A post-mortem, or autopsy, is a procedure carried out after someone has died which aims to establish their cause of death.
By examining the tissue and organs of the deceased person, a post-mortem examination can reveal information about how, when and why they died. There are two different kinds of exam: a coroner’s post-mortem and a hospital post-mortem.
Coroners are experienced lawyers or doctors who work for the courts, and oversee an autopsy of potentially unnatural or suspicious deaths. The purpose of a coroner’s autopsy is to establish facts about the cause of death and determine whether a legal inquest is needed.
A legal inquest is a formal hearing in court where the coroner’s theory is tested. If the cause of death is agreed upon in court, other legal proceedings relating to the death, such as criminal charges, may follow.
A coroner’s post-mortem can be requested by police or a medical practitioner in cases where:
The family of the deceased do not have the right to object to a coroner’s post-mortem, because once it has been requested, the coroner is required by law to investigate.
A hospital post-mortem takes place with the consent of someone close to the deceased after someone has died following an illness. The purpose of a hospital post-mortem is to answer any unresolved questions about:
It may help the family of the deceased come to terms with the death, by understanding how the disease manifested. In some cases, it may reveal information about hereditary factors which played a role in the death, which could be significant for surviving relatives.
Hospital post-mortems are often less intrusive than coroner’s autopsies, as they tend to be restricted to the part of the body affected by the illness.
A post-mortem is carried out by a pathologist. Pathologists are specialists in understanding how disease causes change to the body’s cells and tissue. They use this knowledge to identify the causes of disease or damage present on the body.
Post-mortems take place in a special exam room which resembles an operating theatre. All post-mortem facilities in the UK are licensed and inspected by the Human Tissue Authority.
If the deceased died in a large hospital, the exam will normally take place in post-mortem facilities on-site. However, sometimes it may be necessary to respectfully move the body from the place where the person died. This could happen if the person died away from a hospital, at a smaller facility, or if the post-mortem needs to be conducted by a specialist at another centre.
If this is the case, the family will be informed before the body is moved to the place where the post-mortem is to be carried out. Afterwards, the body is taken to the facility’s mortuary.
During a post-mortem exam, the pathologist makes a single incision down the torso and one at the back of the skull. Through these, they are able to examine the internal organs, which may be removed or opened for closer examination if necessary. Any organs which are removed are returned to the body before the end of the exam.
Small, two-penny sized samples may be taken from the organs or body tissue if the pathologist needs to examine cells under a microscope or conduct any diagnostic tests. If a pathologist needs to retain any samples for testing, they must get signed permission from family members to do so.
In hospital post-mortems (where the cause of death is known or strongly suspected), the pathologist may only need to perform a partial autopsy. This may be limited to a single organ or part of the body, in which case the rest of the body is left untouched.
After the exam, the pathologist sutures and cleans the incisions before dressing them in the same manner as an ordinary surgical wound.
The family of the deceased can view the body at any time before or after the post-mortem, provided they give reasonable notice to the mortuary or coroner’s office.
After the post-mortem, the body will have two incisions – one running down the torso and one on the back of the head. These are dressed by the pathologist before the body is returned to the mortuary, funeral director or family. However, if the body is dressed and lying on its back, it is not possible to tell that a post-mortem has been carried out.
It depends on the type of post-mortem. Coroner’s post-mortem exams do not require the consent of family members to go ahead. However, not all deaths referred to a coroner result in post-mortems; only about 25% warrant a full exam.
If the death is not suspicious, but medical staff or the family might benefit from a fuller understanding of what caused the death, the family may give consent for a hospital post-mortem. Unlike a coroner’s post-mortem, this can only go ahead with the family’s consent.
The results of the post-mortem will determine what happens to the body afterwards. With hospital post-mortems, the body is released to the family after the exam. Similarly, if the coroner’s office is satisfied that there is no need for further investigation, the body will be released to the family with a ‘pink form’, stating the cause of death.
This normally takes less than 28 days, but in some cases could take longer. If this is the case, the coroner must notify the family as soon as possible and explain why there is a delay in releasing the body.
In about 10% of cases, the coroner decides to open an inquest. This is a hearing held in a court of law in which medical specialists present evidence in order to try and establish facts about the cause of death. The coroner should complete their investigation before the inquest begins so that the body can be released.
Prior to the inquest, the coroner issues the family with a ‘fact of death’ certificate, which may be used for probate- however, the death can only be recorded with the registry after the inquest has determined the cause of death.
Depending on the cause of death and circumstances surrounding it, there may be criminal and civil proceedings which follow the inquest findings to try and determine who is responsible for the death.
The pathologist who conducts the post-mortem exam may need to keep small samples of some tissue or organs to complete their investigation. They may need to test the samples in a lab or examine them under a high-powered microscope. However, they must get written permission from the family in order to keep any tissue or organ samples.
A post-mortem may delay the funeral in some cases. The body is normally ready for release to the funeral director on the day of the post-mortem. However, the exam may not take place immediately after death. This is more likely with coroner’s post-mortems, as there may be a need for more extensive testing and investigation in order to determine the cause of death.
These tests may delay the completion of the post-mortem. However, it rarely takes longer than 28 days. If the exam is expected to take longer than this, the coroner must notify you in writing and explain why there has been a delay.
If the post-mortem was carried out in a hospital, you could request a full copy of the pathologists report from the hospital. The doctor who oversaw the care of the deceased person will be able to explain and discuss the results of the post-mortem with you.
In the case of a coroner’s post-mortem, the coroner will let you know the result of the findings. You may also request a full copy of the pathologist’s report (there may be a fee for this) and ca ask for a GP or hospital doctor to explain the report’s findings to you if necessary.
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