Autopsy and the Coronial System

What is an autopsy?

an examination of the body after death to determine the cause of death

What does postmortem mean?

after death

What are the two main types of autopsy?

1) Coroner's postmortem

2) Hospital postmortem

Which is more common, a Coroner's or Hospital postmortem?

Coroners (95%)

True or false: family consent is required for a Coroner's postmortem

false

True or false: family consent is required for a hospital postmortem

true

What is the purpose of a hospital postmortem?

for doctors to learn more about a disease process and symptoms

What is the purpose of a Coroner's postmortem?

to find out how somebody died

True or false: the cause of death is already known when a hospital postmortem begins

true

Give the three clauses from the Coroners and Justice Act of 2009 that state the terms when a coroner has a duty to investigate death:

1) there is reason to suspect the deceased died a violent or unnatural death

2) the cause of death is unknown

3) the decreased died in custody or state detention

Give 9 examples of 'violent or unnatural deaths':

1) due to surgical/ medical intervention

2) due to delay in surgical/ medical intervention

3) drugs (illicit or prescribed)

4) acute alcohol toxicity

5) suicide

6) after a fall/ accident

7) after a car crash

8) due to neglect

9) related to occupation

What is the significance of the 2004 Human Tissue Act for hospital postmortems?

consent is needed for the use and storage of human tissues

What body oversees the 2004 Human Tissue Act?

Human Tissue Authority

Give the hierarchy of who can consent to postmortems when the deceased's wishes are unknown, and they don't have a nominated representative:

1) spouse or partner

2) parent or child

3) brother or sister

4) grandparent or grandchild

5) niece or nephew

6) stepfather or stepmother

7) half brother or half sister

8) friend of longstanding

What two consent checks should be completed before asking family members about postmortems?

1) check if the deceased's wishes are known

2) check if they have a nominated representative

What are the three conditions that consent needs to be valid?

1) voluntary

2) informed

3) capacity

Give the four conditions a person needs to be able to do in order to be deemed to have capacity:

1) understand info

2) retain info

3) weigh up info

4) communicate info

Describe the societal benefits of postmortems: (3)

1) they document accurate data about the health of a population

2) they can be used to notify a population about communicable diseases

3) provide evidence in murder and justice cases

Describe the medical benefits of postmortems: (2)

1) education (anatomy and understanding rare diseases)

2) can be used to identify adverse effects of new treatments

Describe how postmortems can benefit relatives: (3)

1) can explain death, aid grieving and provide closure

2) can be used to identify and alert family of any genetic risks

3) can be used for evidence in legal proceedings and aid compensation claims

What goes in the first section of the medical certificate of cause of death?

the disease or condition that directly led to death

When is a death reported to a coroner?

when the cause of death is unknown or uncertain

What is the purpose of a coroner's court:

an inquest into cause of death is carried out, where no one is on trial, using evidence found in the PM, witnesses and contextual information

What is the job of a coroner?

to find out who died, when, where and how they came to their death

How has technology changed the number of PM's reported to the coroner?

the use of CT scans has caused a shallow, downward trend

What kind of input can witnesses of face provide in a coroner's court?

face value, fact, information

What kind of input can experts provide in a coroner's court?

opinions

What is meant by an 'open' cause of death?

the evidence doesn't lead to a conclusion

What is meant by a 'narrative' cause of death?

the cause of death doesn't fit into a category, so it requires a background narrative

What are the two conditions for a death to be considered suicide?

1) deceased must have completed death inducing act on themselves

2) deceased must have intended to die

What is a Prevention of Future Death Report?

a report used when there is risk of future death, providing a warning, which organisations have no obligation to act upon - the coroner cannot compel action