The Court of Appeal has spoken again on the extent of the obligations on the coroner to investigate deaths of those detained under the Mental Health Act 1983. The case of R (Allen) V HM Coroner for Inner North London (and others) 2009, which can be accessed here highlights the principles to apply and in particular considered the following:  

Whether the coroner should always call a jury when a detained patient dies  

It was held that the decision whether to summon a jury is a matter solely for the coroner. However, if he decides the death occurred in circumstances the continuance or possible recurrence of which is prejudicial to the health and safety of the public or any section of the public, then he should exercise discretion to call a jury.  

When is Article 2 engaged?  

There was a suggestion in the review process that Article 2 is only engaged (and hence an investigation with a wider scope required) when there is evidence of fundamental failure(s) which led to the death. This suggestion was rejected by the Court of Appeal. It emphasised that the vulnerability of detained persons, including mental health patients, is the reason why the obligation to protect their right to life under Article 2 is owed to them by the detaining authority.

It is worth remembering though, that this applies to patients detained by the NHS. For other patients, the requirement to hold an Article 2 inquest is less stringent. Coroners are much less likely to say Article 2 is engaged.  

Causation – how far reaching does the coroner’s inquiry have to be?  

The Court of Appeal decided that there was a limit to how far the coroner has to go with the inquiry. It is a matter of discretion which he needs to exercise in each case in order to elicit a conclusion on the central issue or issues.  

What is being investigated is what caused or may have caused or contributed to the death. If there is no causal link between an event or fact and the death then the link between the investigation and Article 2 is broken and the coroner does not have to inquire.  

A full Mills & Reeve briefing on the case can be accessed here