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10 February, 2010

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Post mortem

A post mortem, or autopsy, is the medical examination of a body and the internal organs after a person has died. There are two types of autopsy - a coroner’s autopsy and a hospital autopsy.

Coroner’s autopsy
A coroner’s autopsy is performed if the coroner or police need information for legal reasons about the cause of death - for example, if the person was murdered or their death was suspicious.

Hospital post mortem
A hospital (or non-coronial) post mortem may be performed if the immediate family give their consent. In this case, the post mortem can help to clarify the reasons why the person died, or offer information to the medical profession on the deceased person’s condition. Some of the reasons for a hospital post mortem can include:

In some cases, the cause of the person’s fatal illness may be unknown or uncertain.
A post mortem can help determine the success (or otherwise) of a treatment method.
A post mortem can give family members information in the case of suspected genetic illness.
Medical science can learn about disease processes, such as atherosclerosis or sudden infant death syndrome (SIDS), or the prevalence of particular diseases.

The right to refuse
The immediate family has the right to refuse or agree to a hospital post mortem of the deceased. They may also choose to consent to a post mortem, but limit the extent of the examination. They can also decide whether or not organs or samples taken from the body may be kept for further study. Be sure to discuss these issues with hospital staff.

Family members do not have the right to refuse a coronial post mortem - this can be performed regardless of the family’s wishes.

The post mortem procedure
The post mortem is performed like a surgical operation. The steps may include:

The post mortem is performed as soon as possible following the family’s consent.
It is performed by a specially qualified doctor, called a pathologist, who is assisted by a technician.
The room in which the post mortem is performed is very similar to a hospital operating theatre.
The body is laid out carefully on an examination table.
The pathologist first looks at the body, noting its appearance.
Photographs and x-rays may be taken.
The pathologist makes a cut on the body from the collarbone to the lower abdomen to examine the chest and abdominal organs.
Tiny tissue samples are taken from each organ for examination under a microscope and may also be sent for chemical analysis or microbiological culture.
In most cases, the brain is examined. This requires cutting through the scalp and skull. The brain is a very fragile organ; to examine it carefully and properly may take up to three weeks.
Some organs may need to be kept for up to six weeks so that further tests can be performed in the pathology department.
After the autopsy, the organs are replaced and the skin is stitched (sutured) closed again as happens after any operation.
The post mortem can take up to three hours.

Tissue samples
Tissue samples taken from the body are usually kept by the laboratory. The samples are kept in the hope that technological advances may one day answer any remaining questions about the cause of death or the nature of the disease. Keeping tissue samples requires the specific consent of the deceased’s next-of-kin.

Organs that have been retained for further testing are returned to the family, disposed of by the hospital or kept for future medical research and training of medical staff, according to the family’s wishes.

The funeral
Once the post mortem is complete, the body can be collected by the family’s chosen funeral director. If some of the organs have been retained for further testing, the funeral may need to be delayed for a few days or weeks if the family wants the body to be whole before it is buried or cremated. In this case, the funeral director can arrange to embalm the body.

Post mortem results
A preliminary report is available within the first few days, but the full results of the post mortem are not usually available until around six to 12 weeks later. It may be best to arrange for the report to be sent to the family doctor, so that the next-of-kin can make an appointment to discuss the findings with their doctor. In other cases, the family could make an appointment with the pathologist.

Where to get help

Your doctor
Hospital staff
Pathologist
State Coroner’s Office Tel. (03) 9684 4444

Things to remember

A post mortem or autopsy is the medical examination of a body after death.
A hospital (or non-coronial) post mortem may be performed if the immediate family give their consent.
A coroner’s autopsy is performed if the coroner or police need information about the cause of death - for example, if the person was murdered or their death was suspicious.

You might also be interested in:
Death in hospital.
Funerals - some issues explained.

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