This essay achieved an 87 in the third year of the author’s degree.
“Post-mortems are traumatic for bereaved families, but the state’s interest in ascertaining the cause of death is always paramount. Even those countries that allow families to register objections to post-mortems do not give them a right of veto - and it would be fundamentally wrong for English law to consider such a drastic move”.
Do you agree with this statement? Discuss critically, giving reasons for your answer.
Introduction
Under English law, the Coroner has a duty to investigate, amongst other dealings, unnatural and violent deaths and situations in which the cause of death is unknown.[1] Section 14 of the Coroners and Justice Act 2009 also allows the Coroner to order a post-mortem/autopsy of the body to establish the cause of death. In practice, the majority of coronial investigations rely heavily on a form of autopsy[2], specifically internal autopsies.[3] A conventional autopsy requires the physical inspection of the internal body.[4] This is an invasive procedure. Nonetheless, an autopsy is the most beneficial tool in determining the cause of death.[5] Through a critical analysis, this essay will argue that there is no necessity to implement the drastic move of a right of veto to post-mortems for bereaved families. There are various other mechanisms which English law can adopt in order to respond to the trauma suffered by familial objections to autopsies - whilst simultaneously protecting the state’s interest in ascertaining the cause of death. First, the current legal position will be examined to defend the position that autopsies can proceed without the deceased’s family's consent. Recent English and European Court of Human Rights case law will be explored to highlight that a right of veto is not an appropriate measure. Next, a comparative examination of foreign jurisdictions will seek to provide a balance between the state’s need to ascertain the cause of death and family objections to invasive autopsies. This will provide insight into alternatives to a family right of veto that English law could employ. Then, alternatives to invasive autopsies will be highlighted as a way of reducing family trauma in post-mortem investigations. As such, removing the need for a veto. Furthermore, it will be argued that too many autopsies are being ordered which causes unwarranted trauma for bereaved families. This analysis will showcase that the state’s interest, whilst paramount, can be too strong. The scholarship of Carpenter and Tait will be used to defend this claim, before concluding that a right of veto is unnecessary.
Case law and the ECHR
The leading English case on family objections to autopsy is Rotsztein[6]. This case highlights the difficulty and sensitive nature of the decision to perform an autopsy by a Coroner. Although Mrs Rotsztein had not died in suspicious circumstances, there was a
conflict between her General Practitioner and the hospital on the cause of death.[7] As a result, the coroner ordered an autopsy, even though Mrs Rotstein and her family were strict Orthodox Jews – a faith which prohibits the desecration of the deceased.[8] The Rotsztein family objected to the autopsy and offered to pay for a non-invasive post-mortem.[9] Nonetheless, the autopsy was performed and the family pursued a judicial review of the decision. Mr Justice Mitting highlighted in his decision that Coroners should, in cases of established religious objection, consider if there is a realistic possibility that non-invasive methods could produce an accurate cause of death.[10] As a result of this case, headlines such as “Coroners must send bodies for scans rather than autopsies if religion demands they stay intact, High Court rules”[11] appeared in the media. However, this is a weak and inaccurate evaluation of the case’s outcome. Although the judgment requires Coroners to consider the use of a less invasive investigation, this is only in cases in which there is no strong requirement for traditional methods.[12] Rotsztein must be distinguished as a case in which there were no suspicious circumstances. As the court put it, this case only addresses situations where the cause of death is unknown – not cases of violent or unnatural death.[13] In effect, this case is distinguished from cases where it is much more in the state’s interest to determine accurate causes of death. As such, the current legal position provides families in non-suspicious deaths more rights over the refusal of an invasive autopsy, whilst protecting the state’s interest in ascertaining the cause of death for public records and research into disease or injury.[14] This showcases there is no need for a complete right of veto as case law has developed to accommodate between the family and the state. As a result, the state’s desire for statistics is balanced with respect for a community’s desires for their dead.[15]
Post-Rotsztein, English law now recognises the need for differentiating between suspicious and non-suspicious deaths. However, one weakness of the current approach is in cases of deaths made to look natural. This is further emphasised by the fact that non-invasive techniques cannot yet fully determine the cause of death.[16] Furthermore, methods such as the one suggested by the Rotsztein family – post-mortem imaging – have been reported as not a suitable substitute for invasive autopsy.[17] Therefore, deaths made to look natural may slip through the cracks if a full autopsy is not ordered based on family objections – allowing for the possibility of a loophole for suspicious deaths. Cassum[18] notes this point was recognised in a study by Boglioli and Taff: that if autopsy can be opposed by families, this would become an obstruction to the effective investigation of deaths.[19] Australian case law similarly recognises the distinction. Raymond-Hewitt[20] emphasises the need for cultural, spiritual and family considerations to take second place to the public interest in cases where suspicious circumstances are involved in the death.[21] Public interest concerns are raised if non-invasive techniques risk not accurately determining the cause of death. Moreover, this proposition stresses why a right of veto should not be even considered: as it risks public safety by allowing the possibility of foul play to go undetected.
