• Reference Number: HEY153/2026
• Departments: Pathology
• Last Updated: 31 August 2026

Introduction

Please accept our sympathies for your loss.

This leaflet aims to help you understand why you may have been asked to give consent for a postmortem examination during this difficult time. We appreciate you may not wish to receive detailed information right now, but if you do, our staff are here to answer any questions you may have and guide you through the consent process. Please feel free to ask questions at any point.

What is a Post-mortem?

A postmortem, also known as an autopsy, is an important medical examination that aims to find out more about a person’s illnesses and the cause of their death.

There are two types of post-mortem:

• Postmortem examination required by His Majesty’s Coroner. This is an investigation required by law and does not require the agreement of relatives.
• Consented post-mortem examination. This is an examination, which can be either requested by the patient whilst alive, you, or by the consultant responsible for your relative’s care. Its purpose is to find more information about your relative’s illness when the cause of death is already known. This can only be done with your full permission, and you will have choices about the extent of the examination.

A consented postmortem cannot take place without the agreement of persons in a qualifying relationship to the deceased.

If you agree to a consented postmortem examination the doctors will issue the medical certificate of cause of death before the postmortem so that you can proceed with the arrangements for the funeral.

Why are Post-mortems carried out?

Postmortem examinations are often associated with establishing a cause of death especially in cases where a Coroner is involved. In these situations, the cause of death may be unclear, sudden or unexplained.

However, when your consent is being sought for a postmortem examination, it usually means the primary cause of death is already understood. The purpose of the examination, in these cases, is often to gain a deeper understanding of the underlying disease process, which may not be fully understood.

Postmortems also have broader and vital implications for medical education and research. By examining tissue samples, doctors can improve their understanding of illnesses and how to effectively treat them.

These examinations are essential for:

• Training medical students and new doctors by providing them with real examples of various medical conditions.
• Helping experienced doctors stay informed about newly discovered conditions and evolving treatment methods.
• Teaching specialised knowledge to improve diagnostic and therapeutic skills.

Medical knowledge continues to grow and evolve. As new conditions are discovered and diagnostic technologies improve, previously retained samples can be revisited to refine or even change earlier diagnosis. This ongoing process of learning and discovery helps improve patient care in the future.

In some cases, with your permission, an organ or parts of an organ maybe retained for medical research or educational purposes. If an organ displays a particularly clear example of a specific condition, it can play a significant role in training healthcare professionals.

It’s important to know that tissues or organs can only be retained in a postmortem examination with the explicit permission of the person providing consent, additionally donating organs for transplantation is a separate process from post-mortem examinations.

Tissues, Blocks and Slides

When you are asked for your consent, the person guiding you through the process will carefully explain the procedure to you.

The discussions will include:

• The need to retain tissue samples and/or whole organs which may be essential for a thorough examination or further study.
• Any requirements for genetic tests, photographs, or x-rays which may be necessary to gain a more comprehensive understanding of the illness.
• The implications of any limitations you may choose to place on the examination, including how it may affect the findings, or the value of the information obtained.

What happens to the tissue samples in the laboratory?

The small tissue samples will be placed into plastic cassettes.

They are then processed into paraffin wax blocks in the laboratory. The blocks are normally about 20mm (less than one inch) square and about 5mm (under one quarter of an inch) thick.

The tissue is chemically treated to remove water, which is replaced with wax. The tissue ‘blocks’ become hard, so that thin sections can be cut with a sharp knife. These sections are very thin – ten times thinner than a human hair.

The sections are placed on glass slides and stained with special dyes to allow examination under a microscope. More than one slide may be cut from a block.

During the process of making the blocks, it is inevitable that very small amounts of tissue will be surplus to requirements. These would normally be disposed of according to hospital policy, unless you have an objection to this. If you have any concerns or specific wishes regarding the handling of these tissues, please feel free to discuss them during the consent process.

Further information on tissue retention and legal requirements relating to the constant can be obtained from the Human Tissue Authority on Tel: 020 7211 3400 or online at www.hta.gov.uk

Why is it useful for tissue blocks and slides to be kept?

Retaining tissue blocks and slides from a postmortem examination is a standard medical practice that serves several important purposes. Medical opinion recommends that these samples be kept at the hospital where the examination was performed as part of the medical record, usually for a period of up to 30 years.

Keeping these samples allows for:

• Future Review: If questions arise about the cause of death, or if there is a need to revisit the diagnosis, the preserved samples can be re-examined.
• Family Health Concerns: If another member of your family experiences a similar medical condition, the samples can assist in understanding potential hereditary or shared health issues.

By signing the consent form, you will have the option to agree to tissue samples being used for:

• Training and educating doctors.
• Teaching and research aimed at improving medical knowledge and treatments.
• Ethically approved medical research audits and public health surveillance.

Many people consent to this knowing that their decision could contribute to a better understanding and treatment of illnesses in the future. It’s important to note that when tissue samples are used in these ways, all identifiable information linking them to your relative is removed to protect privacy.

