Bereavement abroad through homicide or culpable homicide - support: memorandum of understanding

10. Death Certification Review Service (DCRS)

Although the primary drivers for the introduction of the DCRS were the improvements in quality and accuracy of Medical Certificates of Cause of Death (MCCDs) issued in Scotland, better public health data and enhanced clinical governance, the commencement of the service also included a review of documentation of deaths outwith the United Kingdom prior to burial or cremation taking place. Previously, a function of this nature was performed by Scottish Government directly and only applied to cremation.

Specifically, the Certification of Death (Scotland) Act 2011 required that a medical reviewer must, on the request of a relevant person, determine whether the documentation relating to the person being repatriated is in order.

The statute states that documentation is in order if it appears to the medical reviewer to be authentic, and equivalent to the certificates or other documentation required under the Births, Deaths and Marriages (Scotland) Act 1965 (offence of disposal of body without authorisation) for the interment, cremation or disposal by other means of the body of a person who died in Scotland.

Section 19 of the Certification of Death (Scotland) Act 2011 allows for a post-mortem examination of a person who died outwith the United Kingdom in certain limited circumstances where no cause of death is available. If the case is eligible for this reason, the autopsy will be paid for by DCRS.

The definition of what constitutes ‘no cause of death is available’ has not been straightforward to interpret as, at the time of application, a definitive diagnosis may not yet be available to the family.

DCRS has a standard operating procedure it invokes where the circumstances of the death abroad require reporting to the PF.

The purpose of the standard operating procedure is to ensure a consistent and professional approach in relation to verifying foreign death certificates as set out within the Certification of Death (Scotland) Act 2011 and incorporating the requirements of the Inquiries into Fatal Accidents and Sudden Deaths etc. (Scotland) Act 2016, by specifying the circumstances whereby the Medical Reviewer (MR) or Senior Medical Reviewer (SMR) will report deaths abroad to the PF.

Essentially, a medical reviewer considering a request to repatriate a body to Scotland from outwith the UK must report that death to the PF, if the deceased had been ordinarily resident in Scotland at the time of the death and the death was:

• Sudden, suspicious or unexplained; or
• Arose in circumstances giving rise to serious public concern; and
• The circumstances have not been sufficiently established in the course of an investigation in relation to the death.

The guidance indicates that the following factors may lead to an investigation by COPFS and should be reported to the PF. The list is not exhaustive. The MR may contact the PF to seek advice if required.

• Concern raised by the family/guardian/next of kin/relevant other;
• Death from trauma (e.g., this may include accident, suicide, etc); or
• Suspicious deaths abroad whether or not the local jurisdiction has investigated or is currently investigating.

To this extent, it will always be helpful to know if the nearest relatives wish further investigation (including an additional post mortem examination) in Scotland.

Because the PF’s locus is confined to cases where the deceased is ordinarily resident in Scotland, it is conceivable this could result in SFIU concluding they have no legitimate interest in the case.

In the above situation, if no cause of death is available, it may still be open to DCRS to instruct an autopsy.