What is an autopsy. How is an autopsy performed. When is a coroner’s autopsy required. Can family members refuse an autopsy. What happens to tissue samples after an autopsy. How long does an autopsy take.

Understanding Autopsies: Types and Purposes

An autopsy, also known as a post-mortem examination, is a detailed medical examination of a body after death. This procedure serves various purposes, from determining the cause of death to advancing medical knowledge. There are two main types of autopsies: coroner’s autopsies and hospital autopsies.

Coroner’s Autopsy

A coroner’s autopsy is conducted when there are legal reasons to determine the cause of death. This type of examination is typically performed in cases of:

• Suspected murder
• Suspicious deaths
• Unexplained circumstances surrounding the death

Hospital Autopsy

A hospital autopsy, also referred to as a non-coronial autopsy, is performed with the consent of the deceased’s immediate family. The purposes of a hospital autopsy include:

• Clarifying the reasons for death
• Evaluating the effectiveness of treatment methods
• Gathering information on genetic illnesses
• Advancing medical science’s understanding of disease processes

The Autopsy Procedure: A Step-by-Step Overview

An autopsy is a meticulous process conducted by a qualified pathologist, assisted by a technician. The procedure typically follows these steps:

1. The body is carefully placed on an examination table in a room similar to an operating theatre.
2. The pathologist examines the body’s external appearance, possibly taking photographs and X-rays.
3. An incision is made from the collarbone to the lower abdomen to examine chest and abdominal organs.
4. Tissue samples are collected from each organ for microscopic examination and further analysis.
5. The brain is examined, which requires cutting through the scalp and skull.
6. After the examination, organs are replaced, and the incisions are sutured closed.

How long does an autopsy take? A typical post-mortem examination can last up to three hours. However, some organs, particularly the brain, may require additional time for thorough examination – up to three weeks in some cases.

Consent and Refusal Rights in Autopsy Procedures

The right to refuse an autopsy varies depending on whether it’s a hospital or coronial post-mortem.

Hospital Autopsy Consent

For hospital autopsies, the immediate family has the right to refuse or agree to the procedure. They can also:

• Limit the extent of the examination
• Decide whether organs or samples can be kept for further study

Coronial Autopsy Objections

In the case of a coronial autopsy, the senior next of kin may object to the procedure. However, there are specific rules and time limits for such objections:

• The request to reconsider must be made within 48 hours of receiving notification from the coroner.
• If the coroner decides the autopsy is still required, the decision can be appealed in the Supreme Court.
• Objections to a coronial autopsy are governed by sections 26 and 79 of the Coroners Act 2008.

Tissue Samples and Organ Retention: Post-Autopsy Procedures

During an autopsy, tissue samples are typically retained by the laboratory. These samples serve several purposes:

• They may provide answers to remaining questions about the cause of death or nature of the disease.
• They can be used for future medical research and training of medical staff.
• They may be kept in anticipation of technological advancements that could yield new insights.

Is consent required for keeping tissue samples? Yes, retaining tissue samples requires specific consent from the deceased’s next of kin.

Organ Retention and Disposal

Organs retained for further testing are handled according to the family’s wishes. They may be:

• Returned to the family
• Disposed of by the hospital
• Kept for future medical research and training

Impact on Funeral Arrangements

Once the autopsy is complete, the body can be collected by the family’s chosen funeral director. However, if organs have been retained for further testing, this may affect funeral arrangements.

Can a funeral be delayed due to an autopsy? Yes, if the family wishes the body to be whole before burial or cremation, the funeral may need to be delayed for a few days or weeks. In such cases, the funeral director can arrange for the body to be embalmed.

Autopsy Results: Timeframes and Reports

The results of an autopsy are typically available in stages:

• A preliminary report is usually available within the first few days after the autopsy.
• The full report, including detailed findings and analysis, may take several weeks to complete.

Why does the full autopsy report take longer? The comprehensive nature of the examination, especially the analysis of tissue samples and potential additional tests, contributes to the extended timeframe for the full report.

