The coroner and post mortem examinations
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- The coroner and post mortem examinations
Coroner's officers work under the direction of coroners and liaise with bereaved families, doctors, police officers and funeral directors. Some coroners' officers are police officers, whilst others are civilians.
If you need help finding your nearest coroner's office, call Bereavement Advice Centre on 0800 634 9494.
On this page:
First steps in a coroner's enquiriesThe post mortem examination
Coroner's post mortem
Consented post mortem
Where does it happen?
Who carries it out?
What's involved?
What happens next?
Will there be a written report?
The inquest
Who attends?
Who can give evidence?
Who can question the witnesses?
What will be decided?
What happens afterwards?
First steps in a coroner's enquiries
The coroner or his/her officer will gather information about the death to decide whether a doctor can issue a Medical Certificate of Cause of Death or whether further investigations are required.
If a Medical Certificate cannot be issued the coroner will usually order a post mortem examination.
If the coroner has been consulted, and there's no requirement for a post mortem examination, the following form will be issued:
- 'A' certificate - which informs the registrar of births and deaths that the coroner is aware of the death but no further investigation is necessary and that permission has been given to the doctor to issue the Medical Certificate of Cause of Death. In some parts of the country this is delivered by the coroner's service direct to the registrar but in other areas you may be asked to collect it from the coroner and take it to the registrar, along with the Medical Certificate.
A post mortem (also known as an autopsy or necropsy) is an examination of the deceased, to see whether his/her death was due to natural causes.
A post mortem may be carried out in two ways; on the orders of the coroner or with the consent of next of kin:
This is the most common type of post mortem examination, ordered by the coroner to find out why someone has died.
This is usually when the death is unexpected or the result of an accident, suicide or suspicious circumstances. Or if the death happened very soon after admission to hospital or after a medical or surgical procedure.
The next of kin will be informed, but in these circumstances the post mortem examination is a legal requirement and the consent of next of kin is not required. It is possible for the family to have a medical representative at the post mortem, but most families do not feel that this is necessary. You should tell the coroner's officer as soon as possible if you think you need to arrange this - and explain your reasons.
You should also tell the coroner or coroner's officer if you have strong objections to a post mortem examination on grounds of religion or culture. Do also speak with your own religious or cultural authorities as they will be familiar with the law and able to guide you.
This is also known as a voluntary or medical interest post mortem, and is carried out with the consent of the family.
The techniques used are identical to a coroner's post mortem but the circumstances are different - namely that a doctor knows the cause of death and is able to issue a Medical Certificate but feels that it would also be helpful to learn more about the condition from which the person died and the effects of any treatment given.
The doctor must ask the next of kin for signed permission to carry out this type of post mortem unless the deceased had already given their signed consent. Whilst this consent is legally binding, in practice doctors will discuss things with the family or executor before going ahead, to avoid causing additional distress.
Post mortems are carried out in purpose-built premises known as mortuaries. These are usually part of a large hospital, but in some major cities there are also public mortuaries.
A post mortem examination is carried out by a pathologist; a specially trained doctor who can diagnose disease by looking at tissues and cells. The pathologist is assisted by anatomical pathology technologists, who are also trained professionals.
The examination involves a careful examination of the body, including the internal organs. Some samples of tissue and body fluids may be retained for microscopic examination. Very occasionally, it may be necessary to retain a whole organ for a period but this will always be explained to you so you can make informed choices about when to hold the funeral.
The coroner or coroner's officer will give you the cause of death found by the pathologist, although in some instances further tests may be required.
After the post mortem examination if natural causes are found and no inquest is needed, the coroner will release the body so that the death can be registered and the funeral can take place. In this instance, the coroner will provide you with:
- Notification by the Coroner (Pink form B/form 100) - the coroner will send this form to the registrar in place of a Medical Certificate from a doctor. You may be asked to take this to the registrar yourself.
Family members should still be able to spend time with their loved one either at the hospital or at the funeral home, as great care is taken at the end of the examination to protect the deceased's appearance.
Will there be a written report?
Post mortem examination reports are technical medical documents, not usually written with the lay person in mind. Some pathologists may add a 'plain English' summary if asked to do so, but it can still be very difficult to read such documents about someone you have been close to.
For a coroner's post mortem
Full reports are often not available for several weeks (or even months) after the initial examination depending on any follow-up tests. If you want a written copy, you will need to ask the coroner's officer and you may need to write to the coroner concerned. You may also be charged a fee.
Some coroners prefer to send the report to a doctor, who will explain and discuss the findings with you. This may be a hospital doctor who was involved in the care of the deceased or a GP.
If an inquest is to be held, the report may not be released until after the inquest takes place.
For a consented post mortem
Consented post mortem examination results have to be requested from the hospital where the examination took place.
Because the report is part of the medical record of the deceased you may have to complete a formal document requesting access to the medical/health record, stating that you only want the post mortem report, in order to comply with the law on patient confidentiality. You may be charged a small fee for this.
You may want to make an appointment with the hospital consultant or a GP to discuss the report's findings. If the hospital has a bereavement office the staff there can often arrange this for you or you can approach the consultant's own secretary through the hospital switchboard.
If the cause of death remains in doubt after a post mortem examination or the post mortem confirms that the death was not from natural causes, an inquest will be held. In Scotland, this is known as a 'fatal accident inquiry'.
If there is to be an inquest, the coroner will open and adjourn proceedings after the post mortem examination is completed, so that the funeral can take place. These are:
- Order for Burial (form 101) - this is issued when there is an inquest and the person is going to be buried. It is usually collected by the funeral director from the coroner's service on your behalf.
- Certificate for Cremation (form E) - this is issued when there is a coroner's post-mortem or inquest and the person is going to be cremated. It is usually collected by the funeral director on your behalf.
- Removal Notice ('Out of England' form 104) - this is issued when the body is going to be moved out of England and Wales. It is usually collected by the funeral director on your behalf.
If charges have been brought against anyone for causing the death, there may be a need for further investigations, and funeral arrangements may be delayed.
All interested parties are invited, but as inquests are open to the public anyone can attend. Journalists are usually present too.
The coroner decides who should give evidence as a witness - and witnesses can be compelled to attend.
Anyone who believes that they may have information that could help is able to give evidence and should inform the coroner. Anyone who believes a particular witness should be called should also inform the coroner.
Who can question the witnesses?
Anyone with a legitimate interest is allowed to question witnesses, but it is very important that the coroner is told the nature of the interest and the questions before the inquest takes place.
Inquests do not determine blame and the verdict must not identify someone as having criminal or civil liability.
Possible verdicts include:
- Natural causes
- Accident or misadventure
- Suicide
- Unlawful or lawful killing
- Industrial disease
- Open verdicts - where there is insufficient evidence for any other verdict
And
Sometimes a coroner does not use one of these short terms but instead describes the circumstances of the death in a longer sentence, known as a 'narrative verdict'.
The coroner may also report the death to any appropriate person or authority such as the Health and Safety Executive; for example, if action is needed to prevent more deaths in similar circumstances.
At the close of the inquest, the coroner will forward information to the registrar of births and deaths to allow the death to be registered. The family can then purchase death certificates from the registrar, in person or by post.
Find out more
To find out more, contact:
Bereavement Advice Centre 0800 634 9494.