When a loved one dies suddenly, or in unanswered circumstances, the anguish for those left behind is acute.
But imagine the additional distress of having to balance a quest for answers against respect for cultural or religious beliefs.
It is a situation that many devout families across Lancashire have found themselves in over many years.
Some faith groups, particularly the Muslim and Jewish communities, are uncomfortable with invasive post mortem examinations because they conflict with their religious beliefs about the sanctity of the body.
Many other people object to intrusive post mortems on humanitarian grounds.
But their only option was to either allow the invasive procedure to take place, or arrange for their loved one to travel to Prestwich, Greater Manchester, where it would cost around £500 for a digital scan of the body.
Last August, after much campaigning, a digital autopsy service was launched at Royal Preston Hospital to largely replace the need for a traditional post-mortem. It is free for all grieving families, irrespective of religion, and there is no longer any need to travel out of the county.
A traditional post-mortem is performed by a pathologist, who has to open the body and remove the organs to carry out the examination.
By contrast, a CT scanner – largely a non invasive process that requires minimal intervention to provide a cause of death – is benefiting communities whose beliefs require their loved ones are buried as soon as possible, or who object to invasive examinations on religious or cultural humanitarian grounds.
The traditional examination has to remain an additional option for cases where particular types of investigation are necessary to clarify the cause of death, such as a murder, where a Home office pathologist is required.
For the past year Dr James Adeley, Senior Coroner for Lancashire and Blackburn with Darwen has been working alongside Lancashire Teaching Hospitals NHS Foundation Trust.
He had liaised with local groups such as the Preston Muslim Burial Society about the benefits of digital autopsies.
Dr Adeley says: “The scheme went live in April and in the first month 114 people were scanned and 96 per cent of those cases produced an acceptable cause of death.
“In the remaining four percent who needed an additional form of investigation, it doesn’t mean it failed in their case, it is often necessary to ensure heart conditions are not missed or if evidence was needed to support a claim such as in a case of lung cancers allegedly caused by asbestos exposure.
“There are also occasions where it isn’t suitable for the scanner to be used as the space is only 66cm wide.”
Several organisations are involved in what is an unusual collaboration.
Operated at the Royal Preston Hospital it is free for all at the point of delivery, like most NHS services.
Lancashire County Council has a contract with firm iGene London Ltd to provide the scanner, digital storage and transport and for the work to be done in NHS time, rather than out of hours like other similar facilities in the UK.
It has also been funded by a sum of money paid to hospitals for undertaking traditional post mortems.
But grateful communities have also been keen to show their support.
Dr Adeley adds: “On two occasions the Muslim community has made significant contributions to this scheme. The money will be spent on extending the current mortuary facilities to improve situations where there is a sudden influx of deceased people.
“Really it doesn’t matter what faith you come from – all families are pleased to have this option available.
“It’s a very resilient service that is here to stay.”
There are around 15,000 Muslims in Preston and the community suffers between 60 and 70 deaths a year.
Since an initial pilot scheme was launched nearly a year ago only around five of those have been referred for invasive post mortems, saving heartache for many devout local families.
Fulwood mosque Masjid-e-Salaam, spearheaded by president Ayub Bux and secretary Mr Hassanjee, has raised more than £15,000 to support the scheme.
Rafiq Omer, who is a trustee of the mosque and president of Preston Muslim Burial Society, says: “We thought it was a good gesture to get together and raise money.
“You can’t put it into words what something like this means for families.”
The scheme is proving very workable but is very much still in development.
Dr Adeley explains: “The other group that we still have work to do with is children who do not scan in the same way as adults and requires MRI scanning.
“We hope to focus on addressing this need later in the year but it will need assistance from national children’s hospitals elsewhere in the country to set up.”
Once the service is fully operational, it could also help to meet the national need for heart valves. The UK needs around five sets a week to meet clinical demand but only has access to three.
A traditional post mortem damages heart valves due to the process involved, but a CT scan means healthy heart valves could be quickly identified and removed from registered organ donors or with agreement from families, and donated to people who need them.