Advancements in Autopsy Techniques and Technology

While the basic principles of autopsy have remained consistent, technological advancements have significantly enhanced the procedure’s accuracy and efficiency. Some of these advancements include:

Imaging Technologies

Modern autopsy procedures often incorporate advanced imaging technologies such as:

• Computed Tomography (CT) scans
• Magnetic Resonance Imaging (MRI)
• 3D reconstruction techniques

These imaging methods allow pathologists to visualize internal structures non-invasively, providing valuable information before the physical examination begins.

Genetic Analysis

Advancements in genetic testing have revolutionized post-mortem examinations. Genetic analysis can now:

• Identify hereditary conditions
• Provide insights into genetic predispositions to certain diseases
• Aid in solving complex cases where traditional methods fall short

Toxicology Advancements

Modern toxicology tests are more sensitive and can detect a wider range of substances than ever before. This has significant implications for:

• Identifying drug-related deaths
• Detecting environmental toxins
• Uncovering cases of poisoning

How have these advancements improved autopsy accuracy? These technological improvements have enhanced the precision of cause-of-death determinations and provided more comprehensive insights into disease processes and injury patterns.

Ethical Considerations in Autopsy Practices

The practice of autopsy, while invaluable to medical science and legal proceedings, raises several ethical considerations that must be carefully navigated:

Cultural and Religious Sensitivities

Many cultures and religions have specific beliefs and practices surrounding death and the treatment of the deceased. Autopsy procedures must be conducted with respect for these beliefs, which may include:

• Timing considerations for burial
• Restrictions on organ removal
• Specific handling requirements for the body

Informed Consent

Obtaining proper informed consent is crucial in non-coronial autopsies. This involves:

• Clearly explaining the procedure and its purpose to the family
• Discussing the potential benefits and emotional impact
• Ensuring the family understands their rights regarding tissue retention and organ disposal

Privacy and Confidentiality

Maintaining the privacy and confidentiality of the deceased and their family is paramount. This includes:

• Secure handling and storage of autopsy reports and findings
• Careful consideration of who has access to autopsy information
• Respectful communication of findings to the family and relevant authorities

How do ethical considerations impact autopsy practices? These ethical considerations shape protocols, guide communication with families, and influence decision-making processes in both medical and legal contexts.

The Role of Autopsies in Public Health and Medical Education

Autopsies play a crucial role beyond individual case resolution, contributing significantly to public health initiatives and medical education:

Epidemiological Research

Autopsy findings contribute valuable data for epidemiological studies, helping to:

• Track disease trends
• Identify emerging health threats
• Evaluate the effectiveness of public health interventions

Medical Education

Autopsies serve as an invaluable teaching tool for medical students and professionals, providing:

• Hands-on experience with human anatomy
• Insights into disease processes and progression
• Opportunities to correlate clinical diagnoses with pathological findings

Quality Assurance in Healthcare

Autopsies can serve as a form of quality control in medical practice by:

• Validating or challenging clinical diagnoses
• Identifying missed diagnoses or complications
• Providing feedback to improve patient care protocols

How do autopsies contribute to medical advancement? By providing concrete data on disease processes, treatment outcomes, and diagnostic accuracy, autopsies continue to be a cornerstone of medical research and education, driving improvements in patient care and public health strategies.

The Future of Autopsy: Emerging Trends and Challenges

As medical science advances, the field of autopsy is evolving to meet new challenges and incorporate innovative technologies:

Virtual Autopsies

The concept of “virtopsy” or virtual autopsy is gaining traction. This approach involves:

• Advanced imaging techniques like CT and MRI scans
• 3D reconstruction of the body’s interior
• Minimally invasive sampling techniques

Virtual autopsies offer several advantages:

• Reduced physical manipulation of the body
• Faster results in some cases
• Greater acceptance in cultures with religious objections to traditional autopsies

Molecular Autopsies

Molecular autopsy techniques are becoming increasingly important, especially in cases where traditional methods fail to identify a cause of death. These involve:

• Genetic sequencing to identify hereditary conditions
• Analysis of protein markers
• Advanced toxicology screenings

Challenges in the Field

Despite technological advancements, the field of autopsy faces several challenges:

• Declining rates of hospital autopsies due to various factors including cost and perceived value
• Shortage of trained forensic pathologists in many regions
• Balancing technological advancements with traditional techniques
• Addressing cultural and religious concerns about autopsy practices

How will these trends shape the future of autopsies? The integration of advanced technologies and molecular techniques with traditional methods is likely to create a more comprehensive, less invasive, and culturally sensitive approach to post-mortem examinations. This evolution may help address some of the current challenges while maintaining the crucial role autopsies play in medical science, legal proceedings, and public health.

