Rapid responses are electronic comments to the editor. They enable our users
to debate issues raised in articles published on bmj.com. A rapid response
is first posted online. If you need the URL (web address) of an individual
response, simply click on the response headline and copy the URL from the
browser window. A proportion of responses will, after editing, be published
online and in the print journal as letters, which are indexed in PubMed.
Rapid responses are not indexed in PubMed and they are not journal articles.
The BMJ reserves the right to remove responses which are being
wilfully misrepresented as published articles or when it is brought to our
attention that a response spreads misinformation.
From March 2022, the word limit for rapid responses will be 600 words not
including references and author details. We will no longer post responses
that exceed this limit.
The word limit for letters selected from posted responses remains 300 words.
I have read the article by Claire Dyer in which Keith Starmer, Director of Public Prosecutions is writing to the GMC Chairman, Peter Rubin, expressing serious concern about the initial post-mortem examination of Ian Tomlinson. (1)
I agree that it is good to highlight the role and responsibilities of all medical experts involved in a suspicious death, particularly the pathologist. I am glad you have emphasised the lack of clarity over the retention of samples in post-mortem examinations. The default rule for most coronial autopsies in my wide experience is that no tissue or other specimens are to be retained and often the pathologist has a great difficulty persuading a coroner to retain any material. The coroner has to pay for the processing and handling of this material. With their limited budgets, coroners discourage pathologists from taking materials at autopsy.
We hope with the appointment of Peter Thornton as the Chief Coroner of England and Wales will highlight these issues and he will establish with pathologists guidelines for retention of tissue at post-mortem examination. (2) As a pathologist dealing with sudden death, I have always emphasised that the heart needs retention for detailed examination because most cases are cardiac in origin and since many of these conditions are genetic I also advise the retention of spleen for DNA examination. (3) It is essential that pathologists and coroners work together on these vital issues.
Yours sincerely,
Dr. Mary Sheppard MB BCH BA BSc MD FRCPath
Consultant Cardiac Pathologist, Royal Brompton Hospital, London
1. Dyer C. GMC is asked to draw up clearer rules for pathologists carrying out postmortem examinations. BMJ. 2012;345.e5293.
2. Dyer C. England and Wales finally get first chief coroner. BMJ. 2012;344.e3743.
3. Sheppard MN. Approach to the cardiac autopsy. J Clin Pathol. 2012;65(6):484-95. Epub 2012/01/31.
Re: GMC is asked to draw up clearer rules for pathologists carrying out postmortem examinations
I have read the article by Claire Dyer in which Keith Starmer, Director of Public Prosecutions is writing to the GMC Chairman, Peter Rubin, expressing serious concern about the initial post-mortem examination of Ian Tomlinson. (1)
I agree that it is good to highlight the role and responsibilities of all medical experts involved in a suspicious death, particularly the pathologist. I am glad you have emphasised the lack of clarity over the retention of samples in post-mortem examinations. The default rule for most coronial autopsies in my wide experience is that no tissue or other specimens are to be retained and often the pathologist has a great difficulty persuading a coroner to retain any material. The coroner has to pay for the processing and handling of this material. With their limited budgets, coroners discourage pathologists from taking materials at autopsy.
We hope with the appointment of Peter Thornton as the Chief Coroner of England and Wales will highlight these issues and he will establish with pathologists guidelines for retention of tissue at post-mortem examination. (2) As a pathologist dealing with sudden death, I have always emphasised that the heart needs retention for detailed examination because most cases are cardiac in origin and since many of these conditions are genetic I also advise the retention of spleen for DNA examination. (3) It is essential that pathologists and coroners work together on these vital issues.
Yours sincerely,
Dr. Mary Sheppard MB BCH BA BSc MD FRCPath
Consultant Cardiac Pathologist, Royal Brompton Hospital, London
1. Dyer C. GMC is asked to draw up clearer rules for pathologists carrying out postmortem examinations. BMJ. 2012;345.e5293.
2. Dyer C. England and Wales finally get first chief coroner. BMJ. 2012;344.e3743.
3. Sheppard MN. Approach to the cardiac autopsy. J Clin Pathol. 2012;65(6):484-95. Epub 2012/01/31.
Competing interests: No competing interests