May a sample be legally removed or an autopsy undertaken without an advance directive or proxy consent to determine whether a critical care patient at risk of COVID-19 infection has died as a result of the virus?

• Published in: South African medical journal 2020-10, Vol.110 (10), p.993
• Main Author: McQuoid-Mason, D J
• Format: Article
• Language: English
• Subjects: Analysis; Autopsy; COVID-19; Health aspects; Informed consent; Laws, regulations and rules; Medical ethics; Necessity (Law); Patient outcomes; Social aspects
• ISSN: 0256-9574; 2078-5135
• DOI: 10.7196/SAMJ.2020.v110i10.15190

It has recently been suggested that ethically and legally the obtaining of biological samples for research after death during the COVID-19 pandemic in South Africa justifies a waiver of consent followed by a deferred proxy consent. However, it is submitted that because deceased persons are not protected by the Constitution, and only partially protected by common law and statute law, such consent and the need for consent to autopsies may be dispensed with altogether under the common law doctrine of 'necessity'. It is pointed out that such information is in the public interest because it will inform critical care facilities on how to save lives of future patients and assist government in responding to the COVID-19 pandemic by adequate planning. It is also reasonably justifiable in the public interest to ascertain the COVID-19 status of deceased persons who may have been exposed to the virus, in order to protect their family, friends, healthcare practitioners, undertakers and staff members, and members of the public with whom they have been in contact. Finally, it is suggested that the law can be clarified by amending the Disaster Management COVID-19 regulations to do away with consent for such autopsies or tissue sample collections from deceased persons exposed to the risk of contracting the virus, subject to certain conditions. S Afr Med J 2020:110(101:993-994.