Qualified post-mortem examination-experiences from Bremen

Abstract

On 1 August 2017, the qualified post-mortem examination was introduced in Bremen by changing the relevant law. A substantial change is the separation of the pure death determination, which can be done by any physician, and the subsequent execution of the post-mortem examination by asuitably qualified physician. For the city of Bremen, the Institute for Legal Medicine (IRM) was charged with this task (in Bremerhaven, the health department).In this article, practical implementation, problems, and advantages and disadvantages of the new law are presented. For the year 2018 we did astatistical evaluation of the qualified post-mortem examination.After notification of acase of death to the IRM, the post-mortem examination will be carried out on the same or the following working day by an IRMdoctor. In 2018, 7585 post-mortem examinations took place. In nearly 300 cases (4%) the type of death had to be changed (natural/not natural).Problems arise if external undertakers are involved. Further challenges arise in the collection of the anamnesis and implementation after extended weekends as well as due to the lack of knowledge about the death scene and generally the difficulty to conclude on the cause of death within the scope of an external post-mortem examination. One advantage to mention is that every deceased person is relatively promptly subjected to apost-mortem examination by aqualified doctor and overall the quality of the examination has improved. Adisadvantage is the increased cost.