T1: Lessons from the autopsy and Medico-legal aspects of the autopsy Flashcards
What are the two types of Post mortem?
A Coroners PM and a Consent/hospital PM.
What are the differences between an autopsy undertaken for a Coronoer and that done with consent under the Human Tissue act?
- The coroner’s PM is undertaken at the request of the Coroner to find out the cause of death. A hospital PM is undertaken at the request of doctors/relatives to learn more about the disease process/symptoms. The cause of death is already known before starting the PM.
- The family are informed of a Coroner’s PM but do not ned to give consent. In a hospital PM, every part of the autopsy requires consent.
- A Coroner’s PM is traditionally a full PM with increasingly partial use of a CT. In a hospital PM it ranges from being a full dissection to being very limited .
- Coroners PM’s are very common (account for 95%). A hospital PM is very rare. Accounts for 5%.
- Family can request a copy of a Coroner’s report for a few. Family are offered a meeting to receive the results and a copy of a hospital PM free of charge.
List situations when a death should be reported to HM Coroner.
Coroners and Justice Act 2009 states that a coroner has a duty to investigate a death:
IF
A coroner is made aware a body is in their area
AND
There is reason to suspect that:
(a) The deceased died a violent or unnatural death e.g. due to surgical/medical intervention, delay in surgical/medical intervention, drugs, acute alcohol toxicity, suicide, after a fall, after a crash, due to neglect or related to occupation
OR
(b) The cause of death is unknown
OR
(c) The deceased died while in custody or otherwise in state detention
OR
(d) The identity of the diseased is unknown.
There is a long list. This is by no means exhaustive.
What are the requirements for informed consent for post mortem examination under the HTA?
Consent must be given voluntary, by an appropriately informed person and a person with capacity. The consent form is very detailed, they must give consent for everything, the date at which consent is withdrawn etc.
How do you give a cause of death in the ONS format?
The primary cause of disease is listed as 1(a). Other disease or conditions that lead to 1(a) are written in 1(b). A disease or condition that lead to 1(b) is written in 1(c).
Other significant conditions that contributed to the death but are not related to the disease or condition (may have hastened the death or reduced the lifespan) are listed as cause 2.
You do not need to write in every box.
What is the difference between an autopsy and a post mortem?
Autopsy: An examination of a body after death to determine the cause of death
Post mortem: Done, occurring or collected after death
What responsibility does the Coroner have over the body off the deceased?
They have possession over the body not ownership. In the coroners court, the coroner directs how the court functions. They can decide based on the conclusion, whether an inquiry is required. The coroner can refuse organ donation but cannot donate the organs on behalf of the individual.
