Kasperowicz, R (on the application of) v HM Coroner for Plymouth

Where no attending doctor can certify the cause of death, the cause must be independently ascertained. A coroner may therefore require an inquest and order a post-mortem examination where the statutory conditions are met. The law does not require every post-mortem to involve complete dissection. Its extent is case-dependent, and less invasive methods may be considered if they can establish the cause of death. Regard for religious beliefs and family distress may inform good practice, but does not create a legal bar to a lawful examination or require the coroner to adopt MRI scanning. The choice between examination methods is principally humanitarian and practical, rather than a matter for judicial intervention.

This was a renewed application for permission to appeal against Gray J’s refusal of an injunction restraining the Deputy Coroner for Plymouth and South West Devon from conducting a post-mortem examination on Adela Kasperowicz.

Mrs Kasperowicz had recently been discharged from hospital and died shortly after developing respiratory difficulties. No doctor was able or willing to certify the medical cause of death. Her grandson and daughter opposed an invasive examination, relying on her religious wishes and proposing MRI scanning as a less invasive alternative. The central issues were whether the coroner was entitled to require a post-mortem and whether the law required a complete dissection rather than a limited examination.

Disposition. Sedley LJ refused permission to appeal. Clarke LJ agreed, and the application was refused.

1. Under section 22(1) of the Births and Deaths Registration Act 1953, an attending registered medical practitioner must certify the cause of death. Where no attending practitioner can do so from first-hand knowledge, the cause must be independently ascertained.
2. The statutory category of a sudden death of unknown cause was engaged. The death remained within that category because no doctor who had seen Mrs Kasperowicz was able or willing to certify its cause. The family’s asserted explanation did not remove the need for medical ascertainment.
3. The coroner was entitled to direct a post-mortem under section 19 to establish the cause of death and whether an inquest was necessary. A post-mortem could provide the answer that a medical certificate would have provided and enable the coroner to register the cause of death under section 19(3). The court therefore had no basis to halt the process required by law.
4. The law did not prescribe the degree of invasiveness required in every case. A limited examination, informed by medical records and evidence from those present, or potentially MRI scanning, could suffice if it enabled completion of the prescribed inquisition, including the finding as to the injury or disease causing death unless impossible. Completion of every line of the post-mortem form was not necessarily required in every case.
5. Sedley LJ considered that limiting an ordinary post-mortem did not require use of the special-examination powers in section 20. If a limited examination could answer the statutory question, limiting it in deference to the family’s feelings was legally permissible. That choice concerned common decency and good practice. Clarke LJ detected no irrationality or unlawfulness in the coroner’s decision, although he expressed the hope that the examination would be as uninvasive as possible.

• Court of Appeal (Civil Division): the renewed application for permission to appeal was refused on 10 January 2005; [2005] EWCA Civ 44.
• High Court, Queen’s Bench Division: Gray J refused an injunction restraining the Deputy Coroner from proceeding with the post-mortem examination. No citation is stated in the judgment.