OSAC 2023-N-0022 Best Practice Recommendations for

Communicating with Next of Kin 

during Medicolegal Death Investigations

1

OSAC 2023-N-0022

Best Practice Recommendations 

for Communicating with Next 

of Kin during Medicolegal 

Death Investigations

Medicolegal Death Investigation Subcommittee 

Medicine Scientific Area Committee

Organization of Scientific Area Committees (OSAC) for Forensic Science
OSAC 2023-N-0022 Best Practice Recommendations for

Communicating with Next of Kin 

during Medicolegal Death Investigations

2

OSAC Draft Proposed Standard

OSAC 2023-N-0022

Best Practice Recommendations for 

Communicating with Next of Kin during 

Medicolegal Death Investigations

Prepared by 

Medicolegal Death Investigation Subcommittee

Version: 1.0

June 2023

Disclaimer:

This OSAC Proposed Standard was written by the Organization of Scientific Area Committees 

(OSAC) for Forensic Science following a process that includes an open comment period. This 

Proposed Standard will be submitted to a standards developing organization and is subject to 

change.

There may be references in an OSAC Proposed Standard to other publications under 

development by OSAC. The information in the Proposed Standard, and underlying concepts and 

methodologies, may be used by the forensic-science community before the completion of such 

companion publications.

Any identification of commercial equipment, instruments, or materials in the Proposed Standard 

is not a recommendation or endorsement by the U.S. Government and does not imply that the 

equipment, instruments, or materials are necessarily the best available for the purpose.
OSAC 2023-N-0022 Best Practice Recommendations for

Communicating with Next of Kin 

during Medicolegal Death Investigations

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1 Best Practice Recommendations for Communicating with Next of Kin during 

2 Medicolegal Death Investigations 

3

4 FOREWORD

5 When a medicolegal death investigation occurs, next of kin may have questions and concerns for 

6 the medicolegal death investigation authority. The ability of medicolegal death investigation 

7 professionals to communicate with next of kin may have a direct impact on how they react 

8 following a death, view the medicolegal death investigation system, and cooperate with the 

9 investigation.

10

11 The best practices outlined in this document address sensitivity in the delivery of information, 

12 associated training, dissemination of information including cause and manner of death, 

13 recognizing and accommodating cultural and religious beliefs, and timely response to next of kin 

14 inquiries. The recommendations herein are also applicable to communications with other family 

15 members of the deceased who are not the legal next of kin.

16

17 KEYWORDS 

18 communication, coroner, death investigation, decedent, medical examiner, medicolegal death 

19 investigation, medicolegal death investigator, next of kin
OSAC 2023-N-0022 Best Practice Recommendations for

Communicating with Next of Kin 

during Medicolegal Death Investigations

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20 TABLE OF CONTENTS

21 1 Scope

22 2 Glossary

23 3 Recommendations

24 4 Bibliography

25 5 Appendices

26

27 1 SCOPE

28

29 This document specifies recommendations for communicating with next of kin during a 

30 medicolegal death investigation. It is intended for medicolegal death investigation authorities. 

31 This document does not address specific investigative practices. 

32 2 GLOSSARY

33 cause of death

34 Medical opinion of the disease or injury that resulted in a person’s death

35

36 decedent

37 Deceased person or any suspected human remains

38

39 family liaison 

40 A member of the medicolegal death investigation team tasked with providing assistance and 

41 support to decedent families

42

43 forensic pathologist

44 Physician who is board-certified in forensic pathology by an accredited credentialing body; 

45 currently American Board of Pathology and American Osteopathic Board of Pathology

46

47 manner of death

48 Classification system based on the circumstances under which death occurred; includes accident, 

49 homicide, natural, suicide, and undetermined 

50

51 medicolegal death investigation

52 Formal inquiry into the circumstances surrounding the death of a human being; investigative 

53 information is considered with autopsy findings and adjunctive studies (if performed) to 

54 determine the cause and manner of death 

55

56 medicolegal death investigation authority
OSAC 2023-N-0022 Best Practice Recommendations for

Communicating with Next of Kin 

during Medicolegal Death Investigations

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57 Person or persons whose duty it is to perform medicolegal death investigations for a designated 

58 jurisdiction, and ensure certification of cause and manner of death; duties vary based on local 

59 enabling statutes

60

61 medicolegal death investigator

62 Individual who performs medicolegal death investigations, and includes those who have not 

63 completed the requirements for certification and is not certified

64

65 next of kin

66 Legally determined hierarchy of interested parties who have authority over the decedent

67

68 postmortem examination

69 Medical examination of a decedent and associated information by specially trained medical 

70 personnel; this may include autopsy, external examination, ancillary tests, evaluation of 

71 circumstances, review of medical records, and other contextual information

72 3 RECOMMENDATIONS

73

74 The medicolegal death investigation (MDI) authority should:

75 3.1: Provide training to medicolegal death investigation professionals who 

76 interact with next of kin

77 Training content should include communication styles, notification of death, communicating with 

78 individuals in crisis, effective crisis intervention, fundamental aspects of grief and loss, physical 

79 and psychological effects of trauma, responding to angry reactions and managing hostile 

80 situations, and the management and return of personal effects, as relevant to individual duties. 

