Medical referees

Under the Cremations Act 1929 (external site), and the Cremations Regulations 1954 (external site), medical referees are appointed to provide independent medical advice about the need to further examine the remains of a deceased person prior to cremation.

Who can be a medical referee?

Registered medical practitioners who have practised medicine for at least five years (not necessarily continuously) can apply through the Director General of Health for appointment as a medical referee. The application should include a letter explaining the reason for the application, a Curriculum Vitae and a copy of the current registration as a medical practitioner in Australia.

Successful applicants are notified in writing and are provided with a copy of the Cremations Act 1929 (external site)and the Cremations Regulations 1954 (external site). Referees are appointed for an indefinite period, limited only by the applicants’ willingness to continue to exercise the role, and their ongoing eligibility under the Act. A medical referee who ceases to provide this service should inform this office of their decision.

A medical referee should be available during working hours to process applications. For long periods of absence (e.g. holidays), alternative cover should be arranged with another medical referee. If this is not possible, then the usual funeral directors should be advised of this absence.

What does a medical referee do?

The role of a medical referee is to scrutinise specific information on the circumstances leading to death. The principal task of the medical referee is to approve (or decline) an Application for permit to cremate (Form 6) (PDF 62KB). The medical referee must ensure that the relevant sections on the cremation forms have been completed.

The referee must:

  • be certain that the deceased has died from natural circumstances
  • establish that there is no indication of any non-natural process, and
  • determine that cremation can safely proceed.

If there are any grounds to believe that the deceased:

  • is infectious, or
  • has received radioactive treatments, or
  • is fitted with a cardiac pacemaker, or any other subcutaneous battery operated or electronic device, or
  • there is any other reason why cremation may be unsafe

then this information must be provided to the applicant, in writing, and attached to the Permit to cremate (Form 9). This information is necessary to minimise the risk of infection, or physical harm, to crematorium staff or the crematorium.

Cremation of a still-born child:

If an Application for permit to cremate (Form 6) (PDF 62KB) has been received in respect of the remains of a still-born child the medical referee must, under Section 8B of the Act:

  • seek independent medical certification, or make other relevant enquiries, to confirm that the child was still-born, and
  • be satisfied that there are no reasons for further examination of the remains, and that a post-mortem examination is not required.
Which forms does the medical referee need to issue a permit to cremate?

Form
Title
Description
6 Application for Permit to Cremate
Always required. Provides the medical referee with information about the deceased. It is usually completed by the deceased's administrator as defined under Section 8 (3A) of the Act, (often the executor of the estate) with assistance from the funeral director. If the application is not made by the administrator (in this case, the executor of the deceased's estate), the applicant must provide a statutory declaration setting out the grounds upon which he claims authority to make the application.
In all cases, the statutory declaration section on the form must also be completed by the applicant, confirming that the information provided is correct.
7 Certificate of Medical Practitioner
Provides the medical referee with medical information about the deceased. It is completed by the doctor who attended the deceased prior to death. The medical referee cannot be the same person as the medical practitioner who completed Form 7.
8 Coroner’s Certificate
Advises the medical referee that the Coroner’s office is satisfied that there are no grounds for refusing approval to cremate. (In practice, the Coroner’s Office uses Form 4 under the Coroners Regulations 1997 for this purpose.)
9 Permit to Cremate
Permits the cremation of the deceased’s remains. This form is completed by the medical referee and must be accurate and legible, and consistent with Forms 6 and 7. The name of the deceased should be written in full and the address of the deceased should be a residential address. Any amendments to the Permit should be made ONLY by the medical referee and any changes must be initialled.
10 Notice of Refusal of Application to Cremate
Withholds permission for the cremation of the deceased’s remains on the grounds of information supplied by the cremation forms. This form is completed by the medical referee. 
When should a medical referee refuse to issue a permit to cremate?
Reason for rejection
Remedy
Form 6 and/or Form 7 are incomplete or inaccurate.
Ensure that the forms are correctly completed.
A Medical Certificate of Cause of Death (or Coroner's certificate) has not been provided.
Ensure the certificate is provided.
The deceased has left a written note that their body is not to be cremated.
The cremation may not proceed unless the Chief Health Officer (CHO) orders the body to be cremated in the public interest.
A body has not been provided.
Ensure the body is provided.
The body (or body parts) has not been correctly identified.
Ensure the body (or body parts) has been correctly identified.
Death was due to violent or unnatural causes.
Refer the case to the Coroner.
There are suspicious circumstances surrounding the death.
Refer the case to the Coroner. 
The doctor completing the Certificate of medical practitioner (Form 7):
  • is a close relative of the deceased person
  • is in partnership with the medical referee
  • has a pecuniary interest in the death of the deceased, and/or
  • is the same person as the medical referee to whom the application for the permit is made.
Ensure that none of the points described apply to the medical practitioner completing Form 7.

When an Application for permit to cremate is refused, a Notice of refusal of Application to Cremate (Form 10) must be completed by the medical referee and given to the applicant, with the advice that they have right of appeal to the CHO or delegate. The medical referee does not have to advise the applicant of the reasons for refusal, but must advise the CHO as soon as possible of his decision.

Relevant parts of the legislation

Cremation Act 1929 (external site):

Section 8: Appointment of medical referees
Section 8 A: Permits
Section 8 B: Permit to cremate still-born child
Section 9: Permit to be sufficient authority to cremate body.
Section 10: Medical referee not to issue permit improperly: and no person to cremate body without permit.
Section 12: Interested persons not to give certificates.
Section 13: Objections to cremation etc.
Section 14: Attorney General or coroner may forbid cremation.

Cremation Regulations 1954 (external site):

Reg. 11, 12:  Forms 6, 7, and 8.
Reg. 13, 14:  The medical referee, and Form 9.

Fees

Medical referees are paid a set fee by the applicant (usually through the funeral director) for completing Form 9. The fees are reviewed periodically and changes are published in the government gazette.

Where to obtain the forms?
Where to send in the forms?

The medical referee should regularly send in all completed cremation forms, and the yellow copy of Form 9, to the Office of the Chief Health Officer at the address below. A Medical Advisor is available to answer questions related to the completion of Form 9.

For further information or to order books of Permits to Cremate (Form 9), please contact:

Office of the Chief Health Officer
Department of Health
PO Box 8172
Perth Business Centre WA 6849
Telephone: 08 9222 2295
Email: EDPHWA@health.wa.gov.au

Last reviewed: 04-01-2019
Produced by

Public Health