As we look to the future, the field of autopsy continues to adapt and evolve, maintaining its vital role in understanding death, advancing medical knowledge, and serving both legal and public health needs. The ongoing development of new technologies and techniques promises to enhance the accuracy, efficiency, and acceptability of autopsies, ensuring their continued relevance in the ever-changing landscape of medical science and healthcare.

Autopsy – Better Health Channel

Summary

Read the full fact sheet

• An autopsy or post mortem is the medical examination of a body after death.
• A hospital (or non-coronial) autopsy may be performed if the immediate family give their consent.
• A coroner’s autopsy is performed if the coroner or police need information about the cause of death – for example, if the person was murdered or their death was suspicious.

An autopsy, or post mortem, is the medical examination of a body and the internal organs after a person has died. There are two types of autopsy – a coroner’s autopsy and a hospital autopsy.

Coroner’s autopsy

A coroner’s autopsy is performed if the coroner or police need information for legal reasons about the cause of death – for example, if the person was murdered or their death was suspicious.

Hospital autopsy

A hospital (or non-coronial) autopsy may be performed if the immediate family give their consent. In this case, the autopsy can help to clarify the reasons why the person died, or offer information to the medical profession on the deceased person’s condition. Some of the reasons for a hospital autopsy can include:

• In some cases, the cause of the person’s fatal illness may be unknown or uncertain.
• An autopsy can help determine the success (or otherwise) of a treatment method.
• An autopsy can give family members information in the case of suspected genetic illness.
• Medical science can learn about disease processes, such as atherosclerosis or sudden infant death syndrome (SIDS), or the prevalence of particular diseases.

The right to refuse an autopsy

‘Hospital’ and ‘coronial’ post mortems have differing rules around refusal rights.

Hospital autopsy

The immediate family has the right to refuse or agree to a hospital autopsy of the deceased. They may also choose to consent to an autopsy, but limit the extent of the examination. They can also decide whether or not organs or samples taken from the body may be kept for further study. Make sure you discuss these issues with hospital staff.

Coronial autopsy

The senior next of kin may object to the carrying out of a coronial autopsy and the coroner must consider their request to reconsider if the request is made within 48 hours of the senior available next of kin receiving a notification from the coroner.

Where the coroner decides that an autopsy is still required, the matter may be appealed in the Supreme Court. But there is a limited time in which these objections to a coronial autopsy may be made. Provisions about objecting to a coronial autopsy are contained in s26 and s79 of the Coroners Act 2008External Link.

The autopsy procedure

The autopsy is performed like a surgical operation. The steps may include:

• The autopsy is performed as soon as possible following the family’s consent.
• It is performed by a specially qualified doctor, called a pathologist, who is assisted by a technician.
• The room in which the autopsy is performed is very similar to a hospital operating theatre.
• The body is laid out carefully on an examination table.
• The pathologist first looks at the body, noting its appearance.
• Photographs and x-rays may be taken.
• The pathologist makes a cut on the body from the collarbone to the lower abdomen to examine the chest and abdominal organs.
• Tiny tissue samples are taken from each organ for examination under a microscope and may also be sent for chemical analysis or microbiological culture.
• In most cases, the brain is examined. This requires cutting through the scalp and skull. The brain is a very fragile organ – to examine it carefully and properly may take up to three weeks.
• Some organs may need to be kept for up to six weeks so that further tests can be performed in the pathology department.
• After the autopsy, the organs are replaced and the skin is stitched (sutured) closed again as happens after any operation.
• The post mortem can take up to three hours.

Tissue samples from an autopsy

Tissue samples taken from the body are usually kept by the laboratory. The samples are kept in the hope that technological advances may one day answer any remaining questions about the cause of death or the nature of the disease. Keeping tissue samples requires the specific consent of the deceased’s next of kin.

