A post mortem examination is an examination of the body after death. It is carried out in purpose built premises. These are usually part of a large hospital but in some major cities there are also public mortuaries.
The examination involves both a careful examination of the body externally and then a detailed examination of the internal organs which often needs the retention of samples of tissue and body fluids. This allows microscopic examination of individual cells. Very occasionally it may be necessary to retain a whole organ for a period of time but the reason for this and the time period required will always be explained to you so you can make informed and appropriate choices about the timing of the funeral.
A post mortem examination (also called an autopsy or a necropsy) is carried out by a pathologist, who is a doctor with specialist training who diagnoses disease through looking at tissues and cells. They are assisted by anatomical pathology technologists who have their own professional training for this role.
A post mortem examination does not usually prevent families spending time with the deceased either at the hospital or at the funeral home as great care is taken of the external appearance at the end the examination.
A post mortem may be carried out on the orders of the coroner or with the consent of next of kin and the differences are explained below.
Post mortem examinations
The most common type is a post mortem examination ordered by the coroner to find out why someone has died. This is most often done when the death is unexpected or is a result of an accident, suicide or the circumstances appear to be suspicious in any way. However the coroner may also order a post mortem if the death has happened very soon after admission to hospital or after a medical or surgical procedure.
The next of kin will be informed of the fact that there is to be a post mortem examination and when and where it is to take place. However it is a legal requirement and the consent of next of kin is not required. It is possible for the family to have a medical representative at the post mortem but most families do not feel that this is necessary. Tell the coroner's officer as soon as possible if you think you need to arrange this and the reason for your concern.
You should also tell the coroner or coroner's officer if you have strong objections to a post mortem examination on grounds of religion or culture. Do also speak with your own religious or cultural authorities as they will be familiar with the law and and will be able to guide you.
These are all different names given a to a post mortem examination carried out with the consent of the family.
The techniques used are identical to a coroner's post mortem but the circumstances are that a doctor knows the cause of death. Therefore s/he can issue a Medical Certificate but feels that it would be helpful to learn more about the condition from which the person died and the effects of any treatment given. The doctor must ask the next of kin for signed permission to carry out this type of post mortem unless the deceased had already given their signed permission during life.
It is possible for the deceased to have given consent for a post mortem to be carried out during their lifetime. This consent is binding in law but in practice doctors will discuss this with the family or executor before going ahead to avoid cauing additional distress.
In some places nurses, midwives and/or bereavement staff have been trained to talk to families about post mortem examinations and to obtain consent from families.
Obtaining Post Mortem Examination Results
Please remember that full post mortem examination reports are technical medical documents and are not usually written with the lay person in mind although some pathologists may add a 'plain English' summary if requested to do so. It can be very difficult to read such documents about someone you have been close to even if you understand the medical terminology.
Full reports are often not available for several weeks (or even months) after the initial examination depending on the follow-up tests that may be required such as histological examination of the tissues under a microscope.
The Coroner or Coroner's Officer will give you the cause of death found by the pathologist at a coroner's post mortem examination although in some instances further tests are required for this to be fully determined.
If you want a written copy of the full report you need to ask the coroner's officer and sometimes to write to the Coroner concerned and they may charge a fee. Some Coroners prefer to send the report to a doctor to explain and discuss the findings with you. This may be a hospital doctor who was involved in the care of the deceased or a general practitioner of your choosing. Sometimes the report is not released until after an inquest if one is to be held.
Consented post mortem examination results have to be requested from the hospital where the examination took place. Because the report is part of the medical record of the deceased you may have to complete a formal document requesting Access to the Medical/Health Record to comply with the law on patient confidentiality. You can state that you only want the post mortem report. You may be charged a small fee for this.~
You may want to make an appointment with the hospital consultant or a general practitioner to discuss the report's findings. If the hospital has a bereavement office the staff there can often arrange this for you or you can approach the consultant's own secretary through the hospital switchboard.
This is a complex area with many issues to consider. Please call us and ask to speak to the Bereavement Manager for further information.