What is Autopsy / Postmortem?
A postmortem is the examination of a body after death. It is also known as an autopsy.
Post-mortems are carried out by pathologists (doctors specialising in medical diagnosis), who aim to identify the cause of death.
Why an Autopsy or Postmortem is carried out.
Postmortems are carried out in either of the following situations.
- If the death has been referred to a coroner, who feels that a post-mortem is necessary to determine the cause of death (for example, because the death was sudden and unexpected). A coroner is a judicial officer (a lawyer or doctor) responsible for investigating deaths.
- At the request of a hospital, to provide information about an illness or cause of death, and to further medical research.
It is estimated that the cause of death can be wrong in up to a third of cases where a post-mortem is not carried out. However, a post-mortem cannot always provide a reason for death.
Post-mortems also play an instrumental role in medical research. They can provide information about illness and health that would not be uncovered in any other way. In fact, much of modern medical knowledge would not have been discovered without the use of post-mortems.
Consent for an Autopsy or postmortem.
If a postmortem is ordered by a coroner, it must take place by law, whether or not the next of kin agrees with the coroner’s decision.
If a post-mortem is requested by a hospital, the hospital must obtain written consent from the deceased’s next of kin or nominated representative. Relatives or partners of the deceased can also request that the hospital carry out a post-mortem to learn more about why their partner or relative died.
As part of a postmortem carried out by a hospital, the pathologist may wish to take samples of human tissue or remove organs for further study and research. This can only be done if the next of kin gives consent.
Relatives of the deceased may notify the coroner that they wish to attend the post-mortem. Alternatively they may wish to be represented at the post-mortem by a medical representative.
Why a autopsy or postmortem is necessary
Post-mortems are carried out if:
- The death has been referred to the coroner, who feels that a post-mortem is necessary to determine the cause of death.
- The hospital has requested it, to provide information about an illness or the cause of death, or to further medical research.
If the death has been referred to the coroner
If the post-mortem has been requested by a coroner and the pathologist decides that tissue samples are needed to establish the cause of death, consent from the next of kin is not required.
However, the coroner must handle organs and tissue samples according to the next of kin’s wishes.
By law, the coroner can order a post-mortem examination to be carried out if the death is referred to them by the police or by a medical professional, such as a GP or hospital doctor. Deaths can be referred to the coroner for a number of reasons, but the main ones are:
- if the death was sudden and unexpected
- if the death was violent or unnatural, or if it occurred under suspicious circumstances
- if the death was a result of an accident
- if the death occurred during medical treatment or in hospital
- if the doctor treating the deceased person had not seen them within 14 days before their death
At the request of a hospital
Many families find post-mortems helpful because they can provide important information about how a loved one died. Understanding the reason for the death of a loved one can often help families come to terms with their loss.
This can be even more important in the case of the death of a child. Finding out why their child died can help parents to accept their loss and lessen any feelings of guilt or blame.
If parents experience the loss of their baby, they may be concerned about whether it is safe to try to conceive again. The information from a post-mortem may be able to provide an answer to that question, and could prevent complications in any future pregnancy.
Tissue samples and organs
Sometimes, a lot of information can be obtained just by looking at the organs in a post-mortem. However, often the only way to understand the cause of death is to examine part of the organ under a microscope. This requires the removal of small pieces of tissue. In some cases, the pathologist may wish to remove an entire organ from the body for further study.
After a post-mortem, any tissues or organs taken from the body are returned. However, some investigations can take several weeks, which may delay the funeral. As a result, you may wish to ask for the tissues or organs to be sensitively and respectfully disposed of to allow the body to be released for the funeral. NHS Guideline on when a postmortem should be carried out.
With consent, tissue samples can be kept for many years for a number of reasons:
- Further investigation. In cases of inherited (genetic) disorders, such as cystic fibrosis, looking back at the tissue of deceased family members may help in the diagnosis and treatment of living members of the family.
- Training. Examining tissue is one of the most important ways doctors learn about illnesses and how to treat them. Tissue samples are used to train medical students and new doctors. They can help experienced doctors learn more about certain conditions, and they can also be useful for providing healthcare professionals with specialist knowledge.
- Audit. Examining tissue samples is an important way of checking the standards and quality of care. For example, tissue samples may be used to check on standards in a hospital pathology service.
- General medical research. When a new disease or health problem emerges, tissue examination on a wide scale may provide useful clues about why the disease emerged and how to treat it. This was the case with variant CJD (Creutzfeldt-Jakob disease).