Hospital Post-mortem Examination

Written consent for a post-mortem examination is required from a person meeting the qualifying criteria set out by the HTA. Standard forms are available in the Bereavement Office (located in the Mortuary) and must be countersigned by the Bereavement Office staff or, if they are unavailable, by the requesting doctor who must be either a Registrar or Consultant. These forms may appear to be complicated but it is essential that consent is as fully informed as possible so that the relatives understand the implications of authorising a post-mortem and what will happen to tissues that have been removed from the body. If you are in any doubt as to what may be required to answer particular clinical issues, please contact the pathologist who will perform the post-mortem examination.

The doctor must also complete a post-mortem (necropsy) request form which will accompany the casesheet to the Pathology Department and guide the pathologist during the examination. If you wish to view the post-mortem examination or be made aware of the main findings, please indicate this on the request form.

Post-mortem examinations will be performed as soon as possible after the request is received and should not delay any funeral arrangements. It is courteous to see relatives as soon as possible after they attend the hospital to collect certificates. Undue delay is likely to compromise obtaining consent to a post-mortem examination. It should be the routine to request a post-mortem examination on all patients who die.

It is important that staff realise the value of the post-mortem examination so that the benefits to others can be stressed when seeking consent from relatives.
  1. The main purpose of a post-mortem examination is to provide information to the relatives on why a patient has died. This information will help the grieving process and provide clear facts around which other decisions can be made.
  2. The post-mortem examination compares the pre-mortem clinical findings with structural changes of a disease process that are present at the time of death. This is a vital function in a teaching hospital where the post-mortem examination is the final part of the teaching process for medical students and for junior medical staff. For patients with uncommon diseases or unusual manifestations of common disease, the reasons for requesting a post-mortem should be clear, but we know that in 10-30% of routine post-mortem examinations major unsuspected diagnoses are found - these may influence the treatment of future patients and will affect the information gathered on causes of death.
  3. The post-mortem examination can reveal diseases that have implications for other members of the public eg.contacts of patients with tuberculosis or meningitis need to be traced; inherited diseases may be recognized for which counselling is relevant.
  4. The training of junior pathologists requires that they should perform as many post-mortems as possible to prepare them for medico-legal work in the future.
  5. Tissue and data for research may be obtained. Unless a patient has been involved in a particular study, this is a minor reason for requesting a post-mortem examination. If it is relevant, it should be pointed out that only small pieces of tissue for microscopy are taken and that there is no question of experiments being performed on the body.
  6. It should be emphasised that the body is not disfigured and is treated with respect during a post-mortem examination and its performance will not affect subsequent arrangements for viewing the body by relatives.
If further guidance is needed please contact any pathologist in the Department.