Conversely, one may suggest that not implementing a right of veto to post-mortems for bereaved families would violate Article 8 – the right to private and family life[22] - and, more so, Article 9 – freedom of thought, conscience and religion[23] – of the European Convention on Human Rights (ECHR) due to many families stipulating religious reasons for why an autopsy should not be performed. However, Article 8 and Article 9 ECHR are qualified rights and the ECHR recognises that they may be interfered with where stipulated by law for the protection of public safety and prevention of crime inter alia.[24] Furthermore, recent case law - Polat v Austria - has confirmed that Articles 8 and 9 do not confer any right to object to an autopsy examination.[25] As such, there is no grounds to consider a right of veto. The Polat case focused on situations where parents refused to consent to the performance of an autopsy on their newborn baby who had passed away after birth. In the UK, the autopsy rate of neonatal deaths stands at just 38%.[26] One reason behind this may be the anxiety of disfigurement of the newborn’s body,[27] which for both Islam and Judaism members is forbidden.[28] However, it is not just religious groups that object on this basis. A study by Rathinam and others stated that 80% of all bereaved families worry about the damage and disfigurement to the body by an autopsy.[29] Although it appears the majority of bereaved families oppose autopsy, it is still a benefit not just to the wider public through determining between accidents and murders, suspicious and non-suspicious deaths, it can also directly benefit the bereaved families themselves through determining inherited diseases.[30] The implementation of a veto would remove these benefits and risk inherited diseases going undiscovered. As a result, bereaved families would be caused even more trauma through undiagnosed disease in the future. As such, a right of veto is unwarranted.
The approach in other jurisdictions
A right of veto is not appropriate as other jurisdictions have different mechanisms for balancing the state’s paramount interest in ascertaining the cause of death whilst recognising objections to autopsy. Moreover, in countries such as the Kingdom of Saudia Arabia, where the law is completely based on Shari’ah law, autopsy is practised[31] and cannot be vetoed in suspicious circumstances – this is also the case in Egypt, Tunisia and Qatar.[32] This is despite Islam’s practice of burying the body immediately after death, negative views of autopsy among Muslims[33] and the significance placed on the wholeness of the body at death.[34] On the other hand, it is difficult to assess the amount of autopsies performed in Islamic countries as there is a lack of published data or research from these countries.[35] Nonetheless, the fact that states - ruled by laws based on religious beliefs with which the practice of autopsy conflicts - do not allow a right of veto to autopsy highlights that the state’s interest in ascertaining the cause of death will always be paramount. The implementation of a veto of autopsy under English law would be fundamentally wrong as this has not been done even in jurisdictions based on religious values - it would be an unprecedented move.
