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What is a post-mortem examination (or autopsy)?

A post-mortem (or autopsy) is an examination of a deceased person by an Anatomical or Forensic Pathologist to obtain clinical information related to related to any disease present as well as the cause of death.

Is there more than one type of post-mortem examination?

Yes. There are coronial and non-coronial post-mortem examinations depending on the circumstances of the death.

What is a coronial post-mortem examination?

If a death is unexpected, unexplained or suspicious it must be reported to the Coroner by NSW Police. The NSW Health policy directive PD2010_054 Coroners Cases and the Coroners Act 2009 provides direction and guidance to NSW Health staff regarding reporting a death to the Coroner. The Coronial Checklist is available to help NSW Health staff to determine whether a death is reportable to the NSW Coroner. For more information about coronial post-mortem examinations please visit the NSW Coroners Court or NSW Health Pathology website.

What is a non-coronial post-mortem examination?

A non-coronial post-mortem examination is usually undertaken when the cause of death is known but there is an interest in determining further information related to both diagnosed and potentially undiagnosed disease. Non-coronial post-mortems are governed by the Human Tissue Act 1983.

Who conducts non-coronial post-mortem examinations in NSW?

NSW Health Pathology provides a non-coronial post-mortem service at the Forensic Medicine Coroners Court Complex in Lidcombe, NSW. All examinations are conducted by a specialist Anatomical Pathologist.

What are the eligibility criteria?

At the time of death, the deceased patient must be aged:

  • 18 years or above OR 16 - 17 years old provided that the deceased person was admitted under the care of a non-paediatric specialist in a NSW public hospital that does not provide a specialist paediatric non-coronial autopsy service. (Note: A 16 or 17-year-old admitted under a paediatrician should be referred to specialist paediatric non-coronial autopsy service)
  • AND the deceased patient must have died in a public hospital including private patients in a public health facility
  • OR the Local Health District (LHD) has taken responsibility for that patient’s care.

NSW Health Pathology does not accept referrals related to workers compensation and/or medico-legal cases, private hospitals or referring clinicians external to the public hospital system including General Practitioners, or directly from family members.

I am a doctor in a public hospital, how do I make a referral?

Information for referring clinicians is available in the NSW Health Pathology Test Catalogue.

Is consent required for a non-coronial post-mortem examination?

Yes. Written consent is required from the person (given when they are alive) or from their senior next of kin (after death).

I am the Senior Next-of-Kin but it is not appropriate in my culture for me to make these decisions. Can someone else do it for me?

Yes. In some cultures, arrangements following a person’s death may traditionally be performed by someone other than the Senior Next of Kin. The Human Tissue Act 1983 allows an available Senior Next-of-Kin to authorise another person (a delegate), in writing, to exercise their functions. The delegate can give written consent for a non-coronial post mortem or autopsy examination.

Will I have to pay for a non-coronial post-mortem examination?

There is no cost to families for the non-coronial post-mortem examination. The referring Local Health District is responsible for all costs including transportation to and from the Forensic Medicine Coroners Court Complex in Lidcombe, NSW.

What happens after consent is given for a non-coronial post-mortem examination?

If the referral for a non-coronial post-mortem is accepted, the examination is scheduled and the deceased person will be transferred to the Forensic Medicine and Coroners Court Complex in Lidcombe for a non-coronial post-mortem examination. If the family wishes to see their deceased relative prior to transfer, requests should be made to the referring doctor and hospital social worker. Viewings for non-coronial post-mortem cases are not available once the deceased person has been transferred to the Forensic Medicine and Coroners Court Complex in Lidcombe.

What happens at a non-coronial post-mortem examination?

The Anatomical Pathologist will review the deceased person’s medical records and then thoroughly examine the exterior of the body for signs of underlying disease. They will then perform an examination of the internal organs following a surgical procedure to open the body. Small samples of tissue will usually be retained for microscopic examination (examination using a microscope). In certain cases, body fluids may be retained for testing (virology, microbiology, etc.).

Why would the Anatomical Pathologist need to retain organs?

The Anatomical Pathologist may need to retain one or more organs (usually the brain or heart) to test for signs of disease that are not immediately apparent. Usually this will be discussed when obtaining consent from the Senior Next-of-Kin or appointed delegate. If the pathologist does retain organs, it is possible to ask that they are returned to the body before being released for burial or cremation. This may result in a delay for the funeral. If it is not possible to delay the funeral, the Senior Next-of-Kin or their delegate can decide whether they would like the organs returned to them or the funeral director for separate burial or cremation. Small samples of tissue and fluids taken during the internal examination will not be returned to the body.

When will I find out the results of the non-coronial post-mortem examination?

A preliminary report will be sent to the referring doctor following the post-mortem examination. The referring doctor or hospital social worker will contact the Senior Next-of-Kin to advise when the report is available and to arrange a time to discuss the findings. The final post-mortem examination will follow in a few weeks after completion of the post-mortem examination and interpretation of any additional testing that might have been needed.

Current as at: Thursday 29 June 2023