Thematic report on organ retention

1. To ensure transparency COPFS should publish annually the number of organs retained after the deceased's body has been released. This information should be included in their publication scheme.

2. There should be an agreed written definition of what constitutes an 'organ' between pathology service providers and COPFS.

3. Attendance on the 'Deaths 2' module and the 'Managing Communication with the Bereaved' course should be mandatory for all staff in the Scottish Fatalities Investigation Unit (SFIU) and other specialist units that deal with fatalities, such as the Health and Safety Division. The training should be completed by legal staff within three months of joining SFIU or other specialist unit.

4. In all cases involving suspected criminality, where an organ is retained following the release of the deceased's body, SFIU should assume responsibility for ensuring that the guidance and procedures relating to the retention of the organ are applied. In particular, SFIU should ensure that the nearest relatives are notified timeously of the retention, informed of likely timescales for the completion of the examination of the organ and their options for its disposal. The views of the nearest relatives on the disposal of the organ should also be obtained.

• A protocol should be drawn up specifying the procedure to be followed including reference to the specific form(s) to be used and the mechanism of recording the information.
• Following the release of the deceased's body and the completion of the examination of an organ, all records retained in the SFIU death file should be copied into any associated criminal file.

5. There should be a presumption that the death certificate should be issued when the deceased's body is released by the Procurator Fiscal.

6. COPFS should introduce one national organ retention form to be completed by the pathology service provider and COPFS in any case where an organ is retained after the body is released. The form should contain the following mandatory information:

• details of the deceased
• the type of organ retained
• where it is located
• how long it is likely to be retained
• when examination is complete
• date the body is released
• the instruction on disposal

7. For reconciliation purposes, a copy of the national organ retention database should be sent each month to a nominated post holder such as the mortuary manager or the administrative manager for each pathology department.

• The requirement to provide a monthly return, including timescales for returns, should be incorporated into all pathology service providers' contracts.
• There should be an agreed stage when entries are removed from the national organ retention database. For example, when the wishes of the nearest relative have been provided to the pathologist.
• SFIU National should create and maintain operating instructions for duties relating to the operation of the Organ Retention Database.

8. The existing contracts between COPFS and the pathology service providers should be amended:

• To provide a presumption that the death certificate should be issued when the body is released.

The contracts should be revised to include:

• A requirement to provide immediate and written notification to COPFS if an organ is retained beyond the deceased's body being released. (It is envisaged that this will be done by submitting the organ retention form.)
• To provide monthly returns within specified timescales to a nominated contact person/post holder in COPFS specifying details of any organs being held. A physical check should be undertaken each month and reconciled with the information provided by COPFS.
• To dispose of any organs in accordance with a written instruction provided by the Procurator Fiscal.

9. All communication on the wishes of the nearest relatives should be provided in writing to the pathologist who should acknowledge receipt. The written instruction and the receipt should be retained in the electronic death file.

10. If nearest relatives fail to engage on the disposal of an organ, COPFS should arrange for a second communication, either in person if there is an established rapport, or by recorded delivery of correspondence seeking their instruction. This second communication should advise that COPFS will arrange for the pathologist to dispose of the organ if the nearest relatives fail to engage or provide an instruction on their wishes within a specified period of time. If, after undertaking all reasonable inquiries, COPFS is unable to trace any nearest relatives, the Procurator Fiscal should instruct the pathologist to dispose of the organ.