REFORMING MALAYSIA’S DEATH-INVESTIGATION SYSTEM: THE APPOINTMENT OF CORONERS AND THE ESTABLISHMENT OF THE CORONER’S COURT

Authors

DOI:

https://doi.org/10.18623/rvd.v22.n7.4057

Keywords:

Coroner System, Appointment, Death Investigation, Malaysia, Legal Reform, Comparative Study

Abstract

In Malaysia, Sessions Court judges perform coroner functions without dedicated training or institutional support, limiting the independence and effectiveness of death investigations. This article examines Malaysia’s coroner appointment framework and the absence of specialised Coroner’s Courts, contrasting it with the established systems in England and Wales, Australia, and Canada. Comparator jurisdictions appoint specialised coroners and operate purpose-built coronial courts with clear statutory mandates. The study identifies key structural gaps in Malaysia’s model and highlights the need for legislative reform, professionalised appointments, and independent coronial institutions to enhance accountability and public confidence. The reform proposals outlined, which include separating the coroner role from judicial duties, setting up a National Coroner’s Office, creating independent Coroner’s Courts, modernising legal frameworks, instituting comprehensive training, and implementing robust audit mechanisms, collectively aim to transform Malaysia’s coroner system into a world-class institution. These measures require legislative reform, institutional capacity building, dedicated funding, and political commitment despite possible resistance or initial costs.

References

Ab Rahman, N. H., Mohd Zahir, M. Z., & Althabhawi, N. M. (2023). Repercussions of COVID-19 lockdown on implementation of children’s rights to education. Children, 10(3), 474. https://doi.org/10.3390/children10030474.

Australian Coroners Information Council. (2018). National best practice for coroners. Australian Government.

Chief Coroner's Guidance No. 6. (2023). The appointment of coroners (Revised January 2025). HM Courts & Tribunals Service. https://www.judiciary.uk/guidance-and-resources/chief-coroners-guidance-no6-the-appointment-of-coroners-revised-january-2025/

Chief Coroner's Guidance. (2019). The role and responsibilities of coroners. HM Courts & Tribunals Service.

Chief Medical Examiner's Office. (2016). Coroner and medical examiner systems in Canada. Ministry of the Attorney General.

Coroners Act 1996 (WA). Western Australian Legislation. https://www.legislation.wa.gov.au/legislation/statutes.nsf/RedirectURL?OpenAgent&query=mrdoc_45934.pdf

Coroners Act 2003 (SA). South Australian Legislation. https://www.legislation.sa.gov.au/__legislation/lz/c/a/coroners%20act%202003/current/2003.33.auth.pdf

Coroners Act 2009 No. 41 (NSW). New South Wales Legislation. https://legislation.nsw.gov.au/view/whole/html/inforce/current/act-2009-041

Coroners Act, R.S.O. 1990, c. C.37. Ontario Legislation.

Coroners and Justice Act 2009. United Kingdom Parliament.

Creswell, J. W. (2014). Research design: Qualitative, quantitative, and mixed methods approaches (4th ed.). Sage.

Criminal Procedure Code (Act 593), ss. 329–341. Laws of Malaysia.

Cross, R., & Tain, N. (2010). Cross on evidence (12th ed.). Oxford University Press.

Fink, A. (2014). Conducting research literature reviews: From the Internet to paper (4th ed.). Sage.

Forsythe, W. (2009). The development of coroner systems: A comparative analysis. Journal of Forensic and Legal Medicine, 16(5), 234–249.

Gan Chee Keong. (2018). An overview of police custodial death cases in Malaysia. Saudi Journal of Humanities and Social Sciences.

HM Courts & Tribunals Service. (2020). Coroner's court: A guide for users. Ministry of Justice.

Judiciary UK. (2025). Coroners: Courts and tribunals judiciary. https://www.judiciary.uk/courts-and-tribunals/coroners-courts/

Lord Chancellor's Department. (2005). Coroners and justice: Implementation programme. UK Government.

Malaysian Bar Council. (2018). Report on the coroner system and proposed reforms. Malaysian Bar Association.

Malaysian Bar Council. (2022). Resolution on the coroner and inquests. https://www.malaysianbar.org.my/cms/upload_files/document/Resolution%20on%20the%20Coroner%20and%20Inquests.pdf

Malaysian Judiciary. (2017). Arahan Amalan Bil. 2 Tahun 2014. Federal Court of Malaysia.

Matthews, P. (2007). Coroner systems in common law jurisdictions: A comparative review. International Journal of Law and the Courts, 12(4), 412–428.

Mohd Zahir, Mohd Zamre, T. N. A. T. Zainudin, R. Rajamanickam, and Z. A. Rahman. “Arahan Do Not Resuscitate (DNR) dalam Sektor Kesihatan dari Perspektif Undang-Undang (Do Not Resuscitate (DNR) Order in Health Sector from the Legal Perspective).” Akademika 89 (2019a): 143–54.

Mohd Zahir, Mohd Zamre, T. N. A. T. Zainudin, H. Yaakob, R. Rajamanickam, H. Harunarashid, A. A. Mohd Shariff,Z. Abd Rahman, and M. Hatta. “Hak Pesakit bagi Melaksanakan Arahan Awal Perubatan: Suatu Gambaran Umum(The Patient’s Right to Implement Advance Medical Directive: An Overview).” Sains Malaysiana 48 (2019b): 353–359.

Na’aim, M. S. M., Mohd Zahir, M. Z., Rajamanickam, R., Dahlan, N. K., & Hashim, H. (2025). Analysing ministerial reasons for banning books under the Printing Presses and Publications Act 1984. Malaysian Journal of Syariah and Law, 13(2), 401–412.

Noorfajri Ismail, F. N. Dusuki, & N. 'Ain Abdul Rahim. (2024). Penubuhan Mahkamah Khas Koroner: Suatu revolusi dalam sistem kehakiman di Malaysia. Jurnal Undang-Undang Malaysia, 38(1), xx–xx.

Office of Chief Justice. (2019). Practice Direction No. 2 Year 2019 on coroner procedures. Federal Court of Malaysia.

Office of the Chief Coroner. (2019). Inquest information guide. Ontario Government.

Payne-James, J., Busuttil, A., & Smock, W. (Eds.). (2013). Forensic medicine: Clinical and pathological aspects. Edinburgh University Press.

Roberts, A., & Anderson, D. (2012). Forensic investigation and the coroner: Comparative practices in Commonwealth nations. Forensic Science International, 219(1–3), 45–52.

Saner, B. (2010). Judicial independence in coroner systems: An examination of international models. Judicial Independence Review, 18(2), 167–185.

Shamshol Azwa Martadza, & Muhamad Helmi Md Said. (2023). Hak asasi manusia dalam proses siasatan kematian di Malaysia: Suatu penilaian semula. Kanun: Jurnal Undang-Undang Malaysia, 35(1), 39–64.

Suhakam. (2021). Report on human rights and death investigations in Malaysia. Human Rights Commission of Malaysia.

Wigmore, J. H. (1970). Evidence in trials at common law (Rev. ed.). Little, Brown and Company.

Downloads

Published

2025-12-18

How to Cite

Wahab, M. H., Rajamanickam, R., & Zahir, M. Z. M. (2025). REFORMING MALAYSIA’S DEATH-INVESTIGATION SYSTEM: THE APPOINTMENT OF CORONERS AND THE ESTABLISHMENT OF THE CORONER’S COURT. Veredas Do Direito, 22, e224057. https://doi.org/10.18623/rvd.v22.n7.4057