81 Examples of appropriate training providers include experienced medicolegal death investigation 

82 professionals, victim assistance programs, mental health professionals involved in trauma 

83 intervention, bereavement programs, hospice programs, and organizations dealing with sudden, 

84 unexpected deaths. Appendix A provides examples of suggested resources.

85

86 3.2: Provide information on the medicolegal death investigation process to 

87 next of kin, with resources in multiple formats 

88 Next of kin should be informed that an ongoing medicolegal death investigation will be performed 

89 to assist in the determination of the cause and manner of death. Additional steps, including the 

90 extent of any postmortem examination, possible accommodations for religious, cultural, and other 

91 individual beliefs, and the potential for organ, eye, and/or tissue donation, should be discussed. 
OSAC 2023-N-0022 Best Practice Recommendations for

Communicating with Next of Kin 

during Medicolegal Death Investigations

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92 The medicolegal death investigation professional should convey preliminary investigative 

93 circumstances, condition of the decedent’s body, timeframes, how information will be shared, 

94 information addressing frequently asked questions (see Appendix B), and who the next of kin can 

95 contact should they have additional questions.

96

97 Grieving next of kin may have difficulty processing information verbally and remembering details. 

98 Medicolegal death investigation professionals should provide information on the medicolegal 

99 death investigation process and available resources in multiple formats. The information should 

100 include answers to common questions in easily understood language. Offering the same 

101 information in commonly spoken languages is encouraged. Access to interpreters not related to 

102 the decedent or the investigation should be provided, including sign language. 

103 MDI authorities are strongly encouraged to employ family liaisons or social workers to provide 

104 information to and answer and direct questions from next of kin throughout the medicolegal death 

105 investigation.

106

107 3.3: Recognize and accommodate cultural, religious, and other beliefs as 

108 practicable

109

110 Grief is a unique and personal experience based on multiple factors, including cultural, religious, 

111 or other beliefs. Communication will be most effective if the medicolegal death investigation 

112 professional recognizes and accommodates the grief and related needs expressed by next of kin 

113 to the extent that the investigation allows. The medicolegal death investigation may alter 

114 mourning rituals, which may create uncertainty, additional frustration, and stress.

115

116 3.4: Provide resources for grief and final disposition assistance

117

118 Information provided should include crime victim assistance programs, advocacy and family 

119 support programs, bereavement counseling and support groups, including cause-of-death specific 

120 organizations, and disposition assistance, as applicable (see Appendix C). Information can be 

121 supplemented by a handout (see Appendix D) and information on the MDI authority’s public122 facing website. Handouts and website information should be made available to law enforcement 

123 personnel and hospitals to provide to family members in the absence of an on-scene medicolegal 

124 death investigator.

125

126 3.5: Ensure that next of kin understand their right to access and obtain 

127 medicolegal death investigation report(s)
OSAC 2023-N-0022 Best Practice Recommendations for

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during Medicolegal Death Investigations

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128 The MDI authority should have a policy regarding how, when, and which next of kin are contacted. 

129 The method of communicating the cause and manner of death to next of kin should be determined 

130 early in the investigation. If next of kin have a specific preference for communication, 

131 consideration should be given to accommodating their wishes, and their preferences should be 

132 documented to ensure MDI authority personnel are aware. 

133

134 Next of kin should be provided the medicolegal report(s), if desired and legally allowed. 

135 Medicolegal death investigation reports may include postmortem examination reports, 

136 medicolegal death investigative reports, toxicology reports, and other ancillary testing or 

137 consultation reports. Reports should be delivered with cover letters informing the recipient of the 

138 contents. 

139

140 Some next of kin may want to know the cause and manner of death, but they may not want copies 

141 of the report(s). The cause and manner of death can be communicated verbally or in writing, as 

142 allowed by law. Information should be delivered concisely but with sensitivity and compassion. 

143 3.6: Ensure that next of kin inquiries are answered in a timely manner

144

145 Inquiries from next of kin should be responded to in a timely manner by the medicolegal 

146 professional suitable to reply. Complicated postmortem findings should be communicated by the 

147 forensic pathologist. In circumstances when next of kin requests for communication are excessive 

148 and/or repetitive, consider utilizing local or national resources to assist in their grief and coping 

149 with the medicolegal death investigation process (see Appendix C). 

