A post mortem examination or autopsy is a medical examination of a body after death, carried out for a coroner. Most examinations performed in England and Wales are conducted by a pathologist of the coroner’s choice with the purpose is to establish the medical cause of death. All suspicious deaths are performed by forensic pathologists who are on the ‘Home Office List’.
The coroner does not require consent of relatives or other for a post mortem examination to be made. The coroner will inform ‘interested persons’ of when and where the autopsy will take place if those persons have notified the coroner of their desire to attend the autopsy, unless it is impractical to notify them or to do so would cause the examination to be unduly delayed.
The people entitled to notify the coroner of their desire to attend include the deceased’s relatives and the deceased’s medical practitioner. Such persons are not entitled to be personally present but are entitled to be represented at the examination by a doctor of their choice and are responsible for any fees.
The Chief Officer of Police may also be represented at the post mortem examination if a notification is sent to the coroner.
Second Post Mortem
The coroner, if necessary, may arrange for a second post mortem.
If after the autopsy concerns remain about the cause of death, the relatives and other interested persons may ask the coroner for a further post mortem examination. Any such examinations would be at their own expense.
In cases where someone has died as a result of a criminal activity and a suspect has been apprehended who may be charged with a serious criminal offence, that person or their legal representation may request a further autopsy.
Is there an alternative?
Alternative methods of examining bodies after death, such as MRI, CT and minimally invasive post mortem are performed at a few specialist centres but are not widely available in all circumstances due to cause of death not being able to be established via these methods.
The coroner will, where at all possible, take into account religious and cultural needs.
Retained tissue and organs after a post mortem
Pathologists cannot always determine a cause of death by macroscopic examination at autopsy. They may need to perform further tests in order to ascertain the cause of death by taking small pieces of tissue to examine under the microscope, taking blood or other body fluids for further tests they see necessary.
At times it may be necessary to take whole organs for further examination, the heart or brain may need to be examined by a specialist pathologist especially in cases where healthy individuals have died suddenly and unexpectedly.
Pathologists may only take material that have a bearing on the cause of death. There are strict rules around taking material from a body at autopsy and the pathologist must inform the coroner, the coroner will inform the relevant interested person and offer the following three options:
a. Material to be disposed of when it has served its purpose
b. Return of material to the deceased’s family or representative
c. Consent for the material to be retained for medical research or other purposes
In cases involving homicide tissue or whole organs may have to be retained by the Crown Court. Other statutory provisions apply, such as the Police and Criminal Evidence Act or directions of the trial judge.
Further information regarding tissue retention and legal requirements relating to consent can be obtained from the Human Tissue Authority at www.hta.gov.uk
Post Mortem report
The report gives details of the examination that was made of the body and details of any tests that have been performed as part of the cause of death investigation. It is sent to the coroner by the person who carried out the post mortem examination.
Copies of the report are normally available only to the interested persons, though its contents may be disclosed during the investigation and inquest in some circumstances a coroner may close an investigation after a post mortem examination if the investigation reveals that the cause of death was natural and there were no circumstances that required an inquest to be held. The coroner will release the body for the funeral and send a form to the registrar of births and deaths stating the cause of death as disclosed by the post mortem examination. The death can then be registered