What is an autopsy. How is an autopsy performed. Why are autopsies important for medical research. Can families refuse an autopsy. How long does an autopsy take. What happens to tissue samples after an autopsy.

What is an Autopsy and Why is it Performed?

An autopsy, also known as a post mortem examination, is a detailed medical examination of a body after death. This procedure is conducted to determine the cause and manner of death, as well as to gather valuable information for medical research and education. Autopsies play a crucial role in advancing our understanding of diseases, improving medical treatments, and solving legal cases.

There are two main types of autopsies:

• Coroner’s autopsy
• Hospital autopsy

Each type serves different purposes and follows distinct protocols. Understanding the differences between these types of autopsies is essential for both medical professionals and the general public.

Coroner’s Autopsy: When is it Required?

A coroner’s autopsy, also known as a forensic autopsy, is performed when there are legal reasons to determine the cause of death. This type of autopsy is typically ordered by a coroner or law enforcement officials in cases where:

• The death is suspected to be the result of a crime
• The circumstances surrounding the death are suspicious or unclear
• The death occurred suddenly or unexpectedly
• There is a potential public health concern

The primary goal of a coroner’s autopsy is to provide evidence for legal proceedings and to ensure that any potential criminal activity is identified and investigated.

Can families object to a coroner’s autopsy?

While families have the right to object to a coroner’s autopsy, the process is more complicated than refusing a hospital autopsy. The senior next of kin must submit their objection within 48 hours of receiving notification from the coroner. The coroner will consider the request but may still decide that the autopsy is necessary. In such cases, the family can appeal the decision in the Supreme Court, but time limitations apply.

Hospital Autopsy: Advancing Medical Knowledge

A hospital autopsy, also referred to as a non-coronial autopsy, is performed with the consent of the deceased person’s immediate family. These autopsies serve several important purposes in the medical field:

1. Clarifying the cause of death in cases where the fatal illness was unknown or uncertain
2. Evaluating the effectiveness of treatment methods
3. Providing information to families about potential genetic illnesses
4. Advancing medical research on various diseases and conditions
5. Improving understanding of complex medical issues like atherosclerosis or sudden infant death syndrome (SIDS)

Hospital autopsies contribute significantly to medical education and the continuous improvement of healthcare practices.

Do families have the right to refuse a hospital autopsy?

Yes, families have the right to refuse or agree to a hospital autopsy. They can also choose to limit the extent of the examination or specify which organs or samples may be kept for further study. It’s crucial for families to discuss these options with hospital staff to make informed decisions.

The Autopsy Procedure: What Happens During an Examination?

An autopsy is a meticulous process conducted by a specially qualified doctor called a pathologist, assisted by a technician. The procedure takes place in a room similar to a hospital operating theater and typically follows these steps:

1. External examination: The pathologist carefully observes the body’s appearance, taking photographs and X-rays if necessary.
2. Internal examination: An incision is made from the collarbone to the lower abdomen to examine the chest and abdominal organs.
3. Tissue sampling: Small samples are taken from each organ for microscopic examination and potential chemical or microbiological analysis.
4. Brain examination: In most cases, the brain is examined, which requires cutting through the scalp and skull.
5. Organ analysis: Some organs may need to be kept for up to six weeks for further testing.
6. Closure: After the examination, organs are replaced, and the incisions are sutured closed.

The entire process can take up to three hours, with brain examination potentially requiring up to three weeks for a thorough analysis.

How soon after death is an autopsy performed?

An autopsy is typically performed as soon as possible following the family’s consent. This prompt action helps preserve the body’s condition and ensures the most accurate results.

Tissue Samples and Organ Retention: What Happens After the Autopsy?

Following an autopsy, tissue samples are usually kept by the laboratory for various purposes:

• Future technological advancements may provide new insights into the cause of death or nature of the disease
• Samples can be used for ongoing medical research and education
• They may be required for legal cases or further investigations

It’s important to note that keeping tissue samples requires specific consent from the deceased’s next of kin.

What options do families have regarding retained organs?

Families have several options when it comes to organs retained for further testing:

• The organs can be returned to the family
• They can be disposed of by the hospital
• With consent, they may be kept for future medical research and training of medical staff

These decisions should be made in consultation with the hospital staff and in accordance with the family’s wishes and cultural beliefs.

