Mclean Maxwell
J Clin Pathol. 2017 Sep;70(9):787-791. doi: 10.1136/jclinpath-2017-204333. Epub 2017 Apr 10.
National coroner data demonstrate differences in the rates at which coroners across England and Wales choose to investigate reported deaths and the frequency by which they record certain conclusions. This study sought to examine how decisions are made by coroners and whether they differed when faced with identical case information.
Three different clinical scenarios were circulated via a web link to all senior coroners. The case information was contained within a 'Decision Board' displayed on screen. Each scenario had nine consistent categories of information, such as the cause of death and the medical history. Participants were asked to indicate an inquest conclusion (verdict) using free text and to provide comments. The way in which participants accessed the case information (order, frequency, etc) was recorded by the computer software.
35 coroners responded. There was little consensus as to conclusion with scenarios 1 and 2 generating four different outcomes and scenario 3 generating an extraordinary eight different conclusions among respondents. Despite coming to widely different conclusions, coroners demonstrated very similar decision-making processes. Conclusions were robustly defended yet proffered alternatives were plentiful. The comments made indicated a difference in the personal attitudes of coroners towards case information.
Different coroners faced with identical case information arrived at widely different case outcomes ranging from no further investigation to finding numerous alternative verdicts. Disparity appeared to be a product of differing personal attitudes among coroners. National coroner consensus to achieve a shared inference from available evidence is urgently needed.
国家验尸官数据显示，英格兰和威尔士各地的验尸官对报告死亡事件展开调查的比率以及记录某些结论的频率存在差异。本研究旨在探讨验尸官是如何做出决策的，以及当面对相同的案件信息时他们的决策是否会有所不同。
通过网络链接向所有资深验尸官发送了三种不同的临床场景。案件信息包含在屏幕上显示的“决策板”中。每个场景都有九个一致的信息类别，如死因和病史。要求参与者使用自由文本指明死因调查结论（裁决）并提供评论。计算机软件记录了参与者获取案件信息的方式（顺序、频率等）。
35名验尸官做出了回应。对于场景1和场景2，在结论方面几乎没有达成共识，分别产生了四种不同的结果；而对于场景3，受访者中竟产生了八种不同的结论。尽管得出了截然不同的结论，但验尸官们展示出了非常相似的决策过程。结论得到了有力的辩护，同时也提出了大量的替代方案。所给出的评论表明验尸官对案件信息的个人态度存在差异。
面对相同的案件信息，不同的验尸官得出了截然不同的案件结果，从不再进一步调查到得出众多不同的裁决。差异似乎是验尸官个人态度不同的产物。迫切需要全国验尸官达成共识，以便从现有证据中得出共同的推断。
