Organ Donation and Autopsy – Consent, Process and Rights

Organ donation in Finland

Organ donation after death can save multiple lives. In Finland, approximately 400 organ transplants are performed annually, but the need is considerably greater. Organ donation is only possible after brain death, when vital functions are maintained mechanically in a hospital.

Which organs can be donated?

After death, the following can be donated:

• Kidneys -- the most common organ transplant in Finland
• Liver
• Heart
• Lungs
• Pancreas
• Tissues -- such as corneas, bones, and skin tissue

A single organ donor can at best save up to eight lives and improve the quality of life for many others through tissue donation.

Consent to organ donation

In Finland, organ donation is based on presumed consent -- the law permits organ donation unless the deceased expressly prohibited it during their lifetime. In practice, the family is always consulted.

Expressing your wish

• Organ donor card -- a physical card in your wallet
• Omakanta -- an electronic expression of will at kanta.fi
• Verbal expression -- tell your loved ones about your wish

When a family member must decide

If the deceased did not express their wish, the closest family member is asked for consent. This is often a difficult decision in the midst of grief. A conversation with your loved one in advance significantly eases the situation.

Organ donation does not change the deceased's appearance and does not prevent an open casket at the funeral. Surgical marks are carefully covered.

Medical autopsy

A medical (clinical) autopsy is performed when the attending physician wants to determine the cause of death more precisely. It is a medical procedure that requires the consent of next of kin.

When is it performed?

• The cause of death remains unclear during treatment
• The physician wants to verify the accuracy of the diagnosis
• The family wishes to have the cause of death determined

Family's decision-making power

The family has the right to refuse a medical autopsy. The physician explains why the autopsy would be beneficial, but the final decision rests with the family. The autopsy is performed at the hospital's pathology unit and usually takes 2--4 hours.

Forensic cause-of-death investigation

A forensic cause-of-death investigation differs significantly from a medical autopsy. It is performed by police order, and the consent of next of kin is not required.

When does the police order an investigation?

• Sudden and unexpected death -- the cause of death is unknown
• Accident -- traffic accident, occupational accident, fall
• Suspicion of crime -- violence, poisoning
• Suspected medical error -- death during or shortly after treatment
• Death in an institution -- in prison, in custody, or in police care

Course of the process

1. The police decides on the forensic investigation
2. The deceased is transported to a forensic medicine unit
3. The investigation is carried out by a forensic physician
4. The investigation takes from a few days to several weeks
5. The burial permit is issued once the cause of death has been determined

The forensic investigation is free of charge for the family. However, it may significantly delay the funeral timeline.

Rights of next of kin and support

Right to information

Next of kin have the right to:

• Receive information about the cause of death and investigation results
• Request a cause-of-death certificate from THL or the police
• Ask about the progress of the investigation and its estimated duration

Emotional support

An organ donation decision or an unexpected autopsy can be a difficult experience for the family. Remember:

• Hospitals often have a crisis worker available
• Grief support services are available immediately after the death
• There is never pressure to rush the decision on organ donation -- time is always given as needed

Read more about first steps after a loved one's death and applying for a burial permit.

Frequently asked questions

How is the wish for organ donation expressed?

By carrying an organ donor card, recording the wish in Omakanta, or by telling your family. An active expression of will eases the family's decision.

Can next of kin refuse organ donation?

Yes, if the deceased did not express their own wish. The deceased's own will takes precedence over the family's wish.

When is a forensic investigation performed?

The police orders an investigation in the case of sudden, unexpected, or unclear deaths, as well as in connection with accidents and suspected crimes.

Does an autopsy delay the funeral?

A medical autopsy delays it by only a few days. A forensic investigation can take from days to weeks.