Autopsy Results: Timeframes and Implications

The results of an autopsy are typically available in two stages:

1. Preliminary report: Available within the first few days after the autopsy
2. Full results: May take several weeks or even months, depending on the complexity of the case and the need for additional tests

These results can provide crucial information for families, medical professionals, and, in some cases, legal authorities.

How do autopsy results impact medical research?

Autopsy results play a vital role in advancing medical knowledge:

• They help identify new diseases or variations of known conditions
• Results can reveal the effectiveness of treatments and medications
• They contribute to the understanding of disease progression and complications
• Findings may lead to improvements in diagnostic techniques and treatment protocols

This information is invaluable for medical education and the continuous improvement of healthcare practices.

The Impact of Autopsies on Funeral Arrangements

While autopsies are crucial for medical and legal purposes, they can affect funeral arrangements. Here are some key considerations:

• Once the autopsy is complete, the body can be collected by the family’s chosen funeral director
• If organs have been retained for further testing, the funeral may need to be delayed
• Families who wish for the body to be whole before burial or cremation may need to wait for retained organs to be returned
• Embalming can be arranged by the funeral director to preserve the body if there are delays

It’s important for families to communicate with both medical staff and funeral directors to ensure their wishes are respected while accommodating the necessary medical procedures.

How can families balance the need for an autopsy with their funeral plans?

Balancing the need for an autopsy with funeral plans requires open communication and planning:

• Discuss timeline expectations with medical staff performing the autopsy
• Consult with the funeral director about potential delays and preservation options
• Consider temporary preservation methods if waiting for the return of retained organs
• Explore cultural or religious accommodations that may be necessary

By addressing these factors early in the process, families can ensure that both the medical and personal aspects of their loved one’s passing are handled with care and respect.

Ethical Considerations in Autopsy Practices

The practice of conducting autopsies raises several ethical considerations that medical professionals, families, and society at large must grapple with:

• Respect for the deceased and their bodily integrity
• Balancing the needs of medical research with personal and cultural beliefs
• Ensuring informed consent from families for hospital autopsies
• Protecting the privacy and confidentiality of the deceased and their medical information
• Addressing potential conflicts between legal requirements and family wishes in coroner’s autopsies

These ethical considerations underscore the importance of clear communication, sensitivity to cultural differences, and robust legal frameworks governing autopsy practices.

How do medical institutions ensure ethical autopsy practices?

Medical institutions implement various measures to ensure ethical autopsy practices:

• Developing comprehensive consent processes that fully inform families of the procedure and its implications
• Establishing clear protocols for the handling and storage of tissue samples and organs
• Providing training to medical staff on cultural sensitivity and ethical considerations
• Regularly reviewing and updating policies to align with evolving ethical standards and legal requirements
• Collaborating with ethicists and community representatives to address complex ethical dilemmas

These measures help maintain public trust in the autopsy process while advancing medical knowledge and serving legal needs.

The Future of Autopsies: Technological Advancements and New Approaches

As medical technology continues to advance, the field of autopsy is evolving. New approaches and technologies are being developed to enhance the information gathered from post-mortem examinations while potentially reducing their invasiveness. Some of these advancements include:

• Virtual autopsies using advanced imaging techniques like CT and MRI scans
• Molecular autopsies that analyze genetic material to identify hereditary conditions
• 3D printing of organs and tissues for more detailed examination and education
• AI-assisted analysis of autopsy data to identify patterns and trends
• Minimally invasive autopsy techniques that reduce physical impact on the body

These innovations promise to expand the capabilities of post-mortem examinations while addressing some of the concerns associated with traditional autopsy methods.

How might these advancements change the future of autopsies?

The integration of new technologies and approaches could significantly impact autopsy practices:

• Increased accuracy and detail in determining causes of death
• Reduced need for invasive procedures, potentially increasing acceptance among families
• Enhanced ability to detect and understand rare or complex medical conditions
• Improved preservation of evidence for forensic cases
• Greater integration of autopsy findings with clinical data for medical research

These changes may lead to a more comprehensive understanding of human health and disease, ultimately contributing to advancements in medical treatment and prevention strategies.

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.

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What Is an Autopsy? A Forensic Pathologist Explains

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March 16, 2023

“I never speak to a happy family. I’m maybe speaking to them on the worst day of their
life—giving them some really horrible news.”

