroner – an independent judicial officer who is appointed by the government and works with the local authority. It is a formal setting where all stand when the coroner enters and leaves the chamber, there’s no eating or drinking allowed and mobile phoned must be switched off during proceedings. An usher will be on hand to explain court etiquette, if needed.

The court is open to the public, so anyone can attend, including friends and family of the deceased, as well as press or other media who may wish to report on the outcome.

5. What is the coroner’s role?

The coroner decides what evidence is heard, from whom and in what order. He or she will determine if evidence should be given orally or in writing, and if there are any ‘interested persons’ such as relatives, legal or insurance company representatives. In addition to information from family members, the coroner may also require reports from doctors/nurses, police officers and anyone who witnessed the death.

Sometimes, the coroner may decide that a jury is needed to reach a conclusion, for instance

• If the person died in custody
• If the death was connected to the person’s own or someone else’s actions at work
• For certain health & safety issues

6. What happens during an inquest?

During the court hearing, the coroner will take the lead in the questioning of any witnesses. Interested persons and/or their representatives may also ask questions, as long as they are relevant to their four questions that the inquest seeks to answer: who died, how, where and when did they die.

Once all the evidence has been collected and considered, the coroner will close the inquest by pronouncing his or her conclusion. Most inquests are complete between 3 and 9 months after the date of death.

7. What are the possible outcomes?

The conclusion of the inquest may have many possible outcomes, including natural causes, accident, suicide, unlawful or lawful killing, and industrial disease (such as work-related lung cancer). The coroner may also record an open verdict where there is insufficient evidence to support another conclusion.

Once the inquest is closed, the coroner forwards the information to the registrar of births and deaths, so that the death can be registered and a death certificate issued.

8. What’s the difference between an inquest and an ‘investigation’?

In some cases, for example if it seems likely that the person died of natural causes, or if only simple questions around the death that need to be answered, a full inquest may not be necessary. The purpose of the investigation is for the coroner to establish the cause of death.

In this case, an interim death certificate can be issued, and the body of the deceased released to the relatives so that funeral arrangements may be made. Investigations typically take 4-12 weeks, having one or two outcomes:

• Confirmation that the death was due to natural causes
• Opening of an inquest if there are questions that still need to be answered.