Implementation of the 2005 Coroners Rules Amendments: a survey of practice in England and Wales: Table 1

Abstract

Background:On 1 June 2005, amendments to the Coroners Rules 1984 were introduced in England and Wales. These principally cover the retention of tissues from autopsies and their subsequent disposal. This study assesses regional variations in the interpretations of the amendments, and their impact on local autopsy practice in Oxford.Methods:A questionnaire was circulated to pathologists in 120 coronial jurisdictions, addressing conditions under which histological material could be retained. A local review of autopsy practice was conducted before and after the introduction of the amendments.Results:Questionnaires were returned from 71 coronial jurisdictions. 35 (49%) coroners provided written guidelines on their interpretation of the amendments. In 52 (73%) jurisdictions, pathologists are authorised to retain material to confirm/refine causes of death from natural causes. In 77% of jurisdictions, coroner’s officers are responsible for obtaining instructions from the next of kin on subsequent retention, use or disposal of retained tissues. In Oxford, there has been a reduction in the proportion of cases in which histology is taken, but an increase in the proportion of cases in which a histology report is issued.Conclusions:There is considerable regional variation in the interpretation of the 2005 Coroners Rules Amendments. These variations have potentially important implications for clinical practice.

Prospective parental consent for autopsy research following sudden unexpected childhood deaths: a successful model

“…However, at present this system is far less effective than the consenting system used by the MRC Sudden Death Brain and Tissue Bank in collaboration with the Procurator Fiscals in Scotland 8 10. This is because of regional differences in coroners’ rules, so an amendment to HM Coroners’ rules would be required to establish a similar system in England 4 5. From a pragmatic perspective, we would propose a model for discussing all areas of research in which the HM Coroner’s Officer provides the hospital with parent contact details where appropriate at the time of referral and a bereavement nurse then contacts the family to explain the autopsy process and the expected time frames and takes oral consent for post-mortem research, such as imaging and tissue retention, prior to autopsy, which would be followed up by written consent.…”

“…Nevertheless, if parental wishes are not known within this period, the tissues taken at autopsy must be disposed of by the hospital. HM Coroners vary widely in their adoption and interpretation of the new rules4 and only in a minority of cases is the appropriate parental consent information obtained and given to the pathologist 5 6…”

Letter to the Editor

“…The HTA stipulates that the relatives be informed of this process (HTA, 2006b) but does not clarify as to who bears legal responsibility to ensure that they have been adequately informed, whilst the Royal College of Pathologists recommends that the pathologist should not directly contact the bereaved relatives as this 'would risk generating confusion and possibly distress' (RCPath, 2006(RCPath, , rev 2007. Incidentally, although the new Coroners Rules stipulate that the coroner has to notify the pathologist of the time period the tissue needs to be stored for on his/her behalf, it has been our experience that we are rarely informed as to when exactly the coroner's function will end, and similar experiences are shared by other centres across the country (Delaney and Roberts, 2007).…”

Histopathology at autopsy: why bother?

“…The coronial service is divided into 109 jurisdictions 9 . Permission to retain tissue for histopathological sampling is at the discretion of individual coroners, who have very different views from one another 10 . The Coroner’s (Amendment) 2005 Rules state that the coroner must notify the pathologist of the period of time that, in the coroner’s opinion, material should be preserved to determine whether a cause of death is unnatural 11 .…”