Dr. Gregory McDonald

Dr. Gregory McDonald, dean of PCOM’s School of Health Sciences and director of the MS in Forensic Medicine program, has served as the chief deputy coroner at the Montgomery County Coroner’s Office
since 2008. He has conducted thousands of autopsies, testified in hundreds of court
cases and has, as he described it, provided closure for many people.

“We are very different from almost every other type of physician,” he said. “We have
different ways of measuring our successes.”

Other doctors, he explained, may have to occasionally deliver bad news but they also
may have victories where they save lives.

“Our victories are measured a bit differently,” McDonald said.

What is an autopsy?

An autopsy is a detailed examination of a body for the purpose of determining how
an individual died. The procedure may be done as part of a criminal investigation
or it may be performed at the request of family members.

According to McDonald, one of the main duties of a forensic pathologist is to testify
about autopsy findings in court.

“It sounds cliche, but it’s really true that we are a voice for these victims,” he
said.

McDonald recounted the case of a young boy beaten to death. He had to describe in
detail what had happened to the boy and how the child had died with the mother sitting
in the courtroom listening to his testimony. The mother later approached McDonald.

“She still had the grace and the dignity to come up to me and thank me for being a
voice for her child,” he recalled.

According to McDonald, autopsies most often lead to a determination of a natural death.
However, there are cases—skeletonized remains for example—that can potentially frustrate
even the most experienced forensic pathologists.

“There are times we’ve looked at everything we can look at and at the end of the day,
we don’t know what happened,“ he said. “An autopsy can only tell so much.”

Where is an autopsy performed?

An autopsy may take place in a hospital or, if circumstances warrant, it may be conducted
at a medical examiner facility or coroner’s office.

The Montgomery County Coroner’s Office (MCCO) where McDonald works will soon be opening a new facility which McDonald says
will improve their ability to process cases and serve the public.

“As society expands and the population begins to increase, you need an expansion of
the death investigation system,” McDonald said.

The death investigation system, he explained, provides a mechanism by which the cause
and manner of death can be determined in cases where the individual passes away in
an unnatural, unobserved or unexplained way.

“As it expands, we need more personnel to cover increased cases,” McDonald said. The
additional personnel ensure the investigations and notification of next of kin will
be handled in a timely manner.

The new MCCO facility will have expanded work space and updated equipment including
new tables, new x-ray equipment, better storage facilities and larger conference rooms
to better accommodate meetings with families as well as educational events for the
public.

When is an autopsy required?

According to McDonald, there are no hard and fast requirements. That, he added, is
a problem as there is a patchwork of different systems which may vary from state to
state or even jurisdiction to jurisdiction.

Even in Pennsylvania, some counties rely upon the local coroner’s office for death
investigations while others—Philadelphia, Delaware and Allegheny counties—have medical
examiners.

Generally speaking though, an autopsy may be conducted when questions exist regarding
how, when, where or why a person died.

Who performs an autopsy?

A medical examiner is a physician who has been specifically trained in forensic pathology, toxicology
and other related areas. In jurisdictions with a medical examiner’s office, the medical
examiner and assistant medical examiners are appointed to office and will often be
formally trained as forensic pathologists. They are responsible for conducting forensic
autopsies in their jurisdictions.

Coroners are elected to office. While they may often be physicians, they may not be
trained as forensic pathologists. Oftentimes, coroners will hire a forensic pathologist
on a contract basis to handle cases.

“We may also call in consultants to help us—like a forensic dentist or forensic anthropologist,”
McDonald said. “However, a forensic pathologist should always determine the cause
and manner of death.”

Who can request an autopsy?

Autopsies fall into two general categories: forensic and hospital-based.

A forensic autopsy is the more common type. When certain criteria are met, a medical
examiner or coroner will have jurisdiction, and therefore, the authority to determine
that an autopsy should be done. These criteria include deaths resulting from trauma
or violence, motor vehicle accidents, drug-related deaths or deaths where people are
not identified.

Hospital-based autopsies usually involve a natural death in a hospital or a home setting
in which family members request an autopsy be performed and sign a consent form.

How is an autopsy performed?

An autopsy is performed in two different phases—an external examination and an internal
one.

In the first phase, McDonald explained, the forensic pathologist will note any identifying
characteristics and any obvious signs of natural disease. The body will be assessed
for post-mortem changes including rigor mortis (stiffening of the joints and muscles)
or livor mortis (settling of the blood) which may help determine time of death. Other
factors including discoloration, bloating, skin slippage or insect activity will also
be noted. The external examination is documented with photography and the forensic
pathologist’s notes.