150

151 4 Bibliography

152 Adelson L. The Forensic Pathologist “Family Physician” to the Bereaved. JAMA 1977; 237: 1585-

153 8

154

155 Baker A, Crandall L. To Hold or Not To Hold. Forensic Science Med Pathol Nov 2009

156 Drayton J., Ellis P., Purcell T., Letter to Editor: Next of kin clinics. J Clin Pathol 1999

157 Hirsch CS. Talking to the Family After an Autopsy. Arch Pathol Lab Med 1984; 108:513-14 

158 Vanezis P, Leadbetter S. Next of Kin Clinics: a new role for the pathologist. J Clin Pathol

159 1999;52: 723-724

160
OSAC 2023-N-0022 Best Practice Recommendations for

Communicating with Next of Kin 

during Medicolegal Death Investigations

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161

162 Appendix A: Communication Resources

163

164 https://www.fbi.gov/news/stories/death-notification-with-compassion

165

166 https://deathnotification.psu.edu/we-regret-to-inform-you

167

168 Palusci VJ, Devinsky O, Drake SA, et al. Family Needs and Follow-up Care After the Sudden, 

169 Unexpected Death of a Child. In: Bundock EA, Corey TS, Andrew TA, et al., editors. 

170 Unexplained Pediatric Deaths: Investigation, Certification, and Family Needs [Internet]. San 

171 Diego (CA): Academic Forensic Pathology International; 2019. Chapter 12. Available from: 

172 https://www.ncbi.nlm.nih.gov/books/NBK577017/

173

174
OSAC 2023-N-0022 Best Practice Recommendations for

Communicating with Next of Kin 

during Medicolegal Death Investigations

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175 Appendix B: Frequently Asked Questions 

176 The following questions are commonly asked by families, and medicolegal death investigation 

177 offices should be prepared to answer the questions honestly and respectfully. The questions can 

178 also be answered in written materials to provide to families and/or have available on their 

179 website in addition to information on grief resources.

180

181 1. Where are they (being mindful of gender)?

182 2. Can I see them?

183 3. Do I need to identify them? How will they be identified?

184 4. What do I do now?

185 a. Include information on final disposition

186 b. Advise family they need to provide the medical examiner or coroner office with 

187 information on their choice of final disposition

188 c. Do not promote or endorse any specific funeral home to avoid conflicts of interest

189 5. Why is the medical examiner or coroner office involved?

190 a. Provide legal requirements

191 6. Will an autopsy be performed? Is there a charge?

192 7. Can I refuse an autopsy?

193 8. Why are autopsies performed? What are they? Who performs them?

194 9. When will they be released? What is the timing?

195 10. How can I obtain a death certificate?

196 11. Who is responsible for making arrangements?

197 12. Are they viewable?

198 13. How do I recover personal effects and clothing collected by the medical examiner or 

199 coroner office?

200 14. Who can I contact with questions?

201 15. How do I learn the cause and manner of death?

202 16. If their identification is pending, what information can be shared?

203 17. What does it mean for a cause of death to be “pending?”

204 18. What information is available publicly?

205 19. Can I meet with the medicolegal death investigator or forensic pathologist?
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during Medicolegal Death Investigations

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206 20. How can I get financial assistance to assist with disposition?

207

208
OSAC 2023-N-0022 Best Practice Recommendations for

Communicating with Next of Kin 

during Medicolegal Death Investigations

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209 Appendix C: Abbreviated Listing of National Advocacy/Family Support 

210 Programs and Resources

211 ● Compassionate Friends, Inc. www.compassionatefriends.org 877‐969‐0010

212 ● The Dougy Center for Grieving Children www.dougy.org 866‐775‐5683

213 (Materials tailored to children and adolescents, will refer to local support resources)

214 ● First Candle www.firstcandle.org 800‐221‐7437

215 ● Interface Children and Family Services https://211ventura.org/mental-healthx/grief216 loss/bereavement-counseling/ 

217 ● Mattel Children’s Hospital UCLA Support Groups:

218 https://www.uclahealth.org/hospitals/mattel/patient-family-guide/admissions219 information/support-services

220 ● MISS Foundation www.missfoundation.org 

221 ● Mothers Against Drunk Driving (MADD) www.madd.org 800‐GET‐MADD

222 ● National Organization of Parents of Murdered Children, Inc www.pomc.com 888‐818‐

223 POMC

224 ● National Center for Victims of Crime www.ncvc.org 202‐467‐8700

225 ● National Organization for Victim Assistance www.trynova.org 800‐TRY‐NOVA

226 ● SADS Foundation www.sads.org 800‐STOP‐SAD

227 ● Sesame Street Grief Resource https://www.sesamestreet.org/toolkits/grief/

228 ● Sudden Unexplained Death In Childhood Foundation www.sudc.org 800‐620‐SUDC 

229 (7823)

230 ● Tragedy Assistance Program for Survivors (TAPS) – (for military families)

231 www.taps.org 800‐959‐8277
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during Medicolegal Death Investigations

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232 Appendix D: MEC Office Brochure Examples

233 ● https://www.hennepin.us/-/media/hennepinus/residents/public-safety/medical234 examiner/medical-examiner-information-for-families.pdf

235 ● https://www.washoecounty.gov/coroner/faq/index.php

236 ● https://drive.google.com/drive/folders/1R1651DrHAsfRrKrj0a1haPtx8IG_N5LT

237

238