Ethical dilemmas in seeking consent for a postmortem examination

Abstract

The past two years have seen considerable focus on postmortem practice. This largely follows two inquiry reports from the Bristol Royal Infirmary and Royal Liverpool Children's Hospital and the associated public reaction. In response, there have been numerous further publications which include guidelines and declarations of intent from the Department of Health; some important responses are still in draft form. Although it might be supposed that these changes will affect only pathologists, it is the process of consent that is the main focus of most recommendations. Paediatricians will need far more knowledge of the issues around the postmortem examination than formerly. There is still some uncertainty and debate as to the limits of discussions that may be needed before postmortem consent can be considered informed. This article will review aspects of usual postmortem practice and some of the issues raised by the various recent reports. Emphasis will be placed on the concerns of parents revealed over the past year or so.