Adult Autopsy

Autopsy & Fetal Losses

Alberta Precision Laboratories (APL) provides adult autopsy services for the province of Alberta. Autopsies must be requested by a physician and must be consented to by the decedent's legally authorized representative (see Consent for Autopsy section below). Autopsies are performed with the utmost care and respect for the decedent, and endeavor to obtain answers to clinical questions that could not be answered during the decedent's life. Autopsy does not disfigure a body, and an open casket funeral can be held after an autopsy in most circumstances. Barring delays with consent, autopsies are typically done within 1-2 days of death, and do not delay funeral proceedings. Autopsies can be performed to adhere to specific religious requests, including expedited completion for burial prior to sundown. Autopsies are performed Monday to Friday. In Edmonton, autopsies may be arranged in advance for the weekend, under special circumstances.

In cases where the death is a notifiable death in accordance with the Fatalities Inquiries Act of Alberta, and the Medical Examiner does not require an autopsy to certify the cause and manner of death, an autopsy can be requested by a physician and performed with the consent of the decedent's legally authorized representative.

The autopsy service works closely with the Comprehensive Tissue Center (CTC) for the north and Southern Alberta Transplant Program for the south. If a decedent is a candidate for organ or tissue donation, and consent for donation is given, that will be completed prior to autopsy. It is only in rare circumstances that autopsy findings would be affected by organ procurement.

For patients or families interested in body donation for education, please visit the University of Calgary Body Donation Program website for the south and University of Alberta Anatomical Gifts Program for the north. Please note that body donation must be arranged prior to death, and autopsy precludes body donation.

For patients or families wishing to contribute to research into their disease, or to contribute to the general body of scientific and medical knowledge to enhance health care, the best option is to discuss the possibility of autopsy with the physicians providing care.

Consent for Autopsy

An Autopsy Consent and Consultation Request form (20597) must be completed and signed by the requesting physician. The form is available on the Alberta Health Services website by searching "Autopsy Consent and Consultation Request" and the APL Test Directory, Autopsy – Adult page.

The autopsy consent form contains three main components:

  • Designation of the legally authorized representative
    • Despite appointing power of attorney or selecting a next of kin prior to death, once an individual dies, the legally authorized representative follows the order listed on the form. It is only with consent from the legally authorized representative that the autopsy can be performed. For cases where the family is estranged or there are other factors, please call the local anatomical pathology laboratory and ask to speak to the autopsy pathologist on service.
    • The legally authorized representative gives consent for a complete or limited autopsy. Unless there are specific circumstances, all autopsies should be complete. Limiting the autopsy limits the pathologist's ability to appropriately and adequately examine all components of the body, and to answer the clinical questions.
    • The legally authorized representative is also asked to consent to, or to decline, retention of tissues and organs obtained at autopsy for education and research purposes. This refers to tissue taken in addition to that being taken for diagnostic purposes. All research projects procuring tissue at the time of autopsy are approved by the APL research department and/or the regional research ethics board. Educational endeavors include procuring specimens for anatomy and pathology teaching for medical students, residents, and clinicians.
  • Witnesses
    • In person consent must be witnessed by one individual. Telephone consent must be witnessed by two individuals.
    • The physician obtaining consent CANNOT witness the consent.
  • Clinical history
    • This component of the consent form is an opportunity to provide a quick overview of the case for the pathologist and the pathology team. It provides an opportunity to alert the team to any potential risks to the staff in terms of infectious diseases, and also provides an overview of the clinical history.
    • Please write any explicit questions to be investigated. The pathology team will endeavor to answer these specifically in the Autopsy Report.
    • Please include any physicians who would like to attend the autopsy or receive a report.
    • Please sign the consent form at the bottom.

Consent of the authorized representative must be obtained by the requesting physician and witnessed by a third party who can verify the identity of the person signing the form.

Identification of Bodies

Refer to the Alberta Precision Laboratories Test Directory:
Alberta Precision Laboratories Test Directory - Adult Autopsy

Autopsy Handling and Transport

  • All bodies must be placed in a body bag for transfer and receipt to site performing the autopsy.
  • Charts and Notice of Death are sent to Vital Statistics at the hospital site to be forwarded with the body.
  • Special handling procedures must be followed for autopsies on bodies with known or suspected communicable disease. Refer to Bodies of a Deceased Person Regulation.
  • Infections do not necessarily preclude autopsies from being performed, however, by communicating that a body has a communicable disease it allows the pathology team to take the necessary precautions to keep them safe, and still obtain the answers to the questions at autopsy.
  • Infections known at the time of death should be listed on the Autopsy Consent and Consultation Request form (20597).
  • Bodies with known or suspected Schedule 1 and Schedule 2 infectious diseases (as per Alberta Regulation 14/2001 Public Health Act) must be hermetically sealed bag/container and tagged with the appropriate Schedule 1 or Schedule 2 label, available on the AHS website. Autopsies may be limited at the pathologist’s discretion depending on the infectious disease. If you have questions regarding a specific communicable disease and how it may influence the autopsy, please contact the local anatomical pathology department and ask to speak to the Autopsy Pathologist on service.

Autopsies from AHS Hospital Sites:

The Admission/Patient Placement department of the hospital where the death occurred is responsible for arranging the transfer of a body to the site performing the autopsy.

Autopsies from Non-Hospital Sites:

  • See above for proper identification of the body. The chart and Notice of Death must accompany the body.
  • Autopsies will be accepted from deaths at home, nursing homes or other hospitals that do not have an autopsy service. This also includes Notifiable Deaths that do not require the Medical Examiner to perform an autopsy to complete the investigation.

Release of Bodies

After an autopsy has been performed, the body can be released directly to a funeral home or the authorized representative with proper documentation from Admissions/Patient Placement and compliance with Laboratory Services guidelines.

The person authorized to pick up the body must show appropriate identification and sign for the acceptance of the body.

Autopsy Reports

A Preliminary Autopsy Report is issued within 3 business days of the autopsy being performed. The purpose of this report is to summarize the clinical history, and to report the general findings at autopsy. If clinicians have any questions regarding either of these components of the report, they should call the reporting pathologist at their earliest convenience. The contact information for the pathologist is contained within the report.

A Final Autopsy Report will be issued within 60 business days of the autopsy, and will incorporate the findings on the histologic sections taken at autopsy, and any other ancillary tests that were performed. Any specific questions asked at autopsy will be addressed in the Final Autopsy Report.

A third component of the report is the Neuropathology Autopsy Report. As the examination of the nervous system requires additional training and expertise, this component is performed and reported by a separate pathologist.

References

Care After Death - Adult and Pediatric Policy (#PRR-05)

Add Bodies of Deceased Persons Regulation

Fatality Inquiries Act