The legal approach in the US state of Minnesota emphasises there are alternatives to a complete right of veto to recognise bereaved families’ objections to autopsy. In contrast to English statute, Minnesotan state law has a mechanism to ensure objections to an autopsy are properly considered. The Coroners and Justice Act 2009 has no such mechanism and fails too mention religious or cultural objections. However, per section 390.11 subdivision 2 of the Minnesota Statute, the law allows representatives of the decedent to object to an autopsy on religious grounds. As a result, medical examiners are forced to communicate with the deceased’s family.[36] If introduced in England, this would mean that religious beliefs, and objections, are much more likely to be made known to the Coroner while making their decision. This would increase family participation in the post-mortem process without the need of a veto. Conversely, Minnesotan law still permits objections to be overridden on the basis of a compelling state interest.[37] Subdivision 2b (1) of the 390.11 statute, lists fifteen different scenarios where it would be necessary for an autopsy even when families object. Therefore, if such an approach was introduced in England it could be criticised for being performative. Nonetheless, the introduction of this mechanism would allow for all families to have the chance for a court to hear their objections to autopsy.[38] This would allow their voices to be heard and would decrease the intrusion on their Article 8 and 9 ECHR rights, whilst maintaining the state’s interest in ascertaining the cause of death. Minnesota is not unique. States including Louisiana, Maryland, New York and California have similar statutes forcing the coroner to consider the religious beliefs of the deceased and their families before an autopsy is performed.[39] Although the criteria listed in the Rotsztein case provides guidance to coroners for considering religious objections, this is not protected in statute. As a whole, the introduction of a similar mechanism in English law would provide a fairer balance between the state’s and families’ interests, reducing any argument for a veto.
Another jurisdiction that English law may take inspiration from is Australia. Australia is a multicultural society.[40] This creates difficulties for coroners dealing with cultural differences.[41] Traditionally, English coronial law has been less focused on rights in contrast to Australia.[42] Similar to the practices noted in some US states above, the state of Queensland mandates information is collected as part of a police investigation where cultural and religious statuses with a tendency to object to autopsies are involved; this information is then communicated to the coroner.[43] One may suggest that Australia and states such as Minnesota only cater for cultural and religious objections to autopsy because of the history of their native people – Australia’s indigenous people and those of Pacific Islander ancestry[44] and Native Americans and those of Midewiwin religion in states such as Minnesota.[45] Nonetheless, by recognising such objections, these states reduce the trauma caused to families by providing some hope their concerns will be listened to. Furthermore, the very fact that these native populations exist and have concerns relating to invasive autopsy[46], yet the government does not allow a right a veto reiterates the paramount nature of the state’s interest in ascertaining the cause of death. Carpenter and others found that following the change of law in Queensland, Coroners now seem to be more swayed by families’ religion which has led to the less invasive autopsies.[47] In contrast, English statute fails to promote communication with families during the making of Coronial decisions. A combination of both jurisdictions would increase family participation in the English process, allowing their oppositions to be heard and reducing the requirement of a veto.
Alternatives to invasive autopsies
In England, internal autopsies prevail.[48] Internal autopsies are invasive by nature. However, some alternatives to the traditional internal autopsy can reduce the invasiveness of the post-mortem assessment resulting in less or even no trauma at all for bereaved families. The notion of using radiographical imaging to lessen the requirement for the performance of a full autopsy has been around for over 33 years – with Mittleman and collaborators recommending this in 1991 for situations of religious objections.[49] Following Rotsztein, the Chief Coroner issued guidance[50] on post-mortem imaging recognising that the use of scanning would reduce the amount of autopsies and would be especially welcomed by some faith groups.[51] Such imaging is non-invasive,[52] which would remove the trauma for bereaved families. As such, there would be no need for a veto to be introduced. However, one limitation of post-mortem imaging is that scanning machines are typically used daily for the living and would not be available for screening the dead.[53] To avoid this tension, dedicated equipment would be required resulting in a significant investment. This is especially the case given the constrained resources of Coroners and Pathologists in England.[54] However, once up and running techniques such as CT scanning are cheaper than conventional autopsies.[55] In a study done by Jones, the professionals in England who actually perform autopsies showed some willingness to adopt scanning techniques, due to considering invasive autopsies as undignified and mutilating.[56] This stresses even those who perform traditional autopsies as their job have negative feelings towards the process. Therefore, it is important to introduce alternatives to invasive autopsies so those with strong objections can avail of them and experience less trauma. Moreover, it has been contended that non-invasive techniques, such as imaging, are appealing to Muslim and Jewish faith groups.[57] Accordingly, a right of veto is definitely not required as there are established alternatives to autopsies which cause less distress and do not interfere with religious objections.
