The scene
A GP member contacted the MDU advice line after receiving a complaint from the family of a deceased patient. The patient had died unexpectedly in the local A&E department and the death certificate had been completed by the hospital.
However, the patient had wanted to donate his body to a medical school, and the family were unhappy that the GP practice had not completed a form from the school in time to allow the donation to be accepted.
The legal position
Under the Human Tissue Act 2004 in England, Wales and Northern Ireland and the Human Tissue (Scotland) Act 2006 in Scotland, appropriate consent for anatomical examination must be in writing and signed by the donor in the presence of a least one witness.
Patients who are considering donating their body should be directed to their local medical school, who will be able to provide them with the information needed to help them make an informed decision about donation and give them the appropriate consent form.
Once the individual has signed a consent form for donation they should be encouraged to inform their family, executors and their GP or hospital consultant, so that timely action can be taken when they die.
After the patient's death, the relevant medical school should be contacted as soon as possible so the body can be preserved without delay. Depending on how the body is kept after death, it must be received by the medical school within three to five days to allow for suitable preservation.
Not all bodies can be accepted for donation even if appropriate consent is in place. Decisions on acceptance cannot always be made until the time of death, as certain medical conditions or circumstances of death may preclude it. For example, infectious diseases or recent surgery might prevent donation, as would the requirement by the coroner for a post-mortem to be performed. The medical school might contact the doctor signing the death certificate or the GP to check that the body is suitable for anatomical examination.
MDU advice
With the help of the MDU adviser the GP framed a conciliatory and empathetic response to the complaint, explaining that the practice had not been made aware of the patient's bequest before death, and that there had been a delay of several days before receiving the request from the medical school.
The practice also explained that completing the necessary paperwork would have required a detailed review of the patient's records and a discussion with the treating clinicians at the hospital to ascertain events leading up to the patient's death. The practice acknowledged that in the future it could add an alert to the records of a patient who wanted to make a similar bequest, to highlight the need to contact the medical school after their death.
This advice line dilemma appears in the 2019 edition of Cautionary Tales.