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Attitudes of UK pathologists and judicial officers towards medicolegal view and grant examinations: a cross-sectional mixed-methods study
  1. Jacob Foster1,
  2. David Sadler1,
  3. Sam Taylor2
  1. 1Centre for Forensic and Legal Medicine and Dentistry, University of Dundee, Dundee, UK
  2. 2Department of Psychology, University of Bath, Bath, UK
  1. Correspondence to Dr Jacob Foster, Centre for Forensic and Legal Medicine and Dentistry, University of Dundee, Dundee, UK; jacobcharlesfoster{at}


Aims Despite the 1988 ‘Dundee Initiative’, which maximised the use of view and grant examinations to reduce the invasive forensic autopsy rate in Tayside, the view and grant itself remains controversial. This is the first study to measure attitudes towards view and grants, applying the Theory of Planned Behaviour to investigate what attitudes are held, the reasons behind them and their association with deciding the scope of postmortem examinations.

Methods A mixed-methods cross-sectional study examined 62 UK pathologists, coroners and procurators fiscal using an online questionnaire. Participants were asked their demographics and attitudes towards view and grants before allocating five fictitious reportable deaths to either view and grant or invasive forensic autopsy (both in ideal and real world conditions), explaining their decisions using free-text.

Results Participants held both positive and negative attitudes towards view and grants, and most were relatively strong and ambivalent. Attitudes predicted respondents’ decisions to favour view and grant or invasive forensic autopsy in all ideal world scenarios, but no real world scenarios. There were significant differences in attitudes and decisions when comparing pathologists and judicial officers, and respondents working in Coroner and Fiscal systems. Thematic analysis was conducted on free-text responses.

Conclusions Discrepancies between attitudes, and ideal and real world choices suggest that what respondents wanted to do did not necessarily translate to what they would actually do in the scenarios tested. Applying concepts of attitudes, norms and perceived control can help to understand decision-making by death investigators, and why some jurisdictions favour more invasive procedures.

  • Autopsy
  • Attitude
  • Decision Making

Data availability statement

Data are available in a public, open access repository. Please visit the Open Science Framework:

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Data availability statement

Data are available in a public, open access repository. Please visit the Open Science Framework:

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  • Handling editor Vikram Deshpande.

  • Contributors JF is responsible for the overall content as guarantor. DS conceived the original idea and supervised the project. JF designed and conducted the study with support from DS (advising on forensic pathology) and ST (advising on social psychology). The Royal College of Pathologists, The British Association in Forensic Medicine and The Coroners’ Society of England and Wales assisted in recruitment of pathologists, coroners and procurators fiscal as participants. JF analysed the qualitative data, and JF and ST analysed the quantitative data. JF wrote the manuscript with support from DS and ST.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.