Ontario coroners to retain control of death investigations
But forensic pathologists likely to be given expanded role
Forensic pathologists will likely be given an expanded role in Ontario death investigations that will fall far short of what they wanted, The Canadian Press has learned.
Nevertheless, coroners continue to fret that pathologists have not given up on a quest to take over entirely.
In an interview this week, Community Safety Minister Madeleine Meilleur indicated she would set aside recommendations from a systemic review of death investigations that coroners viewed with deep suspicion.
Instead, Meilleur suggested she would adopt a joint proposal from the province's chief coroner and chief forensic pathologist that would leave the system firmly under coronial control.
Among other things, Chief Coroner Dr. Andrew McCallum and Chief Forensic Pathologist Dr. Michael Pollanen suggested willing pathologists should be appointed as coroners — but could not then do autopsies.
They also recommended pathologists be allowed to offer an opinion on the cause of death in autopsy cases, and a process be developed to resolve any conflict with the coroner in charge.
Currently, death-investigation services are provided by both the Office of the Chief Coroner and the Ontario Forensic Pathology Service.
Coroners investigate and determine how someone died. Pathologists only get involved when a coroner calls for an autopsy, but the coroner remains responsible for certifying the cause of death.
"We will continue with the two parallel systems," Meilleur said.
"There may be a way for them to get together, and I feel the recommendation that is put forward by the two chiefs would do that."
The chiefs' recommendation is different from those contained in a government-commissioned KPMG review that had alarmed coroners.
Among other things, the $300,000 systemic review recommended pathologists be designated as special coroners to take over investigations where autopsies are requested, shutting coroners out.
Ontario's coroners, most small-town doctors who do the work on the side, feared that would lead to a model in which civilians investigate deaths under pathologist control.
Although pleased by the joint recommendation to leave coroners in charge, the Ontario Coroners Association remained fretful they had won the battle, but not the war.
"Unfortunately, the situation that led to this systemic review has not changed (and) there will continue to be a push for a medical-examiner system," Dr. Louise McNaughton-Filion, association president, wrote to her members last week.
"We need to have a decision, once and for all, that the coronial system will remain for the people of Ontario and that forensic pathologists can do their valued work, but in a separate institution."
Neither Pollanen nor McCallum would comment as they prepare to talk to coroners and pathologists about the KPMG review and their proposal at a panel discussion this weekend in Toronto.
Meilleur said she wanted to hear from the two groups before announcing the changes, likely after Christmas.
She was also defended the review, which coroners said was driven by power-hungry pathologists.
"It's important that periodically we check to make sure that our system is as high quality and as sustainable and effective as possible," she said.
Dr. Alan Drummond, of Perth, Ont., a part-time coroner for almost 20 years, said he was relieved by the joint submission.
"The benefit of a physician-based system is our ability to compassionately relate to the concerns of families and our innate ability to advocate for both them and for required system change," Drummond said.
"Neither of the other two scenarios would have provided loved ones what they really need: an empathetic ear and a passionate desire to lessen preventable death."
Meilleur noted no one wants to go back to the recent past of Dr. Charles Smith, whose shoddy pediatric forensic pathology ruined lives and led to wrongful convictions.
She praised Pollanen for developing a top-notch pathology system in Ontario following a public inquiry prompted by Smith's work, and said pathologists deserved a larger role in death investigations.