Every year, more than 85,000 post-mortem examinations take place in the UK. If a family member has died, you may well be wondering whether a post-mortem might be an option – and what to expect if so. Here’s what you need to know.

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What is a post-mortem examination?

A post-mortem (or ‘autopsy’) is an examination of the body of someone who has died. The aim of the examination is to find out more about what caused their death.


Who performs a post-mortem examination?

Post-mortem examinations are carried out by a pathologist, usually in a hospital mortuary or in a special examination room. They’re assisted by anatomic pathology technologists.

Pathologists specialise in histopathology, the study of diseases and their causes. Their training allows them to pinpoint when, how and why someone has died. Forensic pathologists investigate deaths that appear to be unnatural, such as when someone is murdered or takes their own life.


When is a post-mortem required?

There are two types of post-mortem examination:


Coroner’s post-mortem examinations

If a death is sudden, unexpected, violent or mysterious, a doctor or police officer will call the coroner in to investigate. In roughly one in four cases, the coroner will arrange a post-mortem.

So, when is a post mortem necessary? A coroner might call for a post-mortem if:

  • It’s not clear why someone has died
  • The death was violent, unnatural or suspicious, such as a murder, drug overdose or suicide
  • It was due to an accident
  • The death came during or shortly after a surgery
  • They weren’t seen by a doctor before their death
  • They died unexpectedly – for example, the sudden death of a child
  • The doctor who signed the medical certificate of cause of death didn’t see the person who died in the 14 days before or after their death
  • An industrial disease or poisoning may have caused the death (e.g. something that might affect others in their workplace)

Family members can’t object to a coroner’s post-mortem examination. But you can request that the coroner try non-invasive methods first, for religious reasons. Jewish and Muslim families can ask for an MRI or a CT scan, for example.

If you ask, the coroner has to tell you when and where the post-mortem examination will take place. A medical professional can attend to observe the person who does the post-mortem on your behalf. This could be the deceased’s GP or another pathologist.


Hospital post-mortem examinations

Hospital post-mortem examinations are ordered by a doctor. Their aim is to find out more about the illness that caused the death. Sometimes, you can ask hospital staff for a post-mortem to better understand why your loved one has died.

A hospital post-mortem examination can only take place with the permission of the person who has died (granted before their death) or of their next-of-kin.

If you’ve been asked for permission, here are a few things that might help you decide:

  • Hospital post-mortem examinations can be limited to just the area of the body that’s affected. For example, just the chest area.
  • They can’t keep any organs or tissue samples without your consent. If you agree, you’ll be able to decide what happens to them when they’re no longer needed by the hospital.
  • You’ll have at least 24 hours to decide. The hospital will give you a number to call if you change your mind.
  • Hospital post-mortems can save lives. Post-mortem examinations can give doctors valuable insight into how they can better diagnose and treat diseases in the future. They can also support the training of medical professionals.


How is a post-mortem done?

The following details on what happens in a post-mortem examination are not for the squeamish – click here to skip ahead.

During a post-mortem examination, the pathologist will make a long incision down the front of the body. The internal organs will be taken out and examined. They may be dissected to check for anything unusual, such as a blood clot or tumour.

A smaller cut is made across the back of the head and the top of the skull is removed. This allows the pathologist and their team to examine the brain.

The pathologist may take small samples of bodily fluids, organs or small, postage-stamp-sized samples of tissue for closer examination and testing. This can only be done with the consent of the coroner or the family.

Once the post-mortem is complete, the organs are replaced, and the incisions carefully sewn up and covered. The body of the person who has died is made ready for viewing by the family. You can come and sit with them, if you like, before the funeral.

Worried about whether your loved one will be treated with dignity? Pathologists follow guidelines on dignified conduct set out by the Royal College of Pathologists and the Human Tissue Authority. These ensure that your loved one will always be treated with the proper respect.


What happens with tissue samples?

If the pathologist recommends it, the coroner may hold on to tissue and fluid samples until an inquest has been held. Alternatively, the coroner may pass them on to the police if they’re needed as evidence. In these cases, the family of the person who has died will be told.

The coroner and the police can hold on to tissue samples for months, or sometimes even years, without permission. But if the pathologist would like to keep anything – perhaps for research or medical training – they need the family’s consent.

The family can also say what should happen to the samples after the coroner, police or pathologist no longer need them.


How long does a post-mortem take, after a death?

The post-mortem examination should take place 1-3 days after the death. If the person who died would have wanted a swift burial for religious reasons, the coroner or hospital team will do their best to accommodate this.


How long after the post-mortem is the funeral?

Most funerals take place around three weeks after a death. Usually, a post-mortem won’t delay the funeral.

However, if the cause of death is still unclear, or if it appears to be violent or unnatural, then the coroner may not release the body until further testing is complete. You may have to wait until the inquest or criminal proceedings are over. If the coroner is investigating a death, you can’t get the paperwork for burial or cremation without their permission.


Getting the post-mortem results

The pathologist will share the preliminary results of the post-mortem with the coroner quite quickly. The coroner’s liaison officer will then explain their findings to the family.

A full report of the pathologist’s findings may come quite a while later, after tests have been completed. The coroner will notify the family and send a copy to the doctor who was caring for the person who has died. The family can also request a copy, but the report often uses medical terminology. If you like, you can ask the family doctor to help you interpret the results.


If there’s an inconclusive post-mortem, what happens next?

If no cause of death is found during the post-mortem, or if the cause appears violent or unnatural, the coroner will hold an inquest. This is a bit like a court case, except that there are no defendants or prosecution. The sole purpose of the inquest is to establish a cause of death.

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