Requesting a consented autopsy

Autopsies are a valuable means of audit of medical care and can often provide medical staff and relatives with useful additional information about the final illness and the effects of treatment. In order to request an autopsy the following must be completed:

If you intend to request a hospital/consented autopsy circle note #2 on the medical certificate of the cause of death and endorse part-B on the reverse of this form (this informs the Registrar of Deaths who will send out a form for additional information following the autopsy). It is helpful to inform the relatives that an autopsy will be requested at an early stage. The medical certificate of the cause of death and the patient’s notes are then sent to the Medical Examiner’s Office (Tel Ext: 39492) of the Medical Examiner’s Office.  Autopsy consent forms and guidance notes are provided by the Medical Examiner’s Office who will also arrange for the doctor to meet with the relatives.

Consent must be obtained from by the highest ranking qualifying relative as defined in the Human Tissue Act 2004 (unless the deceased gave permission for autopsy or appointed a nominated representative before death) and should be sought by the most senior clinician involved in the care of the deceased. The person seeking consent should have had training in bereavement management and have witnessed a post mortem examination. The autopsy consent form allows a relative to limit the examination to an area of interest (e.g. brain, thoracic or abdominal cavities). In most autopsies tissue samples are retained for histological assessment, and for some diseases, retention of a whole organ may be desirable to allow detailed examination following fixation (e.g. brain or heart). Relatives may refuse consent for the retention of tissue samples or organs. Any restrictions on the autopsy may limit its value and clinicians may find it useful to discuss each case with the pathologist before meeting relatives to discuss the likely impact of restrictions. Please refer to Trust policy TRW.HGV.POL.216 (G:\DocumentLibrary\UHPT Trust Documents\Healthcare Governance\) “Consent to Examination or Treatment Policy.pdf“– section 9 – Completing Consent Forms,  Appendix 2 – Procedure for obtaining Consent for Adult Autopsy.

The autopsy request form should include a summary of the clinical findings, indicate specific areas requiring clarification and highlight any infections present. Following completion of these forms the Medical Examiner Officer will send the notes to the Anatomical Pathology Department.

Doctors and medical students who have attended the patient during their last illness are welcome to view the autopsy.  As most autopsy preparatory work can be completed before the doctor is called, a minimum amount of their time need be required. Autopsies are usually performed in the mornings. However, there is no set time for the demonstration and interested doctors are advised to contact the Department regarding their particular patient. A clinical firm may wish to nominate a doctor to attend and report back to the team the findings at autopsy.  The results of hospital autopsies are sent to the clinician in charge and general practitioner.

If general practitioners wish to request autopsies they should contact the Department of Cellular and Anatomical Pathology (01752 792355) to discuss the case with the pathologist and obtain the relevant forms.

Perinatal Autopsies

Fetal, perinatal and infant autopsies are currently carried out at the John Radcliffe Hospital, Oxford. Separate request and consent forms are available in the central delivery suite. In addition to the completed request and consent form, a photocopy of the full obstetric history relating to the pregnancy is also required. Contact John Radcliffe Hospital 01865 221246 to arrange the autopsy. Babies are sent to the John Radcliffe Hospital weekly and will remain there for 7 days before return. Occasionally, there is a need to retain the baby for more than one week eg if organs or tissues have been retained for examination and have been requested to be returned to the baby prior to return to Derriford.

Viewing bodies after death

Bodies can be viewed in Derriford Hospital Mortuary, by prior arrangement with the Mortuary staff (Ext. 55045). They provide a routine service from Monday to Friday between 08.00-16.30 hours.

A 24-hour emergency service is provided throughout the year to deal with urgent enquiries and traumatic incidents. Body viewing by next-of-kin should be undertaken between 0800 and 2000 by arrangement with mortuary staff (outside of these hours in exceptional circumstances only). Any other out-of-hours mortuary enquiries should be made to the on-call Anatomical Pathology Technician (contact via switch board).