Autopsy Flashcards
Hospital autopsies
-10% of UK autopsies - responsible for majority of autopsy decline recently
-audit, teaching, governance, research
Medico-legal autopsies
-90% of UK autopsies
-conducted by request of coroner
What are the 2 types of medico-legal autopsies?
Coronial autopsies - undertaken when the cause of death is unclear - who died, when, where, how?
Forensic autopsies - deaths involving crime, potential homicide investigation
What types of deaths are referred to coroners?
Presumed natural - unknown cause, not seen by doctor within last 14 days, largest group
Presumed iatrogenic (illness caused by medical examination or treatment) - peri/postoperative deaths, anaesthetic deaths, complications of therapy
Presumed unnatural - accidents, industrial death, suicide, unlawful killing (murder), neglect, custody deaths
Who makes referrals to coroners?
-doctors - under GMC guidance - no statutory duty
-registrar of BDM - statutory duty
-relatives
-police
-pathological technicians
-other interested parties
What duty do doctors have to refer deaths to coroners?
Common law duty to refer & GMC guidance
What autopsies are performed by histopathologists?
-HOSPITAL AUTOPSIES
-coronial autopsies - natural deaths, drowning, suicide, accidents, road traffic accidents, fire deaths, industrial deaths, peri/postoperative death
What autopsies are performed by forensic pathologists?
CORONIAL AUTOPSIES - homicide, death in custody, neglect, any from histopathologist list which may be performed by 3rd party
Name the 5 laws related to autopsies
1) Coroners Rules 1984
2) Coroners Act 1988
3) Human Tissue Act 2004
4) Amendment Rules 2005
5) Coroners & Justice Act 2009
Describe the Coroners Rules 1984
-autopsy asap
-autopsy by pathologist of suitable qualification/experience
-promptly report findings to coroner only
-autopsy only on appropriate premises
Describe the Coroners Act 1988
-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 & inquest will be needed
Descibe the Human Tissue Act 2004
-autopsies only to be performed on licensed premises
-licence holder
-consent from relatives for any use of tissue retained at autopsy if not subject to coronial legislation/retained for criminal justice purposes
-public display requires consent from the deceased
-penalties include up to 3 years imprisonment and/or fine for breaching this act
Descibe the Amendment Rules 2005
-pathologist must tell coroner what material have been retained
-coroner authorises retention & sets disposal date
-coroner informs family of retention
-family has choices - return material to teaching, retain or research/teaching, respectful disposal
-coroner informs pathologist of family’s decision
-pathologist to keep record
-autopsy report must declare retention & disposal
Describe Coroners & Justice Act 2009
-coroner can now defer opening the inquest & instead launch an investigation
-enshrines a system of medical examiners
-little practical change to the pathologist
-inquests now have conclusions, not verdicts
What is a coronial autopsy?
A systematic scientific examination that helps the coroner determine who the deceased was, when & where they died & how they came about their death
