Since the last edition of this book several significant events, notably the conviction of Dr Harold Shipman for the murder of a number of his patients and separate concerns about organ retention following inquiries into events at Alder Hey Hospital and elsewhere, have focused the attention of the general public and the legal and medical professions on the systems in place for the investigation of sudden death. Much notice was directed to the fact that Dr Shipman himself was able to certify the deaths as natural, thereby avoiding referral to and scrutiny by the coroner service. At the present time, coroners can legally respond only to referrals, and lack the legal powers to screen all deaths pro- actively.

Since the conviction of Dr Shipman, three separate inquiries into different aspects of the investigation and certification of sudden death have been held. Some of the resulting proposals will be looked at later but, despite the publication of a draft Coroners Bill in 2006, at the time of writing the law remains unchanged, as stated below. The coronership continues to respond to and investigate those deaths which have been referred to it for a wide variety of reasons (approaching nearly one half of all deaths in England and Wales, an increase from the previous level of just over one third), rather than screening all deaths that occur, whether in the community or in hospital, and then determining which ones should be subjected to further scrutiny.