Education And Debate

Obtaining consent for autopsy

BMJ 2003; 327 doi: https://doi.org/10.1136/bmj.327.7418.804 (Published 02 October 2003) Cite this as: BMJ 2003;327:804
  1. Michael B McDermott (michael.mcdermott@olhsc.ie), consultant histopathologist1
  1. 1 Our Lady's Hospital for Sick Children, Crumlin, Dublin 12, Ireland
  • Accepted 28 August 2003

Consent for autopsy is usually obtained by the consultant in charge of the case. Given the detailed information now required, should pathologists take on this role?

The recent controversy about organ retention has led to big changes in the information given to bereaved families. Professional bodies continue to advocate that the clinical consultant in charge of the case has the primary role in the hospital's interaction with relatives at this time.1 However, their unfamiliarity with autopsy procedures could lead to discrepancies between what is discussed and what the pathologist actually does. As the only pathologist at my hospital, I have taken on responsibility for giving information to relatives and completing autopsy documentation. Although not without its difficulties, this meeting leads to a transparency beneficial to both parents and the pathologist.

Public disquiet changes practice

The Bristol Royal Infirmary inquiry into deaths of babies having heart surgery caused widespread public concern about the quality of information delivered to families about postmortem examinations.2 There was particular disquiet that parents had not been specifically informed that this procedure would entail the retention of whole organs for detailed laboratory examination. Similar revelations at other hospitals and in other countries, including Ireland and Australia, prompted a series of public and private inquiries and have resulted in radical changes to the procedures used for conveying information and obtaining consent for postmortem examinations (box 1).1 3 4


Embedded Image

Bereaved parents need a full understanding of postmortem proceedings

Credit: AMY ECKERT/PHOTONICA

Experience with new guidelines

One of the main indications for retaining a whole organ, as opposed to a tissue fragment, is the investigation of congenital heart disease. As the national centre for the treatment of children with congenital heart disease, my hospital has been at the centre of this public debate since it began in Ireland in September 1999. The hospital introduced revised …

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