However, non-invasive techniques such as imaging are not entirely accurate. Such methods are not complete solutions,[58] with some critics noting they are not as accurate as internal autopsies.[59] Accurate causes of death are necessary for ensuring justice in situations of foul play but also for the effective planning of health systems.[60] Consequently, the state’s interest in ascertaining the cause of death would be eroded. Stawicki and others have forecasted that future technological advances could make imaging autopsy more mainstream.[61] Recent research has suggested that artificial intelligence (AI) and machine learning could aid post-mortem imaging.[62] This could also combat the lack of post-mortem imaging experts.[63] One of the reasons post-mortem imaging is not entirely accurate is the huge amount of data it creates – which creates a large workload to work through.[64] Machine learning techniques are already being used to automate CT imaging in other branches of medicine.[65] Furthermore, studies have shown the possibility of the automatic detection of heart-related causes of death.[66] Although this study is limited to heart-related causes of death, it forecasts that with the right technological advances in the near future, AI could assist in improving the accuracy of imaging autopsies. Stawicki agrees that with the right advances imaging autopsy could replace invasive alternatives.[67] This would remove the need for a veto altogether. But, technology is not yet that developed. One further hurdle must also be overcome for imaging autopsy to be made standard. Jones found that Home Office Registered Forensic Pathologists (HORFPs) – those who conduct autopsies – were hesitant to accept non-invasive procedures as they are subject to strong accountability regulations.[68] In other words, possible mistakes of the new technologies may land at their feet. These obstacles must be overcome to implement imaging techniques and decrease the trauma caused to bereaved families whilst protecting the state’s interest. This is something a complete right of veto cannot achieve – as it removes the state’s interest in ascertaining causes of death. With the correct technological advances, a right of veto will not be necessary.
Unnecessary autopsies
Even without using new technologies, the Shipman Inquiry found a general prioritisation of medical cause of death over legal circumstances which emphasised itself through a substantial reliance on full internal autopsies by HORFPs.[69] Furthermore, if a Coroner does not order a full internal autopsy and something is not picked up, then the Coroner could be held accountable for this omission.[70] Consequently, autopsies are being ordered as a precaution. The Shipman Inquiry noted that too many autopsies are carried out by Coroners, most of which do not add any knowledge of the cause of death.[71] As a result, a large number of unnecessary coronial autopsies are carried out under English law as the state’s interest in ascertaining the cause of death is too strong. Reducing the amount of unnecessary autopsies would remove the unwarranted trauma for bereaved families who object to autopsies. Instead of implementing a right of veto to remove such trauma, an action plan to lower the amount of internal autopsies performed without any need would be a better approach. The internal autopsy rate in England and Wales is 99%.[72] In contrast, Janet Smith, who compiled the Shipman Inquiry, recommends that 80% of deaths require only a simple investigation and no autopsy in a normal coronial system.[73] As such, it is clear that too many internal autopsies are being performed. Naturally, by reducing the amount performed, the volume of trauma experienced by families who object would also decrease. By reducing the state’s interest in ascertaining the cause of death, English law can retain the state’s interest and reduce trauma all whilst not having to implement a right of veto.
