The vast majority of deaths occur naturally or in circumstances where the cause can be quickly established by a medical practitioner so when is a post-mortem required? Where the reason for death is not obvious or seems to have occurred in a violent or unnatural way, or in state detention, carrying out a post-mortem is the process of getting the answer to the important question of how a person died.
What is a post-mortem?
A post-mortem is the medical examination of the deceased’s body, carried out to establish the cause of death. Most often this involves an extensive internal examination of the body tissue and organs but can also involve toxicology tests to examine if chemical substances are present in the body. Samples can be taken and parts of the body may be retained if further tests are required particularly, where the cause of death is complex or disputed. It is often also called an ‘autopsy’ and is undertaken by a specialist Doctor called a Pathologist.
What is the purpose of a post-mortem?
In the case of an unexplained death, a post-mortem is necessary to find out the precise cause of death, particularly where a doctor cannot easily identify and issue a death certificate for the cause. It may reveal that the reason for death was the result of some ill treatment, criminal act or negligence which might not be discovered if there were no enquiry into the cause of death. There are two main types of post-mortem.
Most often, a post-mortem forms part of a Coroners Inquest, which is held to try to find out how a death occurred. When an inquest is required, normally as a result of a death in unexplained circumstances, the Coroner must ‘open’ it as soon as possible and then, if necessary, adjourn for the period of time needed to gather evidence. Part of this process is to order a Post-mortem. This should be undertaken quickly, as the body cannot be released for cremation or burial until the process is concluded. Naturally, the sooner the post-mortem is carried out the better evidence will be obtained before the body begins to deteriorate.
There may be a need for a number of additional detailed examinations of specific organs before a cause of death can be discovered. In rare cases, the post-mortem may not reveal a conclusive reason for the death.
Generally, the post-mortem does reveal the cause of death, and where for example it is as a result of natural causes that will conclude the process. If further investigation is required the Coroners Inquest will be opened and adjourned. It may be that the Post-mortem reveals lessons which can be learned to prevent future deaths which is part of the Coroners role, or that someone needs to be held legally accountable for how the person died.
Where the death is suspected to be as a result of a crime the post-mortem is carried out by a forensic pathologist skilled in such investigations. There is sometimes a request for a second post-mortem, especially where a criminal act is suspected, made by the legal representatives of the suspect. This can cause delay to the body being released and in turn lead to additional upset to the family of the deceased. The Chief Coroner is able to issue guidance on the appropriate use of post-mortems.
The second main use of post-mortems is to help medical practitioners to find out more about an illness or the cause of death, or for the purposes of medical research. The request for a hospital post-mortem may be made by the next of kin but consent is always required, either from the patient before death or from a close relative afterwards.
Hospital post-mortems are often more limited in scope in terms of the parts of the body that are examined when compared to Post-mortems ordered by a Corner. It may be that Doctors discover evidence that then leads to the death being referred to the Coroner for a formal Inquest.
A post-mortem is a vital way of ensuring that a proper investigation into the reasons for a person’s death can be conducted. Many instances of foul play or medical negligence would not be revealed without the ability to carefully examine the body to assess what led to death. They are also useful in furthering the understanding of medical practitioners of particular conditions for the good of medical research.
Gov.UK: Guide to coroner services