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New technology offers hope of non-invasive post-mortems

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The death of a loved one can be a distressing and confusing time in any circumstances but when the death is unexpected and the state in the form of the coroner and a coroner’s inquest becomes involved additional distress is inevitable, especially when the family is told there will be a post-mortem regardless of their wishes.

The role of the Coroner

The coroner’s job is to determine the circumstances Cause of Death for the benefit of the family and for the wider community who may also be at risk from the same or similar circumstances. In the case of a sudden death the coroner will usually order a post-mortem examination even when the family object.

A death will be referred to the coroner if it is unexpected, such as the sudden death of a baby (cot death) or was violent, unnatural or suspicious, such as a suicide or drug overdose. Likewise, if death was the result of an accident or injury or occurred during or soon after a hospital procedure, such as surgery, the coroner will become involved.

Mesothelioma and Asbestosis

Deaths connected to certain industrial diseases, such as the asbestos-related diseases mesothelioma or lung cancer, constitute an unnatural death under the Coroner’s Act 1988 and need to be notified to the coroner. In these cases an inquest must take place to establish and record the cause of death. In all other circumstances, the purpose of the coroner requesting a post-mortem is to establish if the death was due to unnatural or unexplained causes, and if so, an inquest will be held. Occasionally, the coroner may request a post-mortem examination without holding an inquest at all or may order the post-mortem examination to determine whether an inquest is needed.

For some relatives, a harrowing time is made even worse by the thought that a post-mortem examination may take place. This is particularly true when issues of religious faith are involved, but generally most people would find the idea of their loved one being ‘cut up’ very distressing. To add to the distress and confusion the release of the body for burial is a decision exclusively for the coroner.  The body is, in law, the ‘property of the coroner’.

No consent needed for a Post-Mortem

What many relatives find equally shocking is that, while the coroner is required by law to request that a forensic pathologist carries out a post-mortem examination, they cannot object to the procedure and their consent or permission to carry out a post-mortem is not required.

Although huge advances have been made in the fields of DNA analysis and toxicology in recent years, most forensic pathologists continue to rely on techniques developed in the 19th century. Their day-to-day work essentially differs little from the way their predecessors would have dissected corpses in a morgue 100 years ago.

New technology for non-invasive autopsies

That may be about to change however with forensic scientists in Switzerland using the latest developments in 3D imagery and radiological medical scanning (CT and MRI) to offer the prospect of non-invasive autopsies that can answer questions about the death and its causes without the need to cut up a body.

The CT scan can tell the pathologists a lot about the identity of a body and the location of any foreign bodies within. However it is less good at recording soft tissue injuries and injuries to the internal organs such as might occur in a serious personal injury and for that reason the system also uses MRI scanning. These technologies have made many full scalpel autopsies unnecessary as the cause of death is evident from the scanning alone.

Virtual post-mortems

Results from such a ‘virtual post-mortem’ are now accepted by the Swiss courts. In the UK, similar post-mortem CT scanning was used to quickly identify the 11 victims of the Shoreham Airshow disaster in 2015, when a vintage aircraft crashed into road traffic.

Paul Ashurst, one of Shoosmiths’s expert lawyers specialising in serious personal injury and industrial disease claims that frequently involve a post-mortem examination comments:

‘While everyone appreciates that an investigation into the cause of death is necessary, we know from our experience in personal injury and medical negligence cases that families who have just suffered the shock of a relative’s death can be very upset when they hear that their loved one is going to be ‘cut up’ despite any objections they may have.’

Paul concludes:

‘This technology offers the hope that many more autopsies can be done by non-invasive scanning alone. That would certainly help in cases where strong and sincerely held religious views make ‘desecration of the body’ morally difficult and the fact that their loved one will remain ‘intact’ will also be a comfort to many other grieving relatives who face a stressful enough time as it is.’

 
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