A coroner will only order a post-mortem examination when it is necessary to find out the cause of death. The examination is not done for research and has to be done by a pathologist who is experienced and appropriately qualified. Go to ‘who does the examination?’ for more information.
Occasionally a doctor can supply enough information to a coroner to be able to hold an inquest without an examination taking place but this is still unusual.
Also, in some parts of the country, it is now possible for the deceased person of someone who has died to be scanned. You need to ask as soon as you are in touch with the coroner’s team if this is available in your area and if it will be possible with your relative/friend. Scanning is not suitable in all cases. If a scan is done and does not show the cause of death, a traditional post-mortem examination may still have to be done.
This is still quite new science and pathologists and radiologists (doctors who interpret scans) are developing their skills in this new specialty.
You also need to be aware that in most cases the family will have to pay for the scanning procedure although this may be refunded if a traditional post-mortem examination has to be done afterwards. The cost will probably be around £500 plus VAT.
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What is a post-mortem examination?
Where does the post-mortem examination take place?
Can I trust the examination to be impartial?
How do I find out the results?
What if I don’t agree with or trust the results of the examination?
Will I be able to see the person before the examination and afterwards?
A traditional post-mortem examination is a careful external and internal examination of the deceased person after someone has died.
Internal organs are carefully removed from the deceased person so they can be examined (both externally and internally) and if necessary, small samples of them are taken to be examined later under a microscope. Samples of fluids from the deceased person may also be kept. Any organs that have been removed for examination are returned to the deceased person except in very rare cases when a whole organ may need to be examined by a specialist or it needs specialist preservation before it can be examined. If this is necessary it will be explained to you.
All the incisions made to allow the internal examination of organs to take place are stitched up at the end of the examination.
You will be asked what you want to happen to any samples that were taken when they are no longer needed by the coroner. Most people choose to allow the samples to be used in the future by pathologists for teaching and research. For more information, you can go to the HTA website.
It is usually also possible to donate a whole organ for research in the future in the rare cases it has been necessary to retain an organ. However some families prefer to delay the funeral until the organ can be returned to the deceased person when all examination of it has been completed.
A forensic post-mortem examination is done when the death is considered to be suspicious in some way. This is a much more detailed examination to ensure all possible evidence is obtained that may help solve the crime.
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Post-mortem examinations are carried out in purpose built rooms within a mortuary. Hospitals have mortuaries to care for their own patients who have died but in many parts of the country, people who die elsewhere and have to have a post-mortem ordered by the coroner are also looked after in the hospital mortuary. However, even if the person you are concerned about is being looked after in a hospital mortuary, you need to be in contact with the coroner’s office about them and not hospital staff.
In some parts of the country there are public mortuaries which are provided by the local council. The coroner’s officers may also be based at the public mortuary.
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When a post-mortem examination is carried out on the orders of the coroner, the examination has to be completely impartial. Although most pathologists also work in one or more hospitals, when they do a post-mortem examination for the coroner they are working for the coroner and not the hospital. If there is a possibility that the hospital might have made a mistake in the care of the person who has died, many coroners will arrange for the body to be moved to a different mortuary to ensure there is no relationship between the pathologist doing the examination and the doctors who were looking after the patient. Or a visiting pathologist may come to the hospital to carry out the examination.
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Usually the coroner’s officer will telephone you to inform you of the findings of the post-mortem examination. This will be what the pathologist has found to be the cause of death with any contributing factors. The coroner’s officer will also tell you when and where you can register the death, provided the death has been from natural causes and not otherwise in circumstances that require an inquest to be held.
A written report from the post-mortem usually takes several weeks to be prepared and will be much more detailed. If you want a copy of this you will often need to formally write to the coroner requesting this. Do bear in mind that post-mortem examination reports are written in technical medical language so you might choose to ask your GP to obtain the report and then ask them to explain it to you. It can also be difficult to read about such detailed examination of someone’s internal organs when it is someone you knew and cared about, even if you are familiar with the process of a post-mortem examination.
The situation may be slightly different if there is to be an inquest and it will also depend on why an inquest is being held. Ask the coroner’s officer for further information.
If someone is being charged with causing the death you may not be able to see the post-mortem report before the court case because it will be part of confidential evidence. Ask your police family liaison officer if you have one or the coroner’s officer.
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You can instruct a pathologist to carry out a private post-mortem examination. Contact the manager of the mortuary where the deceased person is being looked after. You should expect to pay at least £500 for this and possibly rather more if you want you want a specialist forensic pathologist.
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Often you will be asked to carry out a formal identification of the person who has died, although this may not be required if you were with them at the time of death. It is usually possible to spend time with someone before the post-mortem examination but this may not be possible if a crime is suspected. In this situation the examination often takes place quite quickly and as few people as possible have contact with the body to help make sure any evidence that might lead to a conviction is not disturbed or confused.
Sometimes if someone has been very badly injured in an accident it may be better to wait until after the post-mortem examination to see someone and possibly until they are being cared for by the funeral director. Some mortuary staff and funeral directors are very skilled at disguising some of the worst injuries, especially those to the face.
Occasionally you may be advised not to see someone after they have died if there were very serious injuries, the person was in water for an extended time or perhaps the body was not discovered until some days or weeks after the death. If you are the immediate next of kin and are responsible for arranging the funeral you can insist on seeing the body BUT if the body has changed in appearance a lot from when you last saw the person, how they look now may remain in your mind for a very long time. Unfortunately it can also be very difficult to disguise the odour of someone who died some time ago. Think carefully about what is best for you and talk it through with someone you trust and who knows you well as well as the coroner’s officer, family liaison officer or funeral director.
Sometimes it may not be helpful to you to see the face of someone killed in a car crash but you could see and hold their hand which you know so well. You may also ask the funeral director to take a photograph to help you decide whether to see your relative or friend directly. Many people will be well-meaning when they say to you ‘remember them as they were’ but only you can make this very personal and sometimes very difficult decision.
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