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This country’s legal measures were reviewed by our legal staff in consultation with in-country lawyers and/or CRVS legal experts. All efforts were made to ensure the accuracy of the legal analysis, however, if you consider there to be any discrepancies or if there have been changes in the law of the country since our staff last updated the legal analysis, we welcome any additional information or insights. Please contact us via this form.
Medicolegal Death Investigation
Zambia
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Death Registration
Declaration and Notification
Informants
Who is designated as the primary informant for unnatural or suspicious deaths?
Other
Recommended Practice based on International Guidelines
To ensure that unnatural and suspicious deaths are registered, legislation should clearly specify who is responsible for reporting the death to the registrar. The primary informant for an unnatural or suspicious death should be an officer of the mediolegal system, regardless of whether the death occurred with or without medical supervision.
Such officers may include: coroners, medical examiners, police or other medicolegal officers. Responsibility should not be placed on the family, as that may result in the death not being declared to the registrar.
If a person has died in circumstances that could necessitate an inquest, any person becoming aware of the death has a duty to immediately inform a coroner, police officer, chief, headman or district messenger. If the notice is given to anyone other than a coroner, that person must convey the information to the coroner. The usual duties to notify a death to the Registrar of the district where the death occurred also apply in such circumstances.
In addition, any person who finds an “exposed body", any person taking charge of such a body and any person causing such a body to be buried all have a duty to give notice of the death to the relevant Registrar.
Death Registration
Procedure and Certificates
Evidence
What evidence or documents are required for on-time death registration?
Medical Certificate of Cause of Death
Recommended Practice based on International Guidelines
Registrars should require proof as to the veracity of the information to be registered. Proof or evidence required for registration must be sufficiently stringent to provide assurance of the accuracy of the information without being so burdensome as to discourage or prevent registration. Documentary evidence is always preferred. Ideally all deaths will have an accurate, detailed medical certificate of cause of death (MCCD). However, in many contexts this will not be possilbe. Lack of MCCD should not prevent death registration; evidence of fact of death should be sufficient to register death. Evidence of fact of death could be a notification of death or other similar document, Witness Statement or other similar evidence.
The form for giving notice of a death (Form XIII) requires the informant to provide a copy of the informant's identity document along with certain documentation, depending on the circumstances of the death. For a death that occurred in a health facility, the informant must include the original medical certificate of the cause of death. For a death that occurred at home, the informant must provide a letter from a traditional leader on cause of death, but there are no directions on what form this letter must take, or what information it must include. Where a body was discovered and brought in dead, a police report must be attached; alternatively, the police must complete a section of the notice form concerning details about the death. In the case of a death from unnatural causes, the coroner’s report must be attached. According to Rule 34(4) of the Births and Deaths Registration (General) Rules, a Registrar is not allowed to register a death without a medical certificate of cause of death or a coroner’s certificate provided at the conclusion of an inquest. However, the form for Notice of Death appears to contemplate the alternatives of information from the police or a letter from a traditional leader in specified circumstances.
The regulations to the National Registration Act state that a death certificate will be issued only after the Registrar has been provided with the deceased’s National Registration Card, and in practice the Ministry requires that the Notice of Death must be accompanied by the deceased’s National Registration Card or passport.
Death Registration
Medicolegal Death Investigations
Medicolegal Death Investigations Authority
Does the law clearly state what types of cases must be referred to the MLDI authority and is this in accordance with international guidance?
Yes
Recommended Practice based on International Guidelines
Deaths due to known or suspected unnatural or external causes should be referred to the Medicolegal Death Investigation (MLDI) authority. This includes deaths due to violence, injury, self-harm, suspicious causes, and sudden, unexplained or unexpected deaths. The types of cases that must be report to the MLDI system are usually contained in a code of criminal procedure, rather than in the civil registration law .
In terms of the Inquests Act, inquests may be held when there is reasonable cause to suspect that a person has died a violent or an unnatural death, or in prison or in police custody, or in any place or circumstances which, in the opinion of the coroner, makes the holding of an inquest necessary or desirable. Any person finding a body or becoming aware that a person has died in circumstances that could necessitate an inquest has a duty to immediately inform a coroner, a police officer, a chief, a headman or a district messenger; if the notice is given to anyone other than a coroner, that person must convey the information to the coroner
Under the Births and Death Registration Act, a medical practitioner who attended the deceased and believes that their death did not result from natural causes, is required to not issue a medical certificate of cause of death (MCCD). The medical practitioner is also rquired to report the case directly to a magistrate (who serves as a coroner) to initiate an investigation. In addition, in any case where no MCCD is issued, the Registrar must notify the nearest magistrate or police officer as another avenue to initiate the investigation process.
What type of medicolegal death investigation (MLDI) system does the country have?