When do Post-mortems take place?

The postmortem examination will be carried out as soon as possible, usually within 2 to 3 working days. It may be possible to arrange it within 24 hours if necessary.

Postmortems are generally conducted during the mornings.

Where will the post-mortem take place?

For patients whose care was provided by Hull Royal Infirmary or Castle Hill Hospital, consented post-mortem examinations are carried out at the Hull Royal Infirmary Mortuary.

For patients whose care was provided by Diana, Princess of Wales Hospital (DPoW) or Scunthorpe General Hospital (SGH), consented post-mortem examinations are carried out at the Lincoln County Hospital Mortuary. The deceased will be transferred there prior to the examination.

Who conducts a Post-mortems?

Postmortem examinations are conducted by Pathologists who are specially trained medical doctors with expertise in examining the deceased and tissues to diagnose diseases.

They are assisted by Anatomical Pathology Technologist staff, and the examination takes place in the hospital mortuary.

What is involved in a Post-mortem?

A full postmortem examination involves examination of each of the main body systems including the brain.

The process typically includes:

• Removal and Retention of Small Tissue Samples: These are examined under a microscope to provide a detailed insight into illnesses or conditions
• Temporary Retention of organs and/or Tissues: Sometimes whole organs may need to be retained for closer examination. This will only occur with your consent, and you’ll be informed if this is necessary.
• Preparation of Blocks and Slides: Tissues may be retained temporarily for the preparation of slides used in microscopic examination.
• Consent for Specific Organ Retention: If the pathologist requires a particular organ for diagnostic purposes, written constant from you will be needed.

It is important to know that you may choose to limit the examination to a specific body cavity (e.g., the chest) or an organ system (e.g., the lungs). However, doing some may restrict the information obtained about the disease or cause of death.

If you wish, you will be able to see your child, partner or relative’s body again after the postmortem examination, before proceeding with your funeral arrangements.

What happens afterwards?

Examination Results:

• The results of the post-mortem are usually available within approximately 12 weeks. A copy of the report will typically be sent to your relative’s GP or hospital consultant, with whom you may wish to schedule an appointment to discuss the findings.

Retention of Organs and Tissue:

If any organs or tissues were retained for further examination, you have several options once they are no longer needed:

• Return to You or the Funeral Director for burial or cremation.
• Return to the deceased prior to release to a funeral provider
• Retain as part of the medical record
• Sensitively Disposed of by the Hospital in accordance with legal and ethical guidelines.
• Donated for Medical Educational Research, which may provide valuable insights for future patients and medical professionals.

If you decide that any retained tissue or organ should be returned to the deceased prior to burial or cremation, this may cause a delay in the funeral arrangements.

Donation considerations:

If you choose to donate tissues or organs for research, the receiving organisation may need to contact you again to obtain specific consent for storage. Please be aware that tissues and organs donated for research may not always be used as they may not be suitable for ongoing scientific studies.

What if I change my mind?

We understand that this is an incredibly difficult time for you, and we recognise that the information provided during the constant process may feel overwhelming or unclear.

This information booklet has been designed to address any concerns you may have, but if you have any further questions, or if anything remains uncertain, please do not hesitate to reach out to us.

For patients whose care was provided by Hull Royal Infirmary or Castle Hill Hospital, you can contact the Mortuary on Tel: 01482 608924.

For patients whose care was provided by Diana, Princess of Wales Hospital (DPoW) or Scunthorpe General Hospital (SGH), you can contact the Lincoln County Hospital Mortuary on Tel: 01522 573711.

Once you have signed the consent form, you’ll be informed of the scheduled time for the postmortem examination. Please be aware that you have the right to withdraw or amend your consent up to 3:30 pm on the day prior to the postmortem procedure. If for any reason you decide to change your mind and wish to withdraw consent, please contact the relevant mortuary service as soon as possible:

Hull Royal Infirmary Mortuary: Tel: 01482 608924 or Tel: 01482 608928

Lincoln County Hospital Mortuary: Tel: 01522 573711.

Explanation of terms

The most common words and terms used to describe what happens in a postmortem examination are explained here. If you are unsure or require further information, please do not hesitate in contacting the mortuary on the number(s) above.

Coroner

The coroner is an independent judicial officer responsible for investigating deaths. He or she is either an experienced lawyer, or an experienced doctor who has also had legal training.

Diagnosis, Diagnostic Use of Tissue and Diagnostic Tests

During the post-mortem examination tissue samples are analysed to determine the cause of death as accurately as possible. Microscopic examination of the tissues can reveal diseases that may not be visible through other methods, including those caused by genetic disorders. As new medical conditions are identified over time, retained tissue samples may allow for the diagnosis of these conditions in cases that were previously undiagnosed or misdiagnosed.

Education (Medical Education, Teaching and Training)

Studying tissue samples is a crucial method through which Doctors deepen their understanding of illnesses and develop effective treatments. Sharing knowledge among medical professionals is essential for upholding high standards of care. Medical students and doctors in training benefit from observing post examinations, discussing the procedure and its findings with experience doctors and learning from real life cases

Fixing/Fixation

Preparation of tissue or whole organs for further testing by preserving with chemicals.