The next phase involves examining the internal organs. That process begins with a
y-shaped incision in which the chest cavity is opened.

“At that point, we’re going to start to examine the different layers we’re seeing,”
McDonald said.

This examination includes looking for abnormal accumulations of fluids and any unusual
masses. The forensic pathologist will also inspect the organs while still in place.
When a gunshot wound is involved, the forensic pathologist will note the wound path,
which organs were struck by the bullet and the amount of blood loss internally. In
those cases, recovery of the bullet is critical.

“They are very important pieces of evidence,” McDonald said.

After the in situ examination is completed, the organs will be removed, examined,
weighed, dissected and sampled. In some cases, slides may be prepared for microscopic
examination.

During the internal examination, the forensic pathologist or autopsy technician will
also collect fluid samples including bile, blood, vitreous and gastric fluids.

After everything has been examined, the organs are placed back in the body.

“We do pride ourselves in the ability to do a complete autopsy but still allow the
family to have a funeral with an open casket if they opt to do that,” McDonald said.

How long does an autopsy take?

The time required to complete an autopsy can vary greatly depending upon the case.

”A case that does not involve a lot of injury or does not require a lot of specimens,
with the help of my technician, can be done in about an hour,” McDonald said.

More complicated ones, he added, can take up to eight hours.

What is an autopsy report?

Once the autopsy is completed and a determination is made regarding cause and manner
of death, the forensic pathologist will issue a report.

“Sometimes I know the cause of death and manner of death right after an autopsy,”
McDonald said. “Other times, if it is a drug death for instance, I might have to wait
until the toxicology results come in.”

The autopsy report is then turned over to the coroner for inclusion in the coroner’s
report. The coroner’s file may also include reports from forensic investigators, law
enforcement, emergency medical services personnel, medical records, dental records
and more.

Providing closure

While the results of an autopsy may sometimes reveal tragic or shocking information,
McDonald sees it as an important step in the grieving process for those left behind.

“I do think I can provide some closure for them,” he said. “You are able to inform
the family and they can move on with their lives and start the grieving process.”

Despite the difficult nature of his job, McDonald takes immense satisfaction in what
he does.

“When it’s something you really enjoy, it’s not work.”

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Autopsy | it’s… What is an autopsy?

I
Autopsy (synonym: section, autopsy)

examination of the body of the deceased in order to ascertain the nature of the existing changes and establish the cause of death. Distinguish pathoanatomical and forensic V. t. Pathological anatomical V. t. — a research of corpses of the persons who died from various diseases in hospital establishments. Forensic medical V. t. is carried out according to a written order (relationship, direction, decision or determination) of the bodies of inquiry, investigation or court to establish the cause and time of death, determine the presence and nature of bodily injuries, lifetime, prescription and sequence of their formation, mechanism and the method of causing, identifying a causal relationship between the identified injuries and the onset of death, as well as to resolve other issues of a biomedical nature.

A forensic medical examination of a corpse is appointed in all cases of violent death (murder, suicide, accident), regardless of the place and time of its occurrence, in case of death suspected of being violent, incl. and sudden (sudden) or from an unknown cause outside a medical institution, upon death of a patient during the first day of stay in a medical institution, if the diagnosis of the disease was not established, as well as upon death of a patient in a medical institution, if the investigating authorities accepted a complaint about an incorrect or illegal its treatment, in all cases of death of unknown persons and upon discovery of a dismembered corpse and its parts. The forensic autopsy of a corpse is carried out in compliance with the norms stipulated by the criminal procedure codes of the Union republics, special rules and the “Instructions on the conduct of a forensic medical examination” (1978). It is carried out by doctors who have undergone special training in forensic medicine – forensic experts. In their absence, V. t. can be entrusted to any doctor (doctor-expert). As a rule, V. t. In some cases, for example, if it is impossible to deliver the corpse to the morgue, it can be carried out in temporarily adapted premises, and in the summer even in the open air.

Forensic medical examination of a corpse includes a detailed examination of the clothes he is wearing and the items delivered with him in order to identify damage, traces and overlays on them (see Material evidence) , external examination (examination) of the corpse with a detailed description of post-mortem changes (Post-mortem changes) , and if damage is found – their nature, localization and features (see Forensic Injuries), examination of soft tissues and internal organs. In contrast to a pathoanatomical autopsy, it is forbidden to use water for washing organs during a forensic medical examination of a corpse, because. if poisoning is suspected, they should be sent for forensic chemical research (see Poisoning in forensic terms). Examination of a corpse, as a rule, is supplemented by forensic chemical, histological, physical-technical, bacteriological studies, etc. Their choice, as well as the nature and number of organs and tissues sent for examination, are determined in each case by a forensic medical expert or medical expert taking into account the alleged cause of death and the questions posed to the examination.

