The provision of biochemical investigations in forensic toxicology for coroners

Abstract

The narrative of this thesis travels through the areas of the coroners acts especially in the Republic of Ireland and the United Kingdom where forensic biochemistry plays a role in the specification of the causes of deaths. There is a deconstruction of the place of doctors in the coronial system and in the new arrangements following the passage of the Coroners and Justice Act 2009 in England and Wales and the potential for change in the Coroners Bill in the Republic of Ireland which fell with the dissolution of the Dail in 2011.

There is an examination of the autopsy guidelines issued by the RC Path and suggestions for change which have been published. There is an analysis of the place of cannabinoids in coroners’ cases and publications setting out the position are included.

A series of recommendations are made regarding improvement in practice for the reporting of biochemical toxicology in the coronial system. Two cases where there appears to be potential misinterpretation of the toxicological evidence, which may result in the review of the causes of death, are detailed as relevant clinical examples.

Some laboratory pitfalls in relation to alcohol analysis have been demonstrated and the consequences of a protocol free service have been detailed with a prescription for improvement and practical solutions to improve outcomes. The under-estimation of the impact of tobacco toxicity is also addressed as is the potential for error due to lack of appreciation of drug-drug interactions. The role of biochemistry in the post-mortem diagnosis of alcoholic and diabetic ketoacidosis is discussed. Multidisciplinary reviews of biochemical toxicology for the coroners’ court are suggested as the best safeguard of accurate interpretation to assist coronial enquiry.

Conclusions suggesting standard operating procedures for post-mortem scenarios are detailed where possible.

Date of Award	Oct 2012
Original language	English
Supervisor	Tara Moore (Supervisor) & Heather Browne (Supervisor)