Conclusion
As observed, the case of Rotsztein recognises the need for appropriate consideration of family objections to autopsy whilst maintaining the position that autopsies can proceed without familial consent. In addition, Articles 8 and 9 ECHR were examined, with the finding that there are just not religious reasons for objecting to autopsies. However, it was contended that autopsies should go ahead for the prevention of future family trauma through undiagnosed disease. Furthermore, a comparative analysis of the laws in Saudia Arabia, Minnesota, and Australia suggested that a right of veto is a drastic and unnecessary move. This is because these jurisdictions have implemented different mechanisms of recognising family objections to autopsy in their regimes. Following this, alternatives to invasive autopsies were put forward as a means of removing the need for a veto. However, technology needs to improve for this to be an effective alternative. Nonetheless, too many invasive autopsies are being performed under English law. Reducing this number would be much more effective for reducing family trauma whilst also lowering the need for a right of veto. Overall, it was shown that there is no necessity to implement the drastic move of a right of veto to post-mortems for bereaved families.
References:
[1] Coroners and Justice Act 2009, s1.
[2] Brenda Carpenter and Gordon Tait, ‘The Autopsy Imperative: Medicine, Law, and the Coronial Investigation’ (2010) 31 JMH 205, 215.
[3] ibid 206.
[4] Tariq Auoub and Jade Chow, ‘The conventional autopsy in modern medicine’ (2008) 101 JR Soc Med 177, 178.
[5] Celine Lewis and others, ‘“We might get a lot more families who will agree”: Muslim and Jewish perspectives on less invasive perinatal and paediatric autopsy’ (2018) 13(8) PLOS One https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0202023> accessed 19 March 2024.
[6] R (Rotsztein) v HM Senior Coroner for Inner London [2015] EWHC 2764 (Admin).
[7] ibid [5].
[8] ibid [6].
[9] ibid [7].
[10] ibid [27].
[11] Paul Gallagher, ‘Coroners must send bodies for scans rather than autopsies if religion demands they stay intact, High Court rules’ The Independent (London, 28 July 2015)
<https://www.independent.co.uk/news/uk/home-news/coroners-must-send-bodies-for-scans-rather-than-autopsies-if-religion-demands-they-stay-intact-high-court-rules-10422561.html> accessed 20 March 2024.
[12] Bruce Baer Arnold and Wendy Bonython, ‘Autopsies, scans and cultural exceptionalism’ (2016) 41 ALJ 27, 28.
[13] R (Rotsztein) (n 6) [24].
[14] Arnold and Bonython (n 12) 28.
[15] ibid 27.
[16] Laila Akber Cassum,‘Refusal to Autopsy: A Societal Practice in Pakistan Context’ (2014) 5:5 JCR&B 1, 3.
[17] James Underwood, ‘Post-mortem imaging and autopsy: rivals or allies?’ (2012) 379 Lancet 101, 102.
[18] Cassum (n 16) 2.
[19] Lauren Boglioli and Mark Taff, ‘Religious objection to autopsy. An ethical dilemma for medical examiners’ (1990) 11 AJFMP 1.
[20] Raymond-Hewitt v Northern Territory Coroner [2011] NTSC 94.
[21] ibid [32].
[22] Convention for the Protection of Human Rights and Fundamental Freedoms (European Convention on Human Rights, as amended) (ECHR), art 8.
[23] ibid art 9.
[24] ibid art 8(2).
[25] Polat v Austria App no 12886/16 (ECtHR, 20 July 2021) [84].
[26] Celine Lewis and others, ‘Factors affecting uptake of postmortem examination in the prenatal, perinatal and paediatric setting’ (2017) 125 BJOG 172, 173.
[27] Lewis (n 5) 2.
[28] ibid 1.
[29] Rajesh Rathinam and others, ‘Perceptions of relatives towards medico-legal investigation and forensic autopsy: A cross sectional survey from rural Haryana’ (2013) 27 JMS 173, 175.
[30] Cassum (n 16) 2.
[31] Madadin Mohammed and Magdy Kharoshah, ‘Autopsy in Islam and current practice in Arab Muslim countries’ (2014) 23 JFLM 80, 81.
[32] Cassum (n 16) 3.
[33] Mohammed and Kharoshah (n 31) 82.
[34] Courtney Campbell, ‘Religion and the body in medical research’ (1998) 8 KIEJ 275, 295.
[35] Mohammed and Kharoshah (n 31) 81.
