Understanding Post-Mortem Examinations
What is a Post-Mortem Examination?
A post-mortem examination (also called an autopsy) is a medical examination of a body after death to determine the cause of death or to investigate the extent of disease. Not all deaths require a post-mortem, but understanding when and why they happen can help reduce anxiety during an already difficult time.
October 2025 Update:
The Medical Examiner system now reviews all deaths, which has reduced the number of unnecessary post-mortems. However, coroner-ordered post-mortems remain mandatory in certain circumstances.
Key Point: There are two types of post-mortem examinations in the UK – hospital post-mortems (which you can decline) and coroner's post-mortems (which are legally required).
Types of Post-Mortem Examinations
Hospital (Consent) Post-Mortems
What it is: A post-mortem requested by doctors to learn more about a disease or condition, improve medical knowledge, or confirm a diagnosis.
Your choice: You can decline a hospital post-mortem. It requires the consent of the next of kin or legal representative.
Purpose: Medical research, training, quality assurance, and understanding rare conditions.
When they're requested:
- The cause of death is known but doctors want to understand the extent of disease
- To confirm a diagnosis for medical records
- To help improve treatment for future patients
- For medical education and training purposes
- To gather information for audit or research
Coroner's (Mandatory) Post-Mortems
What it is: A post-mortem ordered by the coroner as part of their investigation into the death.
Your choice: You cannot refuse a coroner's post-mortem. It's a legal requirement when the coroner orders it.
Purpose: To establish the medical cause of death when it's unknown, suspicious, or meets certain legal criteria.
When they're ordered:
- The cause of death is unknown or uncertain
- Death was sudden or unexplained
- Death was violent, unnatural, or suspicious
- Death occurred during or shortly after surgery or medical procedure
- Death may be work-related or due to industrial disease
- Death occurred in prison or police custody
- Medical examiner has concerns requiring further investigation
What Happens During a Post-Mortem
Understanding the procedure can help reduce anxiety:
External Examination
The pathologist first examines the outside of the body, documenting any injuries, marks, medical devices, or other relevant features.
Internal Examination
An incision is made (usually Y-shaped on the chest and abdomen) to access internal organs. The pathologist examines organs, takes samples for testing, and documents findings.
Sampling and Testing
Small tissue samples may be taken for microscopic examination or toxicology testing. These samples can be critical for determining cause of death.
Closure and Restoration
After examination, the body is carefully closed with stitches. Pathologists take care to restore the body's appearance as much as possible.
Important: Post-mortems are conducted with dignity and respect. The body is treated with care throughout the procedure.
Limited vs Full Post-Mortems
Not all post-mortems involve examining the entire body:
Full Post-Mortem
Examination of the chest, abdomen, and head. This is the standard approach when the cause of death is completely unknown.
Limited Post-Mortem
Examination of specific areas or organs only. For example:
- Chest and abdomen only (if head examination not needed)
- Head only (for suspected brain-related deaths)
- Specific organs relevant to known conditions
Needle Biopsies
In some cases, small tissue samples can be obtained using needles rather than full surgical examination. This less invasive approach may be offered when appropriate.
For hospital post-mortems, you can discuss with doctors which type of examination they're requesting and whether a limited examination would provide the information needed.
Religious and Cultural Considerations
Many religions and cultures have specific views about post-mortem examinations:
Hospital Post-Mortems
For consent post-mortems, you can decline based on religious or cultural beliefs. Doctors will respect your wishes.
Coroner's Post-Mortems
Even if your religion opposes post-mortems, you cannot refuse a coroner's examination. However:
- Explain your religious concerns to the coroner's office
- They may expedite the process to minimize delay
- Some coroners will accommodate requests for limited examinations
- In exceptional cases, non-invasive imaging (CT/MRI) may be considered as an alternative
Jewish and Muslim Faiths
Both faiths traditionally prefer burial within 24 hours and have reservations about post-mortems. Coroners' offices are usually sensitive to these concerns and will:
- Prioritize the post-mortem to minimize delays
- Release the body as quickly as possible
- Consider whether the examination is absolutely necessary
- Explore less invasive alternatives when appropriate
Timeline and Results
Understanding the timeline helps with planning:
When the Post-Mortem Takes Place
- Coroner's post-mortems: Usually within 1-3 days of the coroner ordering it
- Hospital post-mortems: Within a few days to a week after consent is given
- Urgent cases: Same day or next day for religious reasons or urgent investigations
Preliminary Results
The pathologist can often provide an initial cause of death within 24-48 hours of the examination. This allows the coroner to release the body for burial or cremation.
