Post mortems and Cremations

Post mortems and Cremations

Post mortemsPost mortems

• Post mortems can be performed for natural deaths

• Post mortems must be performed if cause of death is unnatural

• Unnatural – performed by Forensic pathology

• Natural – Anatomical pathology departments

• Unnatural deaths – by law required to do a post mortem (No. 61 of 2003: National Health Act, 2004)

• Natural deaths – usually on request from either the clinician or the family

• Post mortem examinations may be conducted if:– The person while alive gave consent– Spouse, partner, major child, parent,

guardian, major brother or major sister gave consent

– Examination is necessary for the determination or confirmation of the cause of death

• Documents required before a post mortem can be conducted:– Signed informed consent – Written authorisation from the medical

practitioner in charge of clinical services of the hospital or institution or of the mortuary

– Summary of the relevant clinical history – Completed death certificate

• All of the documents are available in the wards of both Kalafong and SBA hospitals

• Why must the death certificate be completed?– Page 1 – section D where you need to

indicate whether a death is regarded as natural or unnatural

– Page 2 – section G indicate what you suspect the cause of death may be

• Cause of death: – Cardio respiratory arrest is not a cause of

death– Most likely cause comes first– Then comes the secondary and contributory

causes– E.g.

– Acute myocardial infarction – Hypertension– Diabetes

• Death certificate– If indicated that death is natural – Anatomical

Pathology will accepted the body for a post mortem examination

– If indicated that death is unnatural – Forensic Pathology case

– If there is any doubt in the nature of the death – consultation with either department welcome

– If you have any doubt in your mind and not prepare to declare the death as natural you have the right to mark it as unnatural

• When will we not perform a post mortem– Neisseria meningitis cases– Hemorrhagic fever cases– Bleeding tendencies of unknown cause– Jacob Creutzfeld cases

CremationsCremations

• Cremations may only take place:– Registered crematorium– With proof that it was the wish of the

deceased

• Where a cremation is desired one of the following persons must give notice at the Administrative officer in charge of the crematorium:– Nearest surviving relative– Executor of the estate of the deceased

• The following documents are required:– Natural death:

• Schedule A: Application for cremation• Schedule B: Certificate from Medical attendant• Schedule C: Confirmatory medical certificate• Schedule E: Authority to cremate• Burial/Cremation order

– Unnatural death:• Schedule A: Application for cremation• Schedule D: Certificate after post mortem

investigation • Schedule E: Authority to cremate• Burial/Cremation order

– Same in case a post mortem was performed on a natural death

• All cremations are subject to approval by the referee / assistant medical referee appointed by the Municipality through the Head medical referee in the Dept Anatomical Pathology UP

• All documents need to be handed in to the medical referee for approval at least 48 hours before the intended cremation

• Documents need to reach the crematorium at least 24 hours before the intended cremation

• Medical referee will approve or reject the application for cremation

• Medical referee has the right to obtain all relevant information regarding the cause of death or circumstances surrounding the death –especially when the information supplied is insufficient

• If the medical referee has any doubt regarding the circumstances surrounding a death – he/ she may request a post mortem examination