Full Post-mortem Examination

A full post-mortem examination involves a thorough examination of all major body systems including the brain, chest and abdomen. It typically includes the removal and retention of small tissue samples for microscopic analysis. In some cases, whole organs may be retained further examination, but this will only be done with your consent

Limited Post-mortem Examination

If you prefer, a hospital consented post-mortem can be limited to a specific body cavity (such as the chest) or organ system (like the lungs). However, it’s important to know that this may not provide a complete understanding of the disease or cause of death

Organ

An organ is a distinct part of the body made up of multiple tissues working together to perform specific functions essential for life. Organs are vital components of the body’s complex systems, each contributing to overall health and functionality.

Person in the Highest Qualifying Relationship

The Human Tissue Act 2004 (HTA 2004) refers to the individual who has the legal authority to give or withhold consent for certain activities involving human tissue, such as post-mortem examinations or tissue donation, when the deceased’s wishes are not known.

The hierarchy of qualify relationships, from highest to lowest, is as follows:

• Spouse or Partner (including civil and long-term partners),
• Parent or Child (in this context a child means a child with capacity to understand what they are consenting to),
• Brother or Sister,
• Grandparent or Grandchild,
• Niece or Nephew,
• Step-parent,
• Half Brother or Half Sister,
• Friend of longstanding.

This hierarchy is used to determine who should be approached for consent when it’s not been provided by the patient prior to death. The person highest in the hierarchy who is available and willing to make decisions holds the authority.

Post-mortem

The term post-mortem comes from the Latin meaning ‘after death’ it refers to a medical examination carried out after a person has passed away. Another common term for this procedure is ‘autopsy’ which means ‘to see for oneself’. Postmortem examinations are conducted by Pathologists who are highly trained medical doctors specialising in studying diseases and the effects on the body. They are supported by a team of skilled Anatomical Pathology Technologist staff to ensure the examination is thorough and accurate.

Retaining or Retention of Tissue and/or Organs

Sometimes one or more whole organs, part of an organ or tissue samples are kept after the post- mortem examination to reach a diagnosis.

Reasons for this are:

• The organ or part of it may need to be examined with a microscope.
• The organ may show signs of a complex abnormality that requires a more detailed examination, perhaps by another specialist.
• The tissue or organ may need to undergo preparation before it can be examined.

Preparation may take several days and sometimes many weeks. With your permission, an organ (or part of an organ) might also be retained for use in medical research or education. If the organ shows a particularly clear example of a specific illness, it may play an important role in the education of medical students, doctors and nurses.

Tissue Samples, Blocks and Slides

Tissue Samples, Blocks and Slides To understand an illness or cause of death properly, the doctor needs to look at part of the affected organ under the microscope. To do this, small samples of tissue are taken from the organ (usually about 1 cm across and about 5 mm thick). These samples are made into hard blocks using wax. From these, very thin sections, 10 times thinner than a human hair, can be cut off. They are placed on glass slides so that they can be examined under a microscope. More than one section can be cut from one block.

Should you require further advice on the issues contained within this leaflet, please do not hesitate to contact:

Hull Royal Infirmary Mortuary on Tel: 01482 608924 or Tel: 01482 608928 and ask to speak to the Mortuary Manager or Deputy Mortuary Manager.

Lincoln County Hospital Mortuary on Tel: 01522 573711 for enquiries relating to consented post-mortem examinations transferred from Diana, Princess of Wales Hospital or Scunthorpe General Hospital.

General Advice and Consent

Most of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion with the healthcare team.

Consent to treatment

Before any doctor, nurse or therapist examines or treats you, they must seek your consent or permission. In order to make a decision, you need to have information from health professionals about the treatment or investigation which is being offered to you. You should always ask them more questions if you do not understand or if you want more information.

The information you receive should be about your condition, the alternatives available to you, and whether it carries risks as well as the benefits. What is important is that your consent is genuine or valid. That means:

• you must be able to give your consent
• you must be given enough information to enable you to make a decision
• you must be acting under your own free will and not under the strong influence of another person

Information about you

We collect and use your information to provide you with care and treatment. As part of your care, information about you will be shared between members of a healthcare team, some of whom you may not meet. Your information may also be used to help train staff, to check the quality of our care, to manage and plan the health service, and to help with research. Wherever possible we use anonymous data.

We may pass on relevant information to other health organisations that provide you with care. All information is treated as strictly confidential and is not given to anyone who does not need it. If you have any concerns please ask your doctor, or the person caring for you.

Under the General Data Protection Regulation and the Data Protection Act 2018 we are responsible for maintaining the confidentiality of any information we hold about you. For further information visit the following page: Confidential Information about You.

If you or your carer needs information about your health and wellbeing and about your care and treatment in a different format, such as large print, braille or audio, due to disability, impairment or sensory loss, please advise a member of staff and this can be arranged.