OSAC 2023-N-0022 Best Practice Recommendations for 

Communicating with Next of Kin During Medicolegal Death Investigations 

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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 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 

July 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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Best Practice Recommendations for Communicating with Next of Kin During 

Medicolegal Death Investigations 

FOREWORD

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

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

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

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

investigation. 

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

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

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

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

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

KEYWORDS 

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

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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TABLE OF CONTENTS 

1 Scope page 2 

2 Glossary page 2 

3 Recommendations page 3 

4 Bibliography page 5 

5 Appendices page 6 

1 SCOPE 

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

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

This document does not address specific investigative practices. 

2 GLOSSARY 

cause of death 

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

decedent 

Deceased person or any suspected human remains 

family liaison 

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

support to decedent families 

forensic pathologist 

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

currently American Board of Pathology and American Osteopathic Board of Pathology 

manner of death 

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

homicide, natural, suicide, and undetermined 

medicolegal death investigation 

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

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

determine the cause and manner of death 
OSAC 2023-N-0022 Best Practice Recommendations for 

Communicating with Next of Kin During Medicolegal Death Investigations 

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medicolegal death investigation authority 

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

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

enabling statutes 

medicolegal death investigator 

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

completed the requirements for certification and is not certified 

next of kin 

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

postmortem examination 

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

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

circumstances, review of medical records, and other contextual information 

3 RECOMMENDATIONS 

The medicolegal death investigation (MDI) authority should: 

3.1: Provide training to medicolegal death investigation professionals who 

interact with next of kin 

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

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

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

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

Examples of appropriate training providers include experienced medicolegal death investigation 

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

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

unexpected deaths. Appendix A provides examples of suggested resources. 

3.2: Provide information on the medicolegal death investigation process to 

next of kin, with resources in multiple formats 

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

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

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

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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The medicolegal death investigation professional should convey preliminary investigative 

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

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

contact should they have additional questions. 

 

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

Medicolegal death investigation professionals should provide information on the medicolegal 

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

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

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

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

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

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

investigation. 

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

practicable 

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

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

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

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

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

3.4: Provide resources for grief and final disposition assistance 

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

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

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

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

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

death investigator. 

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

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

Communicating with Next of Kin During Medicolegal Death Investigations 

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

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

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

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

documented to ensure MDI authority personnel are aware. 

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

Medicolegal death investigation reports may include postmortem examination reports, 

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

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

contents. 

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

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

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

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

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

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

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

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

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

4 Bibliography 

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

8 

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

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

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

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

1999;52: 723-724 
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Communicating with Next of Kin During Medicolegal Death Investigations 

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Appendix A: Communication Resources 

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

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

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

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

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

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

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

 
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Appendix B: Frequently Asked Questions 

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

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

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

website in addition to information on grief resources. 

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

2. Can I see them? 

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

4. What do I do now? 

a. Include information on final disposition 

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

information on their choice of final disposition 

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

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

a. Provide legal requirements 

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

7. Can I refuse an autopsy? 

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

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

10. How can I obtain a death certificate? 

11. Who is responsible for making arrangements? 

12. Are they viewable? 

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

coroner office? 

14. Who can I contact with questions? 

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

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

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

18. What information is available publicly? 

19. Can I meet with the medicolegal death investigator or forensic pathologist? 

20. How can I get financial assistance to assist with disposition?
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Appendix C: Abbreviated Listing of National Advocacy/Family Support 

Programs and Resources 

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

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

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

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

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

● Mattel Children’s Hospital UCLA Support Groups: 

https://www.uclahealth.org/hospitals/mattel/patient-family-guide/admissionsinformation/support-services 

● MISS Foundation www.missfoundation.org 

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

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

POMC 

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

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

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

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

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

(7823) 

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

www.taps.org 800‐959‐8277
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Appendix D: MEC Office Brochure Examples

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

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

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