Recommendations

Chapter 11. Consent

4. National Health Service Hospital Post Mortem
Consent Form for Children

4.1 Section 1
Patient Details:
| Name of hospital |
Contact number
|
|
Name of child
|
Hospital reference number
|
|
Address
|
Telephone/fax numbers
|
|
Date of birth
|
General practitioner
|
|
Date of death
|
Address
|
|
Place of death
|
Telephone/fax numbers
|
|
Next of kin
|
Allocated bereavement adviser
|
|
Relationship to child
|
Date of appointment
|
|
Address
|
Telephone/fax numbers
|
|
Hospital consultant
|
|
4.2 Section 2
Purpose of hospital post mortem examination to establish:
|
Cause of death
|
Effects of treatment
|
|
Effects of surgery
|
Accuracy of diagnosis
|
4.3 Section 3
Post mortem examination may extend to:
|
The whole body
|
Access restricted to a surgical incision
|
|
The chest and abdomen
|
Small samples from specified organs
|
4.4 Section 4
Consent:
|
Consent to full post mortem examination
|
Consent can be refused
|
|
Consent can be limited to specified organs
|
|
4.5 Section 5
Purposes for retaining organs:
|
Diagnostic
|
Medical education
|
|
Therapeutic
|
Research
|
4.6 Section 6
Purposes for retaining tissue:
|
Diagnostic
|
Research
|
|
Therapeutic
|
To enable organs to remain in the body
|
|
Medical education
|
To enable organs to be returned to the
body for the funeral
|
|