[36] Gail Kulick and others, ‘From Dysfunction and P om Dysfunction and Polarization to Legislation: Native American Religious Freedom Rights and Minnesota Autopsy Law’ (2016) 42 MHLR 1699.
[37] ibid 1705.
[38] ibid 1721.
[39] Jack Bierig, ‘Informed consent in the practice of pathology’ (2001) 125 APLM 1425, 1426.
[40] Prue Vines, ‘Objections to Post-mortem Examination: Multiculturalism, Psychology and Legal Decision-making’ (2000) 7 JL&M 422, 423.
[41] ibid 424.
[42] Rebecca Scott Bray and Greg Martin, ‘Exploring fatal facts current issues in coronial law, policy and practice’ (2016) 12 IJLC 115, 131.
[43] Belinda Carpenter and others, ‘Communicating with the Coroner: How Religion, Culture, and Family Concerns May Influence Autopsy Decision Making’ (2011) 35 DS 316, 318.
[44] Arnold and Bonython (n 12) 27.
[45] Kulick and others (n 36) 1706.
[46] ibid 1703.
[47] Carpenter and others (n 43) 334.
[48] Carpenter and Tait (n 2) 205.
[49] Connolly and others, Autopsy Pathology: A Manual and Atlas (3rd edn, Elsevier 2016) 20.
[50] Chief Coroner, ‘The use of Post-Mortem Imaging (Adults)’ (Courts and Tribunals Judiciary, 14 January 2016) < https://www.judiciary.uk/guidance-and-resources/chief-coroners-guidance-no-1-the-use-of-post-mortem-imaging-adults/> accessed 25 March 2024.
[51] ibid [5].
[52] Stanislaw P. Stawicki and others, ‘Postmortem use of advanced imaging techniques: Is autopsy going digital?’ (2008) 2 OPUS 12 SCIENTIST 17, 20.
[53] Britt Blokker and others, ‘Non-invasive or minimally invasive autopsy compared to conventional autopsy of suspected natural deaths in adults: a systematic review’ (2016) 26 ER 1159, 1173.
[54] Imogen Jones, “`It's All About Justice': Bodies, Balancing Competing Interests, and Suspicious Deaths” (2018) 45 JLS 563, 579.
[55] Blokker and others (n 53) 1169.
[56] Jones (n 54) 578.
[57] Lewis and others (n 5) 9, 15.
[58] Arnold and Bonython (n 12) 27.
[59] Blokker and others (n 53) 1174; Stawicki and others (n 52) 20.
[60] Christina Paganelli and others, ‘The evolution of minimally invasive tissue sampling in postmortem examination: a narrative review’ (2020) 13(1) GHA 1, 2.
[61] Stawicki (n 52) 22.
[62] Akos Dobay and others, ‘Potential use of deep learning techniques for postmortem imaging’ (2020) 16 FSMP 671.
[63] ibid 671.
[64] ibid.
[65] ibid 677.
[66] Lars C. Ebert and others, ‘Automatic detection of hemorrhagic pericardial effusion on PMCT using deep learning - a feasibility study’ (2017) 13 FSMP 426.
[67] Stawicki and others (n 52) 22.
[68] Jones (n 54) 579.
[69] Carpenter and Tait (n 2) 206.
[70] ibid 214.
[71] Janet Smith, The Shipman Inquiry. Third report—Death certification and the Investigation of deaths by Coroners (Cmd 5854, 2003) 223.
[72] Carpenter and Tait (n 2) 206.
[73] Janet Smith, ‘The Shipman Inquiry: death certification’ (2004) 44 MSL 280, 284.
