What is a post-mortem examination?
A post-mortem examination (also known as an autopsy) of a body is carried out by a trained pathologist to determine the cause of death. A post mortem may be required if the cause of death isn’t clear, or there are concerns that the death may be from unnatural causes.
This happens with almost half of all deaths each year, so it’s quite common. If a coroner decides that a post mortem is necessary, you won’t be able to finalise the funeral date until it’s been carried out. However, you can start making arrangements. In most cases, post mortems are carried out within a few working days of a person’s death, although it can take longer.
When might a post-mortem examination be requested?
A coroner investigates deaths from unknown and unnatural causes, and deaths while in custody. Coroners are usually solicitors, although a few are doctors. Most deaths are reported to the coroner by doctors or police officers, but anyone who is concerned that a death may not be natural has the right to inform the coroner.
A death may be reported to a coroner if the:
- cause of death is unknown
- death was violent or unnatural
- death was sudden and unexplained
- person who died wasn’t visited by a medical practitioner during their final illness
- medical certificate of cause of death isn’t available
- deceased wasn’t seen by the doctor who signed the medical certificate within 14 days (28 days in Northern Ireland) before death or immediately after they died
- death occurred during an operation or before the person came out of anaesthetic
- medical certificate suggests the death may have been caused by an industrial disease or industrial poisoning.
In Scotland, each medical certificate of cause of death is independently checked by a team of reviewers. Also, the coroner is known there as the procurator fiscal.
What happens once a death has been reported to the coroner?
Once a death has been reported to the coroner, it will investigate and decide if a post-mortem examination is necessary.
If a post-mortem examination is required
If the death has to be investigated, the first steps will be to gather background information, such as the deceased’s medical history and the circumstances of the death, as well as speaking with the immediate family if at all possible.
About one in four of deaths notified to the coroner lead to a post-mortem examination. If the coroner decides that one is necessary, it will be carried out by a pathologist – a doctor who works for the coroner’s office and specialises in finding the cause of death.
About one in four of deaths notified to the coroner lead to a post-mortem examination.
A post-mortem examination is a careful visual examination of the exterior of the body followed by a detailed internal examination of all the major organs of the body in the chest and abdomen, together with the brain. You can’t object to a coroner carrying out a post mortem, but you must be told when and where the examination will take place if you ask for it.
Your loved one’s body will be treated with dignity and respect and surgical incisions will be carefully closed and covered so that your loved one’s body can still be viewed before or during the funeral if you wish.
If a post-mortem examination is unnecessary
The coroner may decide that a post mortem is unnecessary if a person was admitted to hospital as a major medical emergency. Similarly, the coroner can permit a doctor to issue a medical certificate of cause of death for someone who has been terminally ill at home and attended daily by a nurse, even if the doctor had not visited in the 14 days (28 days in Northern Ireland) before the death.
If the coroner decides that the cause of death is clear, they issue a certificate to the registrar stating a post mortem isn’t needed, provided:
- the family is entirely satisfied that everything possible was done
- it was a natural disease process that caused the medical emergency
- there were no procedural problems with the treatment.
Requests from a hospital
Sometimes, hospital doctors ask for a post-mortem examination to provide more information about an illness or the cause of death, or to further medical research.
Hospital post-mortems can only be carried out with consent. Sometimes, a person may have given their consent before they died. If not, a person who is close to the deceased can give it.
What happens after the post mortem examination?
Once the post-mortem examination is complete, the coroner will release the body to be buried or cremated if no further examinations are needed.
- If the body is released with no inquest, the coroner will send form 100B (also called the pink form) to the registrar stating the cause of death.
- The coroner will also send form Cremation 6 to the funeral directors if the body is to be cremated.
What if the coroner decides to hold an inquest?
In about one in ten deaths, the coroner will hold an inquest into a person’s death. This can happen when the:
- cause of death is still unknown following the post-mortem examination
- person possibly died a violent or unnatural death
- deceased died in prison or while in police custody.
An inquest is similar to a criminal court case, but there is no defence or prosecution. The coroner isn’t trying to establish who’s responsible for the death, only to discover the cause of death. It may take six months or longer for an inquest to take place.
The coroner must release the body for burial or cremation as soon as possible. If they have finished their examination, the body should be released before the inquest. If the coroner can’t release the body within 28 days, then they must notify the known next of kin or personal representative of the reasons for the delay.
An inquest is similar to a criminal court case, but there is no defence or prosecution.
After the inquest has taken place, the coroner will register the death. Before then the coroner can give you an interim certificate of the fact of death to prove the person is dead. You can use this to let organisations know of the death and apply for probate.
When the inquest is over, the coroner will come to a conclusion as to why your loved one died and tell the registrar what to put as the cause of death.
For more information on coroners and inquests, see the government’s guide to coroner services.
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