In a recent judgment, the court has confirmed that, in circumstances where a prisoner’s death is clearly due to natural causes, the procedural obligation under Article 2 ECHR is not engaged.

This case involves a prisoner who was diagnosed with a rare and notoriously difficult to diagnose type of cancer. Chemotherapy and radiotherapy were undertaken but Mr Tyrrell developed bilateral pneumonia from which he died. This cause of death was confirmed during the post mortem examination. As would be expected, the death was investigated by the Prisons and Probation Ombudsman (PPO) with the assistance of a clinical reviewer. Notwithstanding comments made by the PPO as to the management of Mr Tyrrell as a prisoner during his illness, the PPO was satisfied that the clinical care given to Mr Tyrrell was equivalent to that which he would have received in the community.

The coroner then instructed his own expert to conduct a review of the treatment. The expert was not critical of the care received, nor of the treatment given. In the circumstances, the coroner did not consider that any further action was required by him under Article 2 and consequently his investigations were concluded. The family brought a claim for Judicial Review on the basis that a Middleton type (i.e. a wider scope) inquest should have been held.

The court was of the view that, whilst the positive obligations under Article 2 were engaged (as they would be for any death which occurs in custody), there was no reason to suspect that the state, in the guise of the prison authorities, had failed to protect his health and well-being. Consequently, the procedural obligations were not triggered. Going further, the court stated that: ‘in the context of a natural death in custody the responsibility of the state for the purposes of the duty to protect life will arise only if there has been a failure to provide timely and appropriate medical care to a detainee obviously in need of it’ [33].

This case endorses the Chief Coroner’s Guidance No 16 relating to those who die subject to Deprivation of Liberty Safeguards. Whist that guidance is not specifically applicable to those in custody at the time of their death, there is a clear correlation of the principles involved.