When opening the corpses of unknown persons or when examining parts of a dismembered corpse, they pay attention to the features of clothing – its style, size, nature of the fabric, factory or other marks, catchy fittings, degree of wear, traces of repair, describe in detail the contents of the pockets. In addition, they make up a verbal portrait, note special signs and other identifying features (see Personal identification) . A frozen corpse is thawed at room temperature before examination. No degree of putrefactive change of the corpse or its destruction can serve as a pretext for refusing an autopsy.

When examining the corpse of a child, it is necessary to establish whether he was a newborn, and if he was, then answer a number of additional questions: was he viable, live-born, full-term and mature, what is the duration of his intrauterine development, how long did he live after birth, it turned out whether he needed assistance and whether proper care was provided. In forensic terms, a newborn is considered an infant who has lived after birth for no more than 1 day, a viable infant is an infant with a body length of at least 38-40 sm weighing at least 1500-1600 g free of malformations and diseases incompatible with life. Establishment of live birth is carried out with the help of so-called life tests. They are swimming (hydrostatic) tests: Galen-Schreyer lung test and Breslau gastrointestinal test (lungs and their fragments, stomach and intestines float in water), Dillon X-ray test (air is determined in the lungs and organs of the gastrointestinal tract during radiography) and some others. The term and maturity of the newborn is determined using generally accepted methods. The duration of intrauterine life is calculated mainly based on the length of the baby’s body: if it is less than 25 cm , then the square root is taken from the set value (in cm ), if more, then the set number is divided by 5; the result obtained corresponds to the number of lunar months. In addition, they are guided by the mass of the placenta (by the end of the 7th lunar month it is 375 g , by the end of the 8th – 450 g , by the end of the 9th – 460 g ) and the length of the umbilical cord (respectively 42 , 46, 47 cm ). The duration of extrauterine life of an infant is judged by changes in the umbilical cord and umbilical ring, the degree of resorption of the birth tumor, the passage of meconium, and the level of filling of the gastrointestinal tract with air.

The main documents that reflect the results of the autopsy are the “Conclusion of the forensic medical examination (expert opinion)” and the “Act of the forensic medical examination of the corpse”, including a record of the results of the autopsy, information about the organs and tissues sent for laboratory research, and the results of these studies, diagnosis and conclusions (conclusion), containing answers to the questions posed to the forensic medical examination of the corpse.

Bibliography Avdeev M.I. Forensic medical examination of a corpse, M., 1976; Khrushchelevsky E. and Shperl-Zelfridova G. Section of corpses of fetuses and newborns, trans. from Polish., M., 1962; Shirinsky P.P. et al. Forensic medical diagnosis of live birth, M., 1974.

II
Autopsy (autopsia; synonym: autopsy, autotomy – obsolete, obduction – obsolete, section)

study of the body of the deceased, which consists in the sequential extraction and dissection of organs and tissues with the identification of pathological changes in them and the establishment of causes of death.

Pathological anatomical autopsy — V. t. by a pathologist in order to establish a pathoanatomical diagnosis and compare the clinical diagnosis with it.

Forensic medical autopsy — V. t. by a forensic medical expert or medical expert in the presence of a decision of the bodies of inquiry, investigation or court ruling.

1. Small medical encyclopedia. — M.: Medical Encyclopedia. 1991-96 years 2. First aid. – M .: Great Russian Encyclopedia. 1994 3. Encyclopedic dictionary of medical terms. — M.: Soviet Encyclopedia. – 1982-1984

Postmortem autopsy of a person: the nuances of the study

Pathological anatomical autopsy, which is also commonly called “necropsy”, is an autopsy of the body of the deceased (or stillborn) with further study of the internal organs. Most often, this procedure is carried out to determine the exact cause of death – because it can not always be established by external signs.

In what cases is a pathoanatomical autopsy used

If we consider the case of death in the bed of an old sick person, then necropsy is usually performed in rare cases – when the initiative comes from relatives.

