Dear colleagues  

We have received an update in relation to The Roles and Responsibilities of Medical Referees 

Please note: We are now referred to as embalmers!

This is for your information and interest. Please share with your members, collagues and anyone else who may be interested.

Form AB regarding biomechanical aids no longer reflects common practice. The Regulations only offer 2 options: that there is no pacemaker in situ, or the medical or nurse practitioner has removed a pacemaker.  It is now very rare for a certifying medical or nurse practitioner to remove a pacemaker. In the vast majority of cases, the certifying medical or nurse practitioner asks the Funeral Director to remove a pacemaker at a later time at the funeral home and, in practice, an embalmer is much more likely to remove a pacemaker if it is present.  This is not an option listed on Form AB but can be written as a separate option. Medical Referees may also ask the embalmer to provide a separate statement in such cases to confirm that it has been removed.  However, there are instances when a medical or nurse practitioner may be unaware of, or overlook, the presence of a pacemaker. The medical or nurse practitioner may certify that no biomechanical aid is present when an embalmer and/or applicant (Form A) has alerted us that one was present. An embalmer should routinely check to ensure no biomechanical aids are present.

The Coroner usually issues a Form AB (signed by a pathologist) but there are instances where the Coroner issues a Form C but declines to issue a Form AB. Typically, these are Coroner referrals where the Coroner has made enquiries that satisfy her or him that no autopsy is required. In the absence of an autopsy, there is no medical or nurse practitioner to issue a Form AB. The most helpful option is for the embalmer to issue a statement that there is no pacemaker even though this does not fulfill the regulatory requirements for a Form AB.

Certificate of medical practitioner or nurse practitioner required:  before giving permission, a Medical Referee must have received a certificate in relation to pacemakers and other biomechanical aids from a medical or nurse practitioner (Form AB), and, if the death is not required to be reported to a coroner, a certificate of medical practitioner or nurse practitioner (Form B) from a medical or nurse practitioner. 

It is important that medical referees pass on patient history as a matter of course so that embalmers and funeral directors are aware of any potential risks such as radioactive medical implants or infectious diseases.