Coroners and Justice Bill

My noble friend Lord Alton of Liverpool has explained the background to the first amendments in this group. I should like to focus on the amendment that is solely in my name, Amendment 72A, and explain the thinking behind it. It may not be correctly worded but I hope that we can make some progress on the principle behind it and end up with a short death certificate, or possibly a series of two that are fit for purpose. The first instance, referred to in paragraph (a) of the amendment, covers cases where such certificates are needed, ""to confirm that death has occurred prior to the full death certificate being provided"." That is meant to deal specifically with brain-stem death. When somebody is diagnosed brain-stem dead, the diagnosis is made on the basis of brain-stem-death testing conducted by two doctors according to a clear protocol. The doctors usually, though not always, conduct the tests with a time gap in between, and they usually, though not always, witness each other's testing. However, the family is told that the time of death is the time of the second brain-stem-death test occurring. That is the time when the person is stated to have died. However, their heart may continue to beat and they may continue to be ventilated. It is in such situations that the family is approached about becoming an organ-donor family. For the family, the whole situation is incredibly distressing. It is very difficult for them to believe that the pink, well-perfused, warm body in front of them is indeed dead, particularly when they see the chest rise and fall, there is still a pulse, and so on. However, the person is already brain-stem dead. He is irreversibly dead. Some intensive care units issue their own certificates to such families to help them understand that the person is brain-stem dead and to help them cope with the subsequent process of organ donation. I have tabled the amendment to try to standardise the format of that certificate and to improve practice. Sadly, there are some families who have declined to donate organs because they had not understood that the person was dead. Indeed, I know of one instance, which to my shame occurred in Wales, in which a consultant whom I know gave the family inappropriate information about the child. The family believed that the child would not be certified dead until after the organs had been harvested. It was a disaster and the family understandably declined to donate organs. The amendment would therefore clarify for the public the point at which death has occurred. It would give them a piece of paper with force in law which states that that was the time of death. After that the organs can be harvested from either a heart-beating or a non-heart-beating donor. The second situation, dealt with in paragraph (b) of the amendment, is quite different. I fully accept that it is possible that I should not have dealt with both situations in one amendment and that it might be better if they were dealt with in regulation and secondary legislation rather than in the Bill. However, this provision deals with the situation, which has already been alluded to, where there has been a death, particularly in a small community, which the family understandably do not want all and sundry to know about, especially when they have to contact utility companies and so on. Perhaps there is a hereditary illness of which others in the family have not been informed. Indeed, the death may have come as such a shock that they are not ready to cope with the implications for themselves and their own children. It may be a death of which they are deeply ashamed; it may involve suicide, drug addiction, alcoholism and so on. It is not necessary for utility companies to know why someone has died, but it is necessary for them—and for housing authorities and so on—to know that someone is dead. That is the purpose of having a short death certificate. It would afford a degree of privacy to the person who has died when the cause of their death does not need to be known for the legal purposes following death. I hope that that clarifies the situation that I am trying to achieve with the amendment.