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AUTOPSIES UNDER INDECENT CONDITIONS

THE LANCETWNDON: SATURDAY, FEBRUARY 77,1934

AFTER protesting for some years to the districtcoroner at the conditions under which local doctorsare called upon to perform post-mortem examina-tions, Dr. D. G. GARNETT, medical officer of healthfor Leiston, Suffolk, has written an open letter tothe Home Office, which appeared in the LeistonObserver on Jan. 13th. He has, he says, receivedsympathy on all hands-from the coroner, fromthe local council, from the East Suffolk countycouncil, from the police, and from the public-but each and all disclaim responsibility and referhim to someone else. He was recently called onto perform an autopsy in a place where therewas scarcely room to turn and where there wasno means of washing, as he found to his cost whenhe accidentally cut himself. It appears in manydistricts to be usual for an examination to bemade in the living-room of the house in whichthe death has occurred. Dr. GARNETT isnot asking that each district council should provideits own mortuary. One centrally placed should,he thinks, serve three or four districts if propertransport were arranged, and no doctor would

object to drive a few miles if he could then beassured of performing the autopsy under decentconditions.

This difficulty, which does not occur in

London, is one to which the DepartmentalCommittee on Coroners referred in 1910. Thiscommittee said the coroner ought to be able totake advantage of the hospital accommodationwithin or outside his district. "There is everypossible objection to a post-mortem examinationbeing conducted in a private house." The committeehad plenty of evidence on this point. A coronerfor a large district in South Wales, where fewhospitals were accessible, said that most of the

post-mortems took place on kitchen tables inovercrowded dwelling-houses. A metropolitanpolice surgeon described the unpleasantness of

taking off the skull cap with relatives withinearshot. A Lancashire coroner spoke of autopsiesconducted in a stable, adding that rats were aptto eat parts of the bodies in these surroundings.If these revolting conditions existed there was

clearly something wrong. The law has hardlybeen helpful either in its language or in its applica-tion. The Public Health Act of 1875 empoweredlocal authorities to provide mortuaries underSection 141 or post-mortem rooms under Section143. The Local Government Board (now replacedby the Ministry of Health) was authorised toinsist upon local action under Section 141, butnot under Section 143. Moreover the Act specifiedthat the post-mortem room must not be providedin a mortuary. The Board felt obliged to insistthat the one place must not be used for the purposeof the other. The restriction was probably imposed

to reassure public opinion, which has always beensensitive as to the possible abuse of anatomicalopportunities. It was realised too that relatives

going to see a body at the mortuary ought not tobe distressed by the sight of a post-mortemexamination conducted upon another body. At

any rate the Local Government Board deprecatedthe housing of mortuary and post-mortem roomunder the same roof. These requirements in theprovinces may be contrasted with the metropolitanarrangements under the Public Health (London)Act of 1891 ; a sanitary authority in Londonmay (and, if required by the L.C.C., must) providea place for post-mortem examinations, and this" may be provided in connexion with a mortuary,but this enactment shall not authorise the

conducting of any post-mortem examination in amortuary." 1 So curious was the legal positionoutside London that a coroner, it seems, could notorder removal of a body to a mortuary for a post-mortem examination, but, if the body was alreadydeposited in a mortuary, he could order it to beexamined there. Local authorities could unite forthe joint provision of proper accommodation, buthere there was another hitch. If the coroner letthe body go out of his district for an autopsy hesurrendered his jurisdiction over it to anothercoroner. This awkwardness was eventuallyremedied by Section 24 of the Coroners (Amend-ment) Act of 1926.The only hope, it seems, of the many doctors

who have to perform autopsies under grosslyunsuitable conditions is to stimulate the localauthority to make the necessary provision underSection 143, either independently or in combina-tion with another authority. Jervis on Coronerssuggests that the parish officers have a common-law duty to provide some place for the examinationof a body. The book hints at the possibility ofdepositing the corpse, if no other convenient placecan be found, in the parlour of the parish church-warden. Perhaps, since the Rating Act of 1925and the consequential Overseers Order of 1927, thisresponsibility of the parish officers has been trans-ferred to the rating authority. Be that as it may,the present haphazard arrangements are evidentlyunsatisfactory. There have, indeed, often been

complaints of the shortage of proper accommoda-tion for the holding of the inquest itself. The

Licensing Act forbids it to be held in a public-house if other suitable premises have been provided-which is not always the case. Coroners of

country districts told the Departmental Committeethat they usually managed to get the town hall’or the magistrates’ court where these were to behad ; in the villages they sometimes had the useof the reading-room. One coroner said the villageschoolmaster would sometimes obligingly give thechildren a holiday so as to make the schoolroomavailable. Now that our country districts are

organised under bigger and richer local authoritiesand that the distribution of public facilities isstudied and reviewed, there seems no excuse forthe embarrassments of which Dr. GARNETT justlycomplains.

1 See THE LANCET, 1933, ii., 1188.