Autopsy continues to have a significant role in allowing a better understanding of a patient’s illness and the relevant factors that led to an individual’s death and remains a valuable tool in the audit of patient care [1, 2]. Before an autopsy can be undertaken it is important that appropriate legal and ethical conditions have been met, and these vary between countries. In many jurisdictions an autopsy may be requested under the authority of a Coroner or police in the case of a suspicious, work-related or ‘unnatural’ deaths, where there may be legal proceedings or financial compensation involved. However, if a death is regarded as due to a natural disease, a ‘consented’ autopsy may be undertaken. For ethical, and in many countries, legal reasons, permission from the relative’s next-of-kin should be obtained prior to undertaking autopsy examination (unless consent had been given during life by the deceased). During the consenting process the family should be informed of the benefits of undertaking the autopsy and, in general terms, what an autopsy involves, which may include retention of organs such as the brain, spinal cord and various tissue samples. The requirements for tissue and organ retention vary from case to case and prior discussion with the pathologist is advised. Where whole brain retention is undertaken, examination is best undertaken after the brain has been fixed in formalin so that it is firm enough for relatively thin sectioning. Brain fixation usually takes between 2 and 6 weeks, depending on the method used, which will result in a delay to the issuing of reports.

A request for autopsy should be made to the pathology department which should include full clinical history, the particular questions that the clinical team would like answered from the autopsy, and any potential for hazard group 3 pathogens (e.g. HIV, hepatitis B or C, tuberculosis, CJD), which will require the pathologist and mortuary staff to take additional precautions. Patients with suspected group 4 pathogens should only have autopsies in highly specialised units.