As some of you may or may not know, when we have a death in the ED we are supposed to contact the coroner's office to make sure with them as to whether they want to retain the case as a coroner's case or not. I won't go into the details here, but most often when the death is either unclear or unexpected, they will likely retain the case (and according to our MCH pathologist Dr. Chantale Bernard, they should). If the coroner retains the case, then they have the power to require an autopsy without parental consent.
In the context of a recent difficult case I have learned that if you ever have a case that is not retained by the coroner, and you feel it should have been (cause of death is not clear), you can always call the coroner's office back and ask to speak to the Chief Coroner. Both Dr. Bernard, and our PICU colleagues have informed me of this, and indicated that the Chief Coroner himself has met with them as a group and expressed the importance of us doing this whenever we feel we are uncomfortable with the coroner's plan with a case.