An autopsy is an almost mandatory procedure when there is no confirmed cause of death. This is especially true in cases where representatives of law enforcement agencies arrived at the scene. If they have doubts that this death can be violent, then the body of the deceased is sent for necropsy without the consent of the relatives. In the absence of a petition from the Ministry of Internal Affairs, the relatives of the deceased may refuse to perform an autopsy.

Most often, an autopsy is refused at the will of the deceased or for religious reasons. Employees usually agree to such a requirement if:

• the deceased was seriously ill before his death and died under medical supervision;
• there is a medical record of the deceased, in which diseases are registered that one way or another led to a fatal outcome;
• relatives can provide the results of a histological examination if the deceased had oncological diseases.

It is possible to have time to refuse an autopsy, that is, to submit an appropriate application, within three days after sending the body to the morgue. According to the law, an autopsy of the received body is carried out within 3 days after arrival, so you can not delay with the application.

Autopsy and forensic examination of a corpse

Necropsy should not be equated with a forensic medical examination of a corpse. There are two major differences between these two terms:

1. Forensic medical examination is an obligatory component after a criminal case has been opened. But necropsy is carried out upon the presence of a petition in writing from relatives or by the personal decision of medical staff, if biological death has been ascertained. If there are suspicions of a violent death (signs of the action of toxic substances, physical damage are found), then the body can be sent for a forensic examination.
2. These two methods use different tools. In addition, necropsy can be carried out in any organization (in other words, in different places). The most important thing is to have the appropriate permission to conduct this kind of autopsy.

Necropsy steps

According to the existing procedure, enshrined in the current Russian legislation, the autopsy is carried out according to the following algorithm:

1. Visual examination of a deceased person.
2. Autopsy and examination of body cavities.
3. Organ harvesting.
4. Examination of organs and tissues.
5. Collection of biomaterial for a number of different studies.
6. Return the body to its original form.
7. Conducting laboratory research and examination of taken biomaterials using a microscope.

Visual inspection

Initially, even before the moment of autopsy, a visual examination of the body by specialists takes place. All found scars and various wounds, burns, scratches (and so on) are recorded in the appropriate document at the time the body arrived at the department.

Organ harvesting

After that, an autopsy of the body is carried out, internal organs and tissues are examined. They are then extracted for further research. At the same time, employees try not to damage them too much, since then they will need to be returned back to the body.

Here it is worth saying that in different countries there are significant differences in relation to organs. So, in the United States of America, organs are usually not sewn into the body, but simply disposed of. In Europe, this is prohibited.

Analysis of biological material

In addition to a general examination of the state of internal organs, they must be studied in laboratories. Based on the cause of death and medical indications received by health workers, the approach to research will differ: biomaterials can be taken from a variety of organs and tissues for analysis.

An example is the study of suspected death due to lung cancer. Lung tissues will be taken to search for tumors on them, as well as neighboring tissues and organs in order to detect cancer cells there. In the Russian Federation, after the end of the stage, the pathologist who supervises the necropsy draws up and signs the “Protocol of the pathological and anatomical autopsy”. He bears legal responsibility for the truthfulness of the testimony.

Body restoration and embalming

After the end of the study, the body is handed over to relatives so that they bury it. For this reason, it is necessary to carry out an autopsy with further prospects for the reconstruction of the body: all organs are placed in their proper places, incisions are sutured, the body is washed. As a result, the body retains its former shape, and the sewn incisions from necropsy are hidden under clothing or hair (if we are talking about research on parts of the skull).

This stage plays a special role during burial in open coffins – this practice exists in Russia, but is quite rare. This is done so that all relatives, friends, acquaintances can see the deceased and see him on his last journey, so the body must have a good appearance. With the right approach to necropsy, traces from the autopsy are invisible.

What is necropsy used for

The autopsy procedure lasts from 30 minutes to several hours. This period of time includes direct work with the body of the deceased. Analyzes and laboratory tests can take several days or even weeks. Conducting necropsy allows you to draw conclusions on the official cause of death: agree with it or refute it.

An autopsy is of great importance in medicine in general – its use allows improving the accuracy of statistical mortality, the correctness of diagnosing a disease, and evaluating the effectiveness of the treatment being undertaken.

Among other things, conducting a pathoanatomical study allows you to identify the diagnosis as accurately as possible and evaluate the work of individual doctors, medical institutions, medical higher educational institutions, and even the medical system of a state or region in general.

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