World without borders: integrating clinical perspectives into the coronial jurisdiction in Victoria, Australia.

A professional world without borders would allow for more appropriate collaboration between the Coroner's office and the healthcare sector in their endeavours to improve patient safety. In Victoria (Australia), the Clinical Liaison Service draws on the distinct experiences and expertise of medical, nursing and research personnel to evaluate clinical evidence for the investigation of healthcare deaths reported to the State Coroner's Office. This approach allows for greater intersectoral collaboration between the Coroner's office and healthcare sector than a traditional English-style coronial system that relies on the expertise of coroners, forensic pathologists and police officers to investigate unexpected deaths. Encouraging collaboration between these two sectors may have averted or at least mitigated the atrocities caused by Harold Shipman or the events at Bristol's Royal Infirmary. This paper describes the work processes employed by the Clinical Liaison Service (CLS) to investigate healthcare deaths in a coronial setting. To describe how this work has fostered the advancement of patient care.

Experience with practice guidelines for medico-legal death investigations: the case of falls-related deaths in hospital.

Western philosophical and political thought has focussed on the significance of individual relativism. The legal system's approach to the investigation and regulation of medical practice is generally ad hoc and based on case law. In contrast, medical knowledge and understanding is progressively shifting towards a system of taxonomies and norms. Clinical guidelines and evidence-based medical practice are now commonplace in clinical practice. Due to the polarity of professional frameworks underpinning medicine and law, there has been an on-going struggle for the successful use of medical law that benefits both the quality of medical practice as well as its practitioners. This paper discusses the principles in developing and implementing a standard investigation tool for the coronial sector using the Falls Investigation Standard as an example, which has been in use for 12 months in the state of Victoria, Australia. It is hoped that using a standardised tool can balance the often conflicting tensions between medical and legal sectors by enabling an in-depth review of each issue while also strengthening the health system's capacity for self-regulation.