Forensic autopsy

Also known as: necropsy, postmortem, postmortem examination
Also called:
necropsy, postmortem, or postmortem examination
Key People:
Karl, baron von Rokitansky

The forensic pathologist goes beyond the mere cause of death; he must establish all the facts, both lethal and nonlethal, with any potential bearing whatsoever on the criminal or civil litigation. The cause of death is not automatically revealed when the body is opened; it is not an isolated tangible and delimited entity; it is a concept—an opinion—as to mechanism or happening and as such is subject occasionally to differences in interpretation. The legal autopsy requires meticulous detailed descriptions, measurements, and documentation.

The goal of forensic autopsies is to determine whether or not death was due to natural causes. Experience in the investigation of the scene of a death in medicolegal cases is important, for the evaluation of circumstances of death may be critical in establishing the mode of death—e.g., suicide. The autopsy may not be able, of itself, to determine intent, whereas the scene and the circumstances may provide unmistakable evidence. Photographic documentation is important in the medicolegal autopsy. The medicolegal postmortem examination must always be complete to rule out any other potential contributory cause of death and therefore must never be limited to a partial study. The identification of the deceased and of all specimens taken from the body is critical; the time of death and the blood grouping must, if possible, be established. In all autopsies, but especially in forensic cases, findings must be dictated to a stenographer or recording instrument during the actual performance of the procedure. The record often becomes legal evidence and therefore must be complete and accurate.

Purposes

The autopsy deals with the particular illness as evidenced in one individual and is more than simply a statistical average. Every autopsy is important to expose mistakes, to delimit new diseases and new patterns of disease, and to guide future studies. Morbidity and mortality statistics acquire accuracy and significance when based on careful autopsies; they also often give the first indication of contagion and epidemics. Nor can the role of the autopsy in medical education be understated. It is the focal point at which the profession learns to assess and to apply medical knowledge. Thus, the autopsy does more than merely determine the cause of death. While the medicolegal autopsy in particular has this important primary objective, most autopsies have a larger purpose.

The Editors of Encyclopaedia Britannica
This article was most recently revised and updated by Amy Tikkanen.

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death, the total cessation of life processes that eventually occurs in all living organisms. The state of human death has always been obscured by mystery and superstition, and its precise definition remains controversial, differing according to culture and legal systems.

During the latter half of the 20th century, death has become a strangely popular subject. Before that time, perhaps rather surprisingly, it was a theme largely eschewed in serious scientific, and to a lesser extent, philosophical speculations. It was neglected in biological research and, being beyond the physician’s ministrations, was deemed largely irrelevant by medical practice. In modern times, however, the study of death has become a central concern in all these disciplines and in many others.

“So many more people seem to die nowadays,” an elderly lady is alleged to have said, scanning the obituary columns of a famous daily. This was not just a comment on the documented passing of a cohort. Various journals now not only list the dead but also describe what they died of, at times in some detail. They openly discuss subjects considered too delicate or personal less than a generation ago. Television interviewers question relatives of the dying—or even the dying themselves—and films depict murders or executions in gruesome and often quite accurate detail. Death is no longer enshrined in taboos. Popular readiness to approach these matters and a general desire to be better informed about them reflect a change in cultural attitudes perhaps as great as that which accompanied the more open discussion of sex after World War I.

Thanatology—the study of death—delves into matters as diverse as the cultural anthropology of the notion of soul, the burial rites and practices of early civilizations, the location of cemeteries in the Middle Ages, and the conceptual difficulties involved in defining death in an individual whose brain is irreversibly dead but whose respiration and heartbeat are kept going by artificial means. It encompasses the biological study of programmed cell death, the understanding care of the dying, and the creation of an informed public opinion as to how the law should cope with the stream of problems generated by intensive-care technology. Swiss-born American psychiatrist and author Elisabeth Kübler-Ross (1926–2004), who was a pioneer in the study of death and dying, was especially known for having identified five stages of grief experienced by the dying. She was credited with bringing acceptance and respect to the new field of thanatology and to the hospice care movement.

Legal and medical quandaries regarding the definition of death and the rights of the terminally ill (or their families) to refuse life-prolonging treatments force physicians to think like lawyers, lawyers like physicians, and both like philosophers. In his Historia Naturalis (Natural History), the Roman author Pliny the Elder wrote that “so uncertain is men’s judgment that they cannot determine even death itself.” The challenge remains, but if humans now fail to provide some answers it will not be for lack of trying.