Organs that have been retained for further testing are returned to the family, disposed of by the hospital or kept for future medical research and training of medical staff, according to the family’s wishes.

The funeral

Once the autopsy is complete, the body can be collected by the family’s chosen funeral director. If some of the organs have been retained for further testing, the funeral may need to be delayed for a few days or weeks if the family wants the body to be whole before it is buried or cremated. In this case, the funeral director can arrange to embalm the body.

Autopsy results

A preliminary report is available within the first few days, but the full results of the autopsy are not usually available until around six to 12 weeks later. It may be best to arrange for the report to be sent to the family doctor, so that the next of kin can make an appointment to discuss the findings with their doctor. In other cases, the family could make an appointment with the pathologist.

Where to get help

• Your doctor
• Hospital staff
• Pathologist
• State Coroner’s Office Tel. 1300 309 519
• National Coronial Information SystemExternal Link

• The National Code of Ethical Autopsy Practice, Department of Health Victoria.
• Information for next-of-kin regarding non-coronial post mortems, Department of Health Victoria.

This page has been produced in consultation with and approved
by:

When and Why Are They Done?

Written by Matt Smith

Medically Reviewed by Jennifer Robinson, MD on December 01, 2022

• Coroners and Medical Examiners
• What Happens In an Autopsy?
• When Is One Required?
• When Is It Optional?
• Family Wishes and Faith

An autopsy is a detailed dissection of a deceased person, done to determine why they died.

If you and your family are dealing with the sudden loss of a loved one, you may find comfort in getting answers at this difficult time. But you should also know that autopsies don’t always have to be done. If you do need one, it’s usually both a medical and a legal process.Laws differ state by state.

You can ask for an autopsy if you have questions about how a family member died. And sometimes doctors will ask your permission to do one if they have questions.

Every local government has an official who records deaths. They’re called either a coroner or a medical examiner.

All but a handful of states require medical examiners to be doctors. Coroners may be doctors as well, but don’t have to be.

Coroners are usually elected officials. Many of them have no medical training. When an autopsy needs to be done, they rely on a medical examiner.

A doctor examines the remains inside and out. They can remove internal organs for testing and collect samples of tissue or bodily fluids such as blood.

The exam usually takes 1 to 2 hours. Many times, experts can figure out the cause of death in that time.

But in other cases, you might have to wait until a lab can do more tests to look for signs of drugs, poisons, or disease. That can take several days or weeks.

In 20 states and the District of Columbia, a pathologist — a doctor who specializes in the study of disease and injury — has to do the autopsy.

Once it is finished, the doctor will report an exact cause of death and how they think it happened — whether someone died from natural causes, an accident, homicide or suicide.

Although laws vary, nearly all states call for an autopsy when someone dies in a suspicious, unusual, or unnatural way.

Many states have one done when a person dies without a doctor present. Twenty-seven states require it if the cause of death is suspected to be from a public health threat, such as a fast-spreading disease or tainted food.

A doctor might ask you to allow an autopsy if your loved one died of an unexpected illness.

They’re usually trying to learn more about what happened, either to ease your mind, to learn whether other family members might be in danger of the same thing, or to find out something that might help other patients. 

In some cases, a condition that a person had in life can only be diagnosed after they die. For instance, doctors can learn for certain that someone had Alzheimer’s disease only after they examine the brain in an autopsy. It’s up to the family to decide whether to allow it.

The dead person’s next-of-kin also can ask for an autopsy if there are some concerns about why someone died. In addition to public officials, some private firms do them for a fee.

Some religious traditions discourage autopsies, believing a person’s body should be kept whole or otherwise left alone after death. Or they say burial should not be delayed.

Many states have laws that honor religious objections. Medical examiners sometimes change the way they do an autopsy out of respect for the family’s beliefs. But states still require one when it’s needed to investigate a crime or head off a threat to public health.

Most examinations shouldn’t delay a funeral or prevent a viewing of the body during a service. Funeral directors are usually able to hide any signs of the autopsy with clothing.

