Ethics & Law

Question 1

Reasons to report death to Coroner (1-6)

Answer 1

1. Cause of death is unknown
2. Deceased was not seen by certifying doctor after death or within 14 days before.
3. Violent, unnatural or suspicious (including any suspicion of medical negligence)
4. Death may be due to an accident (whenever it occurred)
5. Death may be due to neglect by self or by others
6. Death due to industrial disease or a person’s employment

Question 2

Reasons to report death to coroner (7-12)

Answer 2

7. Death due to abortion
8. Death during operation or before recovery of effects of anaesthetic
9. Death may be due to suicide
10. Death during or shortly after detention in police/prison custody or while detained under MHA
11. Death may be related to poisoning
12. Death occurred during or within 12 months of pregnancy

Question 3

Reasons for hospital autopsy

Answer 3

Thorough examination of the dead, their disease for

• audit (many actual reasons for death vs reported are different)
• evaluating effectiveness of new treatments
• teaching
• research

Question 4

Types of coroner’s autopsy

Answer 4

Forensic - police involved, photos taken, everything kept as evidence, performed by forensic pathologist

Coroner’s - everything else

Question 5

Hierarchy of consent under Human Tissue Act

Answer 5

Person them-self (in life)
Nominated next of kin

Someone with qualifying relationship before they died, in order of;

• spouse or partner
• child or parents
• sibling
• grandparent or grandchild
• niece or nephew

Question 6

Verification of death

Answer 6

No response to verbal or painful stimulus
No palpable carotid pulse
No breath sounds 2 mins
No heart sounds 2 mins
Pupils fixed, dilated and unresponsive to light

Question 7

Parts of the death certificate

Answer 7

1a = immediate cause of death (not a mechanism e.g., asphyxia OR one of the ‘failures’)

1b = predisposing factor of 1a

1c = predisposing factor of 1b

2 = other factors contributing to but not directly to death

Question 8

Requirements for cremation certificate

Answer 8

See the deceased body
Know COD
Check that it does not need referral to coroner

Question 9

Permissions of a licence under Human Tissue Act

Answer 9

Post-Mortem

Removal from deceased body of relevant material of which it consists or contains for a scheduled purpose (other than transplant)

Storage of a deceased body or relevant material of which it consists or contains for a scheduled purpose

Purpose may be: clinical audit, education or training related to human health, performance assessment, public health monitoring, quality assurance.

Question 10

Consent for hospital autopsy - for a deceased child

Answer 10

If competent child has refused in life - should be respected (as an adult).

If no decision made, persons with parental responsibility can consent or refuse.

If no one with parental responsibility, use hierarchy of relationships.

Question 11

Who can consent for donating anatomy for examination or public display?

Answer 11

Only the person

Question 12

Consent for surgical specimens

Answer 12

If patient consents beforehand, can be used for

• diagnosis
• audit
• teaching
• research

Question 13

Principles of mental capacity act

Answer 13

Everyone initially assumed to have capacity
People are allowed to make ‘bad decisions’
Person not able to make a decision if:
- cannot understand info relevant to decision
- cannot retain info
- cannot use/weigh in that info when making decision
- cannot communicate the decision

NOTE: Every effort should be made to support these steps e.g., info in additional languages.