Coroner System
Recommended Practice based on International Guidelines
MLDI systems can be categorized into four types: law enforcement-led systems, coroner systems, medical examiner systems, and coroner/medical examiner hybrid systems. There is no best practice. All four types of systems are capable of providing quality information to the 5 MDLI questions: 1) Who died (i.e., what was the person’s name, if known)? 2) When did the death occur? 3) Where did the death occur? 4) What was the cause of death? and 5) What was the manner of death (e.g., natural, accident, suicide, homicide, or undetermined)?
Death Registration
Medicolegal Death Investigations
Death in custody
Does the law mandate that law enforcement and/or heads of custodial institutions report all deaths in custody to the medicolegal death investigation authority?
Yes
Recommended Practice based on International Guidelines
All deaths in custody should be viewed as potentially unlawful or suspicious deaths and
should therefore be referred to the medical-legal authorities. “Deaths in custody” refers to those deaths in which the circumstances of the death place the decedent in either direct or indirect contact with law enforcement in such settings as incarceration, apprehension and pursuit. For deaths that occur in a detention facility, the head of the detention facility or the head of health services within the detention facility should initiate the process of notifying the medical-legal authorities. For deaths that occur during pursuit or apprehension, the police chief should refer the death to the medical-legal authorities.
Inquests must be held in every case where the deceased was a prisoner, a person in the custody of a police officer or a person detained in custody under a detention order. It is the duty of the prison officer having charge of a prisoner, or the police officer or other person having charge of a detained person to give notice of the death to the coroner for the jurisdiction where the death occurred.
The law is silent on deaths that occur during pursuit or other forms of direct or indirect contact with law enforcement.
Does the law clearly state who is responsible for medically certifying cause of death when deaths are unnatural or suspicious, or otherwise referred to the MLDI authority?
Yes
Recommended Practice based on International Guidelines
Deaths due to unnatural causes (such as accident, self-harm or violence); man-made or natural disasters; suspicious causes, or where CoD cannot be determined by the attending physician should be referred to the Medicolegal Death Investigation (MLDI) authority for medical certification of cause of death. The certifier of cause of death should be the forensic physician working with the MLDI authority who conducted the post-mortem examination on the deceased.
If an inquest takes place in terms of the Inquests Act, the cause of death will be determined in the course of the inquest. There is no explicit direction about transmission of inquest findings to the Registrar, but Rule 36 of the Births and Deaths Registration (General) Rules directs the Registrar to record the information from the coroner’s certificate in the register after an inquest.
The coroner has discretion to dispense with an inquest if it appears to the coroner that the death was due to natural causes, either on the basis of a post-mortem examination conducted by a medical practitioner or otherwise. It is not clear in the latter situation how the cause of death is determined and reported to the Registrar.
Cause of Death
Medical Certification
Medical Certificate of Cause of Death Form
Is the same form used for all types of deaths, including natural deaths and deaths referred to MLDI?
No
Recommended Practice based on International Guidelines
It is recommended practice to use the same MCCD form which should be WHO MCCD compliant) for all types of deaths, including natural and unnatural deaths (and fetal deaths).
The medical certificate of cause of death for natural deaths is “Medical Form No. 14”, which is referenced but not prescribed by Rule 33 of the Births and Deaths Registration (General) Rules. An additional, more detailed cause of death form is prescribed for completion by a medical practitioner who attended the deceased during his or her last illness as a pre-condition for cremation (Form 2 in the Public Health (Crematoria and Cremation) Regulations). Where a death is referred for a possible inquest, there are two forms that request information on the cause of death - one for the post-mortem examination conducted by a medical practitioner on the order of the coroner (Coroner's Form 3), and one to be completed by the coroner at the conclusion of the inquest (Coroner's Form 5).
Cause of Death
Transmission of Cause of Death Data
Transmission of Cause of Death Data
For a death referred to the MLDI system, does the law specify how cause of death information is transmitted to the civil registrar and/or statistics agency?
Yes for transmission of information to civil registrar
Recommended Practice based on International Guidelines
The law should designate who is responsible for submitting the MCCD or cause of death data to the civil registration authority and/or the national statistics agency in cases of deaths investigated by the MLDI system. Responsibility may be place on the forensic physician that certified the cause of death or an official within the MLDI system, such as the coroner, medical examiner, or police officer. In some countries, this person will submit the MCCD or cause of death information to the civil registration agency, which in turn will submit COD data to the national statistics agency. In other countries, this person will submit the MCCD or cause of death data directly to the national statistics agency. The MCCD should not be given to the family as a means of transmission.
The Notice of Death form that informants must submit to the Registrar (Form XIII in the Births and Deaths Registration (General) Rules) requires that the coroner’s report must be attached if the death resulted from unnatural causes. Section 18(9) of the Births and Deaths Registration Act states that, where the cause of the death has been determined by a coroner's inquest, the cause of the death recorded by the Registrar-General in the Register of Deaths must be the cause determined by the inquest. There is no explicit direction about transmission of inquest findings to the Registrar, but Rule 36 of the Births and Deaths Registration (General) Rules refers to the receipt of the coroner’s certificate by the Registrar.
