Post mortem examination and the gift of donation

Parents usually find it helpful to know as much as possible about why their baby or child has died. A post mortem examination can provide families with valuable information.

In certain situations, where doctors are unsure about the cause of a baby's or child's death, they have to discuss it with a coroner who will decide if further investigation (which may involve a post mortem examination) is needed. Coroners are independent, legally trained judicial officers who are required to investigate deaths where the causes or circumstances are either unclear, or unnatural. If the coroner (in Scotland, the procurator fiscal) orders a post mortem examination, consent from the family will not be sought. Otherwise, parents will have to give their written consent to a post mortem examination being carried out. This can be a difficult decision for grieving parents to make, but the examination may help parents know as much as possible about what led to the death of their child.

A post mortem examination, or autopsy, involves a careful external and internal examination of the child's body by a pathologist, a doctor with specialist training. Many parents worry about what will happen to their child at post mortem, and whether they will be able to see their child again. There is no reason why parents cannot see their child after post mortem, and if dressed, the incisions made on the child's body and head will not be visible. A child's face, hands and feet will not be affected by the examination.

The post mortem examination will be carried out as soon as possible after consent has been given, usually within 72 hours, and is conducted with respect and dignity. A child may be taken to another hospital so the examination can be carried out by a specialist children's pathologist. Results are usually available within six weeks. The consultant or family GP should discuss the results with the baby's or child's parents and ensure they are given full, understandable explanations and an opportunity to ask questions .

The examination may help to identify a cause of death which was unclear, reveal illnesses or conditions that had not previously been diagnosed, or give information about the effect of treatment. While a post mortem examination may still leave some questions unanswered and does not always find a definitive cause of death, it can rule out certain diseases and conditions and provide families and the staff who care for them with valuable information and knowledge for the future.

The Gift of Donation

Facing the tragedy of a child's death is monumental, but many families have gained comfort through the gift of donation, which can give hope to others. This can be a difficult issue to think about, but many families have appreciated being given the opportunity to consider this option.

Organ donation will only be considered when death is inevitable, and organs will not be taken without discussion with relatives, even where the person carried a donor card. The decision always rests with the family.

For organ donation to be possible, two independent doctors will have had to carry out tests to confirm brain stem death. When this has been established and if the family decide to go ahead, detailed discussions with a transplant coordinator will take place.

Following transplant operations, information about recipients can be made available to the donor's family. Many families have said that this has been a great comfort and help to them.

The option of donation after death extends beyond organ donation. Tissue such as corneas, skin, bone and heart valves can be donated within a short time after death.