DOCTORS’ DUTIES IN ISSUING DEATH CERTIFICATES

Northern Advocate, 30 May 1936, Page 8

DOCTORS’ DUTIES IN ISSUING DEATH CERTIFICATES

£ [Per Press Association—Copyright.} £ DUNEDIN, This Day. /VUTSPOKEN comments on £ '"several aspects of the case were made by the coroner, Mr J, R. Bartholomew, S.M., at the conclusion yesterday of the inquest into the death of Mora £ May Mackenzie, , aged 29, > • whose body was exhumed at Anderson’s Bay Cemetery on April 24. The coroner found that the actual cause of death, peritonitis, arose from a criminal abortion. .jfV vf A large part of the evidence of Dr. f " A. S. Moody was taken up with an outline of his responsibilities in the % case, and he also detailed the custom o' of members of the British Medical As- *’■ sociation in such circumstances. ■f'- menced his evidence, the coroner iri- * ■ Shortly after Dr! Moody had comtimated that witness must make full 1, disclosures. Dr. Moody: “I understand that. In cases like this I do not ask questions.” The Chief Detective: “You knew the cause of this woman’s trouble?” No Proof. Dr. Moody: “My opinion was that £ she was seriously ill, and I would ' not say beyond doubt what was the nature of the illness. I thought it might be septicaemia, but I had no proof of it. I made no. inquiries, and ’ made no examination.” ~ Discussing the duties of doctors ir relation to the issue of death certi- % ficates, Dr. Moody said: “I will give " you the casies in which I would notify the police. They are: (1) If I knew an offence had been committed on a young and inexperienced person; (2) if it had been performed against the patient’s will; (3) if the patient desired to make a statement to the police.”

Doctor’s Duties.

“Was my subsequent action any different from that of a minister of religion who receives a confession of crime ; f arid' remains silent?” Dr. Moody asked. “My patient refused to make a statement, and, as she refused to make a statement, I am bound, as a member of the British Medical • Association, to follow the rule l M ;"df'. .the council, which is dated 27, 1915, and is as - ifollows: ‘That the council is /61: opinion that a medical practitioner should not, under any circumstances, disclose voluntarily without the patient’s consent, information which he has receoved from the patient in his professional capacity.’

COMMENT AT INQUEST INI EXHUMED v DUNEDIN WOMAN

“Unfortunate Ruling.”

Not to Act as Screen.

“Must Report Matter.”

“The most important thing from our New Zealand point of view is the opinion quoted in the New Zealand Medical Journpl,, dated October 29, 1932. This opinion was given to the the Obstetrical Society of New Zealand. It comes from the DirectorGeneral of Health, and has been given to the medical profession of this country as guidance of the course they should follow in cases of abortion.”

Dr. Moody went on to quote the following statement by the DirectorGeneral: “The Department is advised that a doctor is under no legal obligation to inform the police as to the cause of death of a person which has been due to an illegal operatipn. He is, of course, under an obligation to insert in the certificate of death, which he furnishes under the Births ‘ and Deaths Registration Act, 1924, the cause of death, both primary and secondary. In that certificate, where death was the consequence of an illegal operation, he should insert the nature of the operation as the primary cause of death. He need not, of course, describe it as an illegal operation, but he would describe the type of operation . and the reason why such operation was the primary cause of death, e.g., owing to incompetence or ignorr ance, if that be the case. With regard to the burial, which took place on April 13, and the death certificate, which was not issued until April 14, the coroner said: “It was stated that this was the usual practice. It was not only gravely irregular, but also a breach of statute law. An undertaker cannot conduct a burial without possession of a certificate, but a much more serious matter concerns the issue of the death certificate in cases such as the present.

“Dr. Moody stated that he was acting under the direction of the British Medical Association, and also in pursuance of the ruling of the DirectorGeneral of Health for the guidance of the medical profession issued on October 29, 1932. This ruling is in direct conflict with that of the Royal College of Physicians, to which I will rrjake reference later. I must characterise the ruling of the DirectorGeneral as, to say the least, most unfortunate and mischievous in effect, as is evidenced by the present case. “The Director-General states: ‘The Department is advised that a doctor is under no legal obligation to inform the police as to the cause of death of a person, which has been due to an illegal operation.’ No doubt there is no express provision of law to that effect, nor is there in any case of homicide, accident or sudden death. The Director-General proceeds: ‘ln that case he should insert the nature of the operation as the primary cause of death. He need not, of course, describe it as an illegal operation.’

“This invites a cloak to be cast over a serious criminal offence, one in respect of which a charge of murder may lie. It is no part of a doctor’s duty to act as a detective, but it is equally certain that it is no part of his duty to act as a screen for the professional abortionist. In my opinion it is altogether wrong and irregular for a death certificate to be given.

“In such case the only cause in which a doctor is justified in giving a certificate is where death was wholly due to natural causes. In all other cases, and where there are any auspicious circumstances, it is his duty to notify the coroner or the police.

“The question of a doctor’s duty in cases of criminal abortion was also considered by the Royal College of Physicians in England in 1916. Following the observations made by the late Mr Justice Avery while charging a grand jury, the college went exhaustively into the matter, and after seeking counsel’s opinion formulated notes for the guidance of the medical practitioners in such cases.

“The whole position is set out in ‘Taylor’s Medical Jurisprudence,’ This states that in the case of criminal abortion a medical practitioner should urge the patient, especially in cases where she might die, to make a statement that might be used if a charge were made, and that if a patient should die he should refuse to give a certificate and should communicate with the authorities.”

It would be seen how materially these directions differed from those of the Director-General of Health, said the coroner. If the medical practitioners of New Zealand governed themselves by the ruling of the Director.-General in preference to that of the Royal College of Physicians—and he was informed that certificates had been issued in similar cases—a situation of such gravity was disclosed as to call for corrective legislation, and it was his duty to report the matter to the Minister of Justice.