The role of post-mortem imaging in preliminary examinations under the Coroners Act 2008 (Vic): a forensic pathologist's perspective.

Changing community attitudes and expectations, allied to the recent incorporation of sophisticated clinical imaging techniques into the medico-legal death investigation process, have presented significant challenges for Coroners and pathologists alike. The traditional functions of coronial systems have expanded from the relatively narrow confines of a judicial determination as to the cause of death on the basis of autopsy findings. Today they include broader responsibilities in death and disease prevention and a more enlightened approach to the social and familial consequences of a death. The Coroners Act 2008 (Vic) reflects this evolution with the introduction of a so-called preliminary examination process allowing for the performance of certain initial processes and procedures in relation to the medical investigation into a death, and with the aim of increasing the quality and robustness of the pathologist's advice to the Coroner before a decision is made as to whether the Coroner will order an autopsy. The post-mortem computed tomography scan (PMCT) is an important component of the preliminary examination process and significantly increases the information available in the early stages of a death investigation. The use of such new technology carries with it the necessity for a re-evaluation of the roles and responsibilities of the participants in the coronial death investigation system, including those of the next of kin. Three coronial case studies are presented to illustrate the impact and consequences of these developments.