This report details the investigation by the HM Inspector of Anatomy, at the request of the Department of Health, into the events following the death of Mr Isaacs in February 1987, and in particular the removal and retention of his brain during an autopsy for research use without his family's knowledge or consent. It also examines whether similar practices have taken place in other public mortuaries after post mortem examinations and considers the issue in the light of clinical and ethical policies, relevant legislation, religious beliefs and the rights of relatives. The report finds that this case was not an isolated incident, and that although much of this post-mortem research was intended for the public good, the issue of covert organ retention has undermined public confidence. Recommendations are made to help ensure the system for investigating deaths reported to the Coroner is freed from any suspicion of covert organ retention and the restoration of public confidence that post mortem research will only be undertaken with consent.