Please be clear as to whether you wish to request a hospital (consent) autopsy, or you need to refer a death to the coroner. The Coroner has indicated that he would like all deaths associated with a hospital acquired infection reported to him: it would be appropriate for the reporting doctor to advise whether the deceased died with the infection or of the infection, or that this is uncertain.
Please do not make promises to relatives that an autopsy will be done the next day. Autopsies are performed in a timely fashion but there are multiple factors determining when they are done. Refer the relatives to the bereavement office for this information.
The range of consent forms and guidelines issued by the Department of Health is available on line.
Tailored UHSM versions are also available on line.
The consent forms are extensive but logical. You need to familiarize yourself with them before meeting with the next of kin.
For a hospital (consent) autopsy, use the form Consent to a post mortem examination on an adult.
In the event of the coroner ordering a post mortem examination, no consent from the next of kin is required. However, the coroner's view of the information that is required from the autopsy is likely to be narrower than that of a clinician. For example, the coroner will be satisfied with a diagnosis of "carcinomatosis", where a clinician will want to know the tumour type and the site of the primary. Once the pathologist is able to give a case of death to the satisfaction of the coroner, there is no authority for further investigation. In particular, the coroner has no authority to allow tissue to be taken for histology, once a natural cause of death has been given. In order to satisfy the needs of medical audit and education, it is necessary to obtain consent from the next of kin for investigations over and above those authorize by the coroner. For this purpose, you need to ask the next of kin to complete the form Post mortem examination on an adult, ordered by the coroner.
Information relating to the manchester coroner is avaiable at http://www.manchester.gov.uk/info/626/coroners
There is extensive advice from the Human Tissue Authority at http://www.hta.gov.uk/guidance/codes_of_practice.cfm
The Trust holds licenses from the Human Tissue Authority for the storage of bodies, the making of a post-mortem examination and the removal of tissues at post mortem : we are listed at the HTA web site under Wythenshawe Hospital
Dr P Bishop is the Designated Individual for the Trust's pathology HTA licences.
An NCEPOD report on coroner's autopsies can be found at www.ncepod.org.uk/2006.htm