Coroners' post-mortem examination
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No. Coroners’ post-mortem examinations and the storage of tissue removed during post-mortem examinations do not require consent from the family of the deceased (see section 11 of the HT Act).
The period of retention is authorised by the coroner. Tissue removed during a coroner’s post-mortem examination may also be seized by the police in the case of a suspicious death. Families must decide whether to proceed with the funeral or request to have the body stored until all tissue is repatriated. This may not always be possible.
Once the coroner’s authority has ended, it is not lawful to store or use tissue for a scheduled purpose without consent from a person in a qualifying relationship with the deceased. The Coroners Rules require coroners to inform a properly interested person (a role defined under the Coroners Rules) of the options available. These are:
- for the tissue to be returned for burial or cremation;
- for the tissue to be disposed of in a lawful manner;
- for the tissue to be retained for use for research or other purposes, with appropriate consent.
It is expected that any wishes will be honoured. However, should consent be given for tissue to be stored and used for a scheduled purpose under the HT Act, such as research, but the tissue is deemed unsuitable for this purpose, it should be disposed of. This should be explained in full at the time consent is taken.
They could be. A properly interested person, as defined in the Coroners Rules, is a relative of the deceased whom the coroner notifies that tissue has been retained and to whom the options for dealing with the tissue on expiry of the retention period must be communicated.
When the coroner’s authority ends, consent under the HT Act is required for storage or use of tissue for a schedule purpose. The person giving this consent must be the person in the highest position in the hierarchy of ‘qualifying relationships’ as defined in the HT Act. This may be a different person from the person with whom the coroner has been in contact.
Occasionally, a properly interested person or person in a qualifying relationship cannot be located, or is too distressed to discuss the options outlined above. Unless consent is given, tissue should be disposed of in a lawful manner within three months of the expiry of the coroner’s authority (see the HTA code of practice on Disposal, paragraph 54).
Where consent has been given for tissue to be used for a scheduled purpose but the tissue is determined to be unsuitable for the purpose, it should be disposed of. Consent is not required to dispose of tissue and disposal of tissue does not have to take place on HTA licensed premises.
Tissue, including that contained in wax blocks, can be disposed of by cremation or incineration. There may be difficulty in cremating slides because practice varies among crematoriums. For more information see the Cremation (England and Wales) Regulations 2008.
The HTA Code of Practice B (Post-mortem Examination) advises that:
"Dignified treatment and separate disposal are the minimum considerations when disposing of post-mortem tissue. This means disposal should be carried out separately from clinical waste, but not that each tissue sample needs to be disposed of individually."
You can read more on disposal of post-mortem tissue in the HTA Code of Practice B (Post-mortem Examination).
The permission of the coroner must be sought before any removal of tissue for transplantation takes place. The decision lies with the coroner whether the removal of the tissue would affect the results of a post-mortem examination.