HALIFAX -- Nova Scotia's medical examiner says he'll consider ordering a public inquiry into the death of a former Canadian soldier who fatally shot his wife, daughter and mother if a provincial review of the man's mental health treatment doesn't lead to changes.

The provincial Justice Department had provided a statement last week stating Dr. Matthew Bowes had decided against ordering a judicial inquiry into the death of Lionel Desmond, a 33-year-old veteran of the war in Afghanistan who suffered from post-traumatic stress disorder.

But Bowes clarified Thursday that if he concludes a hospital review of Desmond's treatment was incomplete, he'd consider using his rarely exercised power to call for a judicial inquiry under the province's Fatality Inquiries Act.

"Certainly, for me, it's a 'No' right now because for me it doesn't make sense to order a public policy renewal mechanism when there's already one occurring," he said in a telephone interview.

"But I'll be watching the results of that (review) very thoroughly, and if it's not satisfactory and it's not comprehensive, if it's not fulsome and it doesn't result in recommendations and if it doesn't result in system change I'm certainly willing to re-examine that issue."

Desmond took his own life after shooting his 52-year-old mother, his wife Shanna, 31, and their 10-year-old daughter Aaliyah.

The Jan. 3 killings in Upper Tracadie, N.S., prompted a difficult debate over soldiers with PTSD, domestic violence and what should be done to prevent such tragedies.

Catherine Hartling, Shanna Desmond's aunt, has called for some form of public inquiry.

Hartling has said some family members want to find out more about Desmond's treatment and the mental health care he was supposed to receive, but remain too devastated by the events to speak publicly about their desires for an inquiry.

Bowes said he hasn't contacted the families, but would take their views into consideration if he does speak to them.

Desmond served in Afghanistan in 2007, and had received treatment from a joint personnel support unit for a year prior to his release from the military in July 2015. Such units provide support to ill and injured soldiers, including mental injuries.

Relatives of Desmond have said that after his release he had also sought treatment from the mental health unit at St. Martha's Regional Hospital in Antigonish.

Following the deaths, Premier Stephen McNeil said the province's health authority will review what services were provided and what protocols were followed.

However, that review is conducted under the province's Quality Improvement Information Protection Act and is kept confidential, though next of kin are eligible to receive a list of recommendations.

Bowes -- who has been medical examiner for 13 years -- said in an interview that he was inquiring with the health authority about what portions of the report he would be receiving, adding he hadn't yet viewed the detailed report or its recommendations.

PTSD has been the top diagnosis for the hundreds of troops released from the military for medical reasons every year since at least 2014. Some 18 military personnel took their own lives in 2015, many of whom had sought some type of mental-health treatment shortly before their deaths.

The Canadian Forces and Veterans Affairs have opened specialized clinics, hired more staff and cut red tape in recent years to provide better care and support as more military personnel have come forward seeking help for PTSD and other disorders.

But some are questioning whether Ottawa and the provincial health authorities have done enough.

Robin Whitford, an Ottawa resident whose husband suffered from PTSD after serving in the military, said in an interview Thursday that the failure to order a public inquiry into the Desmond case prompted her to write a letter to the prime minister on Wednesday.

"A government that says it cares about the well being of all soldiers, veterans and their families, would surely want to know how this could have happened," she wrote in the letter.

"With the amount of money and resources that is spent on the very programs and services that are supposed to help support injured vets and their families should we simply accept these kinds of tragedies as unavoidable consequences of war?"

"Please show us that this is not acceptable, that the lives of the Desmond family mattered."