Autopsy

An autopsy, or post mortem, 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 autopsy

A hospital (or non-coronial) autopsy may be performed if the immediate family give their consent. In this case, the autopsy 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 autopsy can include:

• In some cases, the cause of the person's fatal illness may be unknown or uncertain.
• An autopsy can help determine the success (or otherwise) of a treatment method.
• An autopsy 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 an autopsy

'Hospital' and 'coronial' post mortems have differing rules around refusal rights.

Hospital autopsy

The immediate family has the right to refuse or agree to a hospital autopsy of the deceased. They may also choose to consent to an autopsy, 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. Make sure you discuss these issues with hospital staff.

Coronial autopsy

The senior next of kin may object to the carrying out of a coronial autopsy and the coroner must consider their request to reconsider if the request is made within 48 hours of the senior available next of kin receiving a notification from the coroner.

Where the coroner decides that an autopsy is still required, the matter may be appealed in the Supreme Court. But there is a limited time in which these objections to a coronial autopsy may be made. Provisions about objecting to a coronial autopsy are contained in s26 and s79 of the Coroners Act 2008.

The autopsy procedure

The autopsy is performed like a surgical operation. The steps may include:

• The autopsy 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 autopsy 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 from an autopsy

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 autopsy 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.

Autopsy results

A preliminary report is available within the first few days, but the full results of the autopsy 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. 1300 309 519
• National Coronial Information System