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Article 67. Carrying out pathological and anatomical autopsy \ ConsultantPlus

prepared the editorial board of the document with changes that did not enter into force

Article 67. Carrying out pathological and anatomical autopsy 1. Pathological and anatomical autopsy are carried out by doctors of the corresponding specialty in order to obtain data on data about data the cause of death and the diagnosis of the disease.

2. The procedure for conducting pathological and anatomical autopsies is determined by the authorized federal executive body.

3. For religious reasons, if there is a written application of a spouse or close relative (children, parents, adopted children, adoptive parents, siblings, grandchildren, grandfather, grandmother), and in their absence, other relatives or a legal representative of the deceased or upon expression of will the deceased himself, made during his lifetime, a pathological-anatomical autopsy is not performed, except in cases:

1) suspicion of violent death;

2) the impossibility of establishing the final clinical diagnosis of the disease that led to death and (or) the immediate cause of death;

3) provision of medical care to a deceased patient by a medical organization in a hospital for less than one day;

4) suspected overdose or intolerance to drugs or diagnostic products;

5) death:

a) associated with preventive, diagnostic, instrumental, anesthetic, resuscitation, therapeutic measures, during or after the operation of blood transfusion and (or) its components;

b) from an infectious disease or if it is suspected;

c) from cancer in the absence of histological verification of the tumor;

d) from a disease associated with the consequences of an environmental disaster;

e) pregnant women, women in childbirth, puerperas (including the last day of the postpartum period) and children under the age of twenty-eight days inclusive;

6) the birth of a dead child;

7) the need for a forensic medical examination.

4. When conducting a pathological-anatomical autopsy, histological, biochemical, microbiological and other necessary methods of examination of individual organs, tissues of the deceased or their parts are an integral part of the diagnostic process in order to identify the causes of death of a person, complications of the underlying disease and concomitant disease, his condition. The will of the deceased, expressed during his lifetime, or a written statement of the spouse, close relative (children, parents, adopted children, adoptive parents, siblings, grandchildren, grandparents), and in their absence, other relatives or the legal representative of the deceased about conducting such research is not required.

5. The conclusion on the cause of death and the diagnosis of the disease is issued to the spouse, close relative (children, parents, adopted children, adoptive parents, siblings, grandchildren, grandfather, grandmother), and in their absence to other relatives or the legal representative of the deceased, law enforcement bodies, the body exercising federal state control over the quality and safety of medical activities, and the body exercising federal control over the quality and conditions for the provision of medical care, at their request.

(as amended by Federal Law No. 170-FZ of June 11, 2021)

(see the text in the previous edition)

grandchildren, grandfather, grandmother), and in their absence, other relatives or the legal representative of the deceased are given the right to invite a specialist doctor (with his consent) to participate in the autopsy.

7. The conclusion on the results of a pathological and anatomical autopsy can be appealed in court by a spouse, close relative (children, parents, adopted children, adoptive parents, siblings, grandchildren, grandfather, grandmother), and in their absence by another relative or legal representative of the deceased in the manner prescribed by the legislation of the Russian Federation.

8. Pathological and anatomical autopsy is carried out with respect for the body of a deceased person and maintaining its maximum anatomical shape.

The procedure for conducting pathological and anatomical autopsies

The Prosecutor’s Office of the Nekhaevsky district explains the legislation governing the procedure for conducting pathological and anatomical autopsies.

The Prosecutor’s Office of the Nekhaevsky District explains the legislation governing the procedure for conducting pathological and anatomical autopsies.

In connection with numerous appeals regarding the autopsy of elderly citizens and the possibility of refusing to autopsy corpses, the Nekhaevsky District Prosecutor’s Office is clarifying the current legislation.

Pathological and anatomical autopsies are regulated by Federal Law No. 323-FZ of November 21, 2011 “On the Fundamentals of Protecting the Health of Citizens in the Russian Federation” and Order of the Russian Ministry of Health No. 354n of June 6, 2013 “On the Procedure for Conducting Pathological and Anatomical Autopsies”.

In accordance with Part 1 of Art. 67 of this Law and clause 2 of the Procedure for Conducting Pathological and Anatomical Autopsies, a pathological and anatomical autopsy is carried out by a pathologist in order to obtain data on the cause of death of a person and the diagnosis of the disease.