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Ontario Strengthening Death Investigation System

Archived News Release

Ontario Strengthening Death Investigation System

Government Supports Changes to Increase Accountability and Transparency

Ministry of the Solicitor General

Ontario plans to expand the role of forensic pathologists, strengthen the inquest process and broaden the role of the Death Investigation Oversight Council to ensure public safety is being served by a high-quality death investigation system.

The changes include:

  • Appointing forensic pathologists as coroners for cases of suspicious death or homicide. Under the new model, forensic pathologists will be responsible for death investigations in cases that may also involve the criminal justice system, ensuring families and police benefit from their forensic expertise throughout death investigations and in court.
  • Expanding the role of the Death Investigation Oversight Council - the first of its kind in Canada - by allowing the council to advise the Chief Coroner on whether to call discretionary inquests.
  • Exploring options that would allow the Chief Coroner the flexibility to assign a lawyer or judge to preside over inquests with complex legal issues.
  • Posting recommendations from inquests online, making them more accessible to the public.

Ensuring Ontario maintains a death investigation system in which coroners and forensic pathologists play vital and complementary roles in protecting and improving public safety is part of the Ontario government's plan to create safe communities and a fair society.

Quick Facts

  • The Office of the Chief Coroner investigates approximately 16,000 deaths per year across Ontario.
  • Currently, approximately 6,000 of these cases require an autopsy, performed by a forensic pathologist.
  • Forensic pathologists appointed as coroners will conduct end-to-end death investigations in approximately 250 death investigation cases annually. This will account for approximately 1.6 per cent of all cases. The new model will be reviewed after two years.
  • The Death Investigation Oversight Council (DIOC) provides independent oversight of Ontario’s coroners and forensic pathologists by ensuring that death investigation services are effective and accountable.
  • Following a competitive bidding process, from 2011-2012 KPMG performed a review of Ontario’s death investigation system for the Chief Coroner and Chief Forensic Pathologist.

Additional Resources


“Ontario has emerged as a world leader in providing death investigations in an accountable, professional and expert manner. These next steps will ensure we continue to lead in providing outstanding service to families, the public and the criminal justice system.”

Madeleine Meilleur

Minister of Community Safety and Correctional Service

“The Death Investigation Oversight Council is unique in Canada. We would welcome an expansion of our role in providing advice to the Chief Coroner and Chief Forensic Pathologist, always keeping foremost in our minds the needs and concerns of the people of Ontario.”

Hon. Joseph James

Chair of the Death Investigation Oversight Council

“The measures we are announcing today support our continued evolution as a high-quality death investigation system, in which coroners and forensic pathologists collaborate and play complementary roles in protecting and improving public safety.”

Dr. Dirk Huyer

Interim Chief Coroner for Ontario

“The field of forensic pathology has grown tremendously in recent years with improved training, education and oversight. It is my belief that having forensic pathologists accountable from beginning to end for cases involving suspicious deaths will result in better service to families and criminal investigators, as well as more comprehensive court testimony.”

Dr. Michael Pollanen

Chief Forensic Pathologist for Ontario

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