Full Report
The complete post-mortem report takes longer:
- Standard cases: 4-8 weeks
- With toxicology testing: 8-12 weeks
- Complex cases: 3-6 months
- With specialist consultations: Can take longer
Important: You don't have to wait for the full report to proceed with the funeral. The body is usually released once preliminary findings are available.
Organ and Tissue Retention
A sensitive topic that requires clear understanding:
Why Samples Are Retained
Small tissue samples are routinely retained for:
- Microscopic examination (histology)
- Toxicology and chemical testing
- Genetic testing if relevant
- Evidence in potential legal proceedings
- Medical research (with consent for hospital post-mortems)
Whole Organ Retention
Sometimes entire organs (like the brain) need to be retained for specialist examination. This should be explained to you, and you have rights:
- You must be informed if organs will be retained
- For hospital post-mortems, you can refuse organ retention
- For coroner's post-mortems, retention may be necessary, but you should be consulted
- Retained organs are eventually returned for burial/cremation or respectfully disposed of according to your wishes
Your Rights
- Right to be informed about what will be retained and why
- Right to request return of retained material
- Right to specify how retained material should be disposed of
- Right to decline retention for research purposes (hospital post-mortems only)
Receiving Post-Mortem Results
How and when you receive information about the findings:
Coroner's Post-Mortems
The coroner's office will contact you with preliminary findings. You'll receive formal notification if an inquest is required. Full reports are provided before any inquest hearing.
Hospital Post-Mortems
A doctor (often the consultant who cared for your relative) will arrange a meeting to discuss findings. You can ask questions and request a copy of the report.
What's in the Report
- Description of external and internal examinations
- Findings from each organ system
- Results of any tests conducted
- Cause of death determination
- Pathologist's opinion and conclusions
Impact on Funeral Arrangements
How post-mortems affect your ability to proceed with the funeral:
Body Release: Usually within 3-5 days of the post-mortem being completed
Funeral Planning: You can plan the funeral while waiting, but can't set a firm date until the body is released
Viewing: Viewing is usually possible after post-mortem, though there may be a short delay for restoration
Burial vs Cremation: Both are possible after post-mortem, with no restrictions
Declining a Hospital Post-Mortem
If you're asked to consent to a hospital post-mortem:
You Have the Right to Refuse
You are under no obligation to agree to a hospital post-mortem. Doctors may ask, but cannot pressure you.
Questions to Ask
- Why is the post-mortem being requested?
- What do they hope to learn?
- Would it change anything about the death certificate?
- Will the findings help future patients?
- Can they do a limited examination instead of full?
- What will happen to any retained tissue?
Reasons People Consent
- To get answers about an unexpected death
- To help improve medical knowledge for future patients
- To understand a rare or complex condition
- For reassurance about genetic conditions affecting family
- To support medical education and training
Second Post-Mortems
In certain circumstances, a second post-mortem may be requested:
Criminal Investigations
If a death becomes a criminal matter, the defense may request an independent post-mortem. This is their legal right.
Disputed Findings
If family members dispute the findings of the first post-mortem, they can request a second opinion, though they may need to fund this privately.
Impact on Family
Second post-mortems cause additional delay and can be distressing. The coroner should keep you informed and the body should be released as soon as possible afterward.
Key Points to Remember
- • Hospital post-mortems require your consent – you can decline
- • Coroner's post-mortems are legally required when ordered – you cannot refuse
- • Post-mortems are conducted with dignity and respect
- • The body is usually released within days for funeral arrangements
- • Full reports take weeks or months, but preliminary findings come quickly
- • Religious and cultural concerns should be raised with the coroner's office
- • Small tissue samples may be retained for testing
- • You have the right to know what's being done and why
Getting Support
- • Coroner's Office: Contact them directly with questions or concerns
- • Hospital Bereavement Team: Can explain hospital post-mortem requests
- • Funeral Director: Can advise on timeline implications
- • Religious Leaders: Can discuss religious perspectives and advocate with authorities
- • Support Organizations: Inquest charity (inquest.org.uk) provides information and support
Scotland and Northern Ireland
Scotland
Scotland uses Procurator Fiscal instead of coroner. The process is similar but has some differences. The Procurator Fiscal orders post-mortems when investigating deaths.
Northern Ireland
Northern Ireland has a coroner system similar to England and Wales, with broadly comparable post-mortem procedures.
Related Guides
You might also find these guides helpful
When Deaths Go to the Coroner
Which deaths are referred to the coroner, what happens during an investigation, and how long the process takes.
What Happens at an Inquest
Complete guide to coroner's inquests, who attends, the hearing process, giving evidence, and possible outcomes.
Your Rights During Coroner Investigation
Legal rights as an interested person, accessing reports, legal representation, and how to raise concerns during the investigation.