Bibliography:
Table of cases
Polat v Austria App no 12886/16 (ECtHR, 20 July 2021)
R (Rotsztein) v HM Senior Coroner for Inner London [2015] EWHC 2764 (Admin)
Raymond-Hewitt v Northern Territory Coroner [2011] NTSC 94
Table of legislation
Coroners and Justice Act 2009
Books
Connolly and others, Autopsy Pathology: A Manual and Atlas (3rd edn, Elsevier 2016)
Journal articles
Arnold BB and Bonython W, ‘Autopsies, scans and cultural exceptionalism’ (2016) 41 ALJ 27
Bierig J, ‘Informed consent in the practice of pathology’ (2001) 125 APLM 1425
Blokker B and others, ‘Non-invasive or minimally invasive autopsy compared to conventional autopsy of suspected natural deaths in adults: a systematic review’ (2016) 26 ER 1159
Boglioli L and Taff M, ‘Religious objection to autopsy. An ethical dilemma for medical examiners’ (1990) 11 AJFMP 1
Bray RS and Martin G, ‘Exploring fatal facts current issues in coronial law, policy and practice’ (2016) 12 IJLC 115
Campbell C, ‘Religion and the body in medical research’ (1998) 8 KIEJ 275
Carpenter B and others, ‘Communicating with the Coroner: How Religion, Culture, and Family Concerns May Influence Autopsy Decision Making’ (2011) 35 DS 316 and Tait G, ‘The Autopsy Imperative: Medicine, Law, and the Coronial Investigation’ (2010) 31 JMH 205
Cassum LA, ‘Refusal to Autopsy: A Societal Practice in Pakistan Context’ (2014) 5:5 JCR&B 1
Paganelli C and others, ‘The evolution of minimally invasive tissue sampling in postmortem examination: a narrative review’ (2020) 13(1) GHA 1
Dobay A and others, ‘Potential use of deep learning techniques for postmortem imaging’ (2020) 16 FSMP 671
Ebert LC and others, ‘Automatic detection of hemorrhagic pericardial effusion on PMCT using deep learning - a feasibility study’ (2017) 13 FSMP 426
Jones I, "`It's All About Justice': Bodies, Balancing Competing Interests, and Suspicious Deaths” (2018) 45 JLS 563
Kulick G and others, ‘From Dysfunction and P om Dysfunction and Polarization to Legislation: Native American Religious Freedom Rights and Minnesota Autopsy Law’ (2016) 42 MHLR 1699
Lewis C and others, ‘Factors affecting uptake of postmortem examination in the prenatal, perinatal and paediatric setting’ (2017) 125 BJOG 172
Mohammed M and Kharoshah M, ‘Autopsy in Islam and current practice in Arab Muslim countries’ (2014) 23 JFLM 80
Rathinam R and others, ‘Perceptions of relatives towards medico-legal investigation and forensic autopsy: A cross sectional survey from rural Haryana’ 27 JMS 173
Smith S, ‘The Shipman Inquiry: death certification’ (2004) 44 MSL 280
Stawicki SP and others, ‘Postmortem use of advanced imaging techniques: Is autopsy going digital?’ (2008) 2 OPUS 12 SCIENTIST 17
Underwood J, ‘Post-mortem imaging and autopsy: rivals or allies?’ (2012) 379 Lancet 101
Vines P, ‘Objections to Post-mortem Examination: Multiculturalism, Psychology and Legal Decision-making’ (2000) 7 JL&M 422
Reports
Smith J, The Shipman Inquiry. Third report—Death certification and the Investigation of deaths by Coroners (Cmd 5854, 2003)
Other
Chief Coroner, ‘The use of Post-Mortem Imaging (Adults)’ (Courts and Tribunals Judiciary, 14 January 2016) < https://www.judiciary.uk/guidance-and-resources/chief-coroners-guidance-no-1-the-use-of-post-mortem-imaging-adults/> accessed 25 March 2024
Convention for the Protection of Human Rights and Fundamental Freedoms (European Convention on Human Rights, as amended) (ECHR)
Gallagher H, , ‘Coroners must send bodies for scans rather than autopsies if religion demands they stay intact, High Court rules’ The Independent (London, 28 July 2015) <https://www.independent.co.uk/news/uk/home-news/coroners-must-send-bodies-for-scans-rather-than-autopsies-if-religion-demands-they-stay-intact-high-court-rules-10422561.html> accessed 20 March 2024
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