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Hospitals 'fail to meet post mortem standards'

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Many hospitals fail to meet recommended standards when obtaining consent for post mortem examinations, a new study suggests.

Researchers looked at the post mortem policies of 26 trusts across England and Wales to find out whether they comply with guidelines set out by the Human Tissue Authority (HTA).

Results show that more than one in 10 trusts (12%) do not outline a clear process for obtaining active informed consent, either from the individual while they were alive or from their next of kin.

Some 12% do not specify which members of staff should take consent, while almost a quarter (23%) fail to state the training requirements of those responsible.

Under HTA guidance, all hospitals should provide staff with a documented consent procedure. The guidelines also state that staff should be trained in dealing with bereavement and specify that responsibility for obtaining consent should not be given to “untrained or inexperienced staff”.

The authors found that there are still “significant shortcomings” in adhering to HTA rules and warned that adequate and clear guidance for the process is essential.

According to the study, hospital post mortem rates have been falling steadily, despite the importance of the procedure in understanding disease and enhancing medical education. Researchers warned that a poorly informed approach to bereaved families is unlikely to reverse this trend.

Writing in the Journal of Clinical Pathology, the authors concluded: “Given the sensitive nature of consent discussions, it is vital that the process is conducted in an appropriate manner.”

Obtaining active informed consent has been a key part of post mortem procedures since the 2004 Human Tissue Act, prompted by the organ retention scandals at Bristol Royal Infirmary and The Royal Liverpool Children’s Hospital.

Consent must be actively sought from either the individual while alive, or when this is not possible, from a nominated representative or close family member. Breaches of the law may result in a prison sentence and a fine.

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