Autopsy

Question 1

What are the 2 types of autopsies?

Answer 1

• Hospital autopsies
• Medico-legal autopsies

Question 2

Describe hospital autopsies

Answer 2

• 10% of all UK autopsies
• Useful for audit, teaching, governance, research

Question 3

Describe medico-legal autopsies

Answer 3

• 90% of all autopsies in the UK
• Coronial autopsies – standard
• Forensic autopsies – deaths involving crime

Question 4

What are the 3 types of death to coroners?

Answer 4

• Presumed natural
• Presumed iatrogenic
• Presumed unnatural

Question 5

Described what presumed natural deaths mean

Answer 5

• Cause of death not known
• Not seen by doctor with recent illness (last 14 days)

Question 6

Described what presumed iatrogenic deaths mean

Answer 6

• Peri/postoperative deaths
• Anaesthetic deaths
• Abortion
• Complications of therapy

Question 7

Described what presumed unnatural deaths mean

Answer 7

• Accidents
• Industrial death
• Suicide
• Unlawful killing (murder)
• Neglect
• Custody deaths

Question 8

Where do referrals to coroner’s come from?

Answer 8

• doctors (GMC guidance – no statutory duty to refer)
• a registrar of BDM (statutory duty to refer)
• relatives
• the police
• pathological technicians or other
  properly interested parties

Question 9

What are the laws relating to autopsies?

Answer 9

• The Coroners Act 1988
• Coroners Rules 1984
• Amendment Rules 2005
• Coroners and Justice Act 2009
• Human Tissue Act 2004

Question 10

Describe Coroners Rules 1984

Answer 10

• Autopsy as soon as possible
• By a pathologist of suitable qualification and experience
• Report findings promptly only to coroner
• Autopsy only on appropriate premises

Question 11

Describe The Coroners Act 1988

Answer 11

• Allows coroner to order an autopsy where death is likely due to natural causes to obviate need for inquest
• Allows coroner to order an autopsy where death is clearly unnatural and inquest will be needed

Question 12

Describe Human Tissue Act 2004

Answer 12

• Autopsies only to be performed on licensed premises
• License holder
• Consent from relatives for any use of tissue retained at autopsy if not subject to coronial legislation or retained for criminal justice purposes
• Public display requires consent from the deceased
• Penalties include up to 3 years of imprisonment

Question 13

Describe Amendment Rules 2005

Answer 13

• Pathologist must tell coroner precisely what materials have been retained
• Coroner authorises retention and sets disposal date
• Coroner informs family of retention
• Family has choices;
  ▪ Return material to family
  ▪ Retain for research/teaching
  ▪ Respectful disposal
• Coroner informs pathologist of family’s decision
• Pathologist to keep record
• Autopsy report must declare retention and disposal

Question 14

Describe Coroners and Justice Act 2009

Answer 14

• Coroner can now defer opening the inquest and instead launch an investigation
• Enshrines a system of medical examiners
• Little practical change to the pathologist
• Inquests now have conclusions, not verdicts