Autopsies

SIGNIFICANCE: Through examination, medical examiners and investigators can learn how someone died, how that kind of death might be prevented in the future, and if the death in question was caused by criminal means.

An autopsy, or postmortem examination, is a way of learning how a person died. The first autopsies were performed by and for medical students, but eventually it became clear that autopsies could also be used to determine if a person’s death was a result of natural causes. If homicide is discovered to be the cause of death, then the results of the autopsy are used in coordination with other evidence to attempt to bring the murderer to justice.

Autopsies are performed in hospitals, medical schools, and forensics laboratories. While training to become doctors, medical students perform autopsies to familiarize themselves with parts of the body—both healthy and unhealthy. When an autopsy is performed at a hospital, it is usually at the request of the family or other legal guardian of the deceased who wants to know how the death came about. Mitigating circumstances regarding the care that person received while alive can sometimes be determined by the autopsy. If it is shown that reasonable steps to keep a patient alive were not taken, then legal action may be sought. A coroner has to decide whether the death of the body found at a crime scene was natural or not. Many times, the only way to find out is by performing an autopsy.

Performing an Autopsy

Before a legal autopsy begins, permission to perform it must be obtained. This permission is usually granted by a family member. If there are no known surviving relatives, a friend may give permission, or a brief period of time may be allowed for a relative search to be performed. If the person in question was enlisted in the military at the time of death, an autopsy may be ordered by the appropriate military commander. Religion also plays a factor: Autopsies are permitted by some faiths, while the doctrines of others may object to the procedure.

An autopsy can range from examination of a single organ removed for further study (a selective autopsy) to dissection of the entire body, one organ at a time (a complete autopsy). The latter is almost always done for a medicolegal/forensic investigation. After the body is placed upon the autopsy table (sometimes with the help of a diener, or attendant), a detailed external examination is made in order to record the body’s height, weight, any visible markings such as tattoos or scars, injuries, and any other trace evidence that can be found. These details can help with a forensic investigation, and if the body is that of an unknown person, they may help with identification.

Once external examination has been completed, an internal examination begins. A standard autopsy starts with a Y- or U-shaped incision cut into the torso, from the shoulders to the pubic bone. The medical examiner or pathologist then proceeds to remove every organ from the neck, chest, abdominal cavity, and skull. If further information is needed, organs are sent to a laboratory for analysis, which may include microbiological (testing for infections), histology (whether the body’s organs and tissues have changed), and toxicology (testing for drugs, poisons, or medications). At every step of the autopsy, a detailed record is kept so that it may be referred to later. After the autopsy is completed, the incisions are sutured shut so that the body can be given to a mortuary in preparation for funeral services.

History of Autopsies

The term autopsy comes from autopsia, a Greek word meaning “to see with one’s own eyes.” Around 3000 BCE, the Egyptians practiced mummification—removing organs through tiny slits in the body so that the body itself remained whole—and the Greek Hirophilus broke religious taboos by dissecting bodies to learn how the inner organs worked. By around 150 BCE, autopsy results had legal parameters in the Roman Empire. Giovanni Battista Morgagni wrote The Seats and Causes of Diseases Investigated by Anatomy in 1769, the first exhaustive written work on pathology.

The nineteenth century Austrian anatomy professor Karl Rokitansky is regarded as the founder of the modern autopsy. Rokitansky personally performed or supervised more than one hundred thousand autopsies and was also one of the world’s first pathologists. Under his leadership, all autopsies were carried out equally so that every part of the body in question could be studied exactly the same way.

The Decline of Autopsies

Even though autopsies help both medical doctors and criminal investigators gain invaluable information, their use is on the decline. Since the 1950s, the number of procedures performed has decreased as the public has become resistant to the idea of autopsies. Pathologists are also overworked on other lab jobs such as biopsies, and interest has fallen in autopsy-based research.

Magnetic resonance imaging (MRI) also plays a part in the decline of autopsies: Because they are noninvasive, people are more comfortable in accepting MRI autopsies, and sometimes MRIs do find things that traditional autopsies miss. Also, full-body autopsies are slowly being removed from medical university curricula because many students and teachers feel the time is better used to study other topics.

Bibliography

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Blanche, Tony, and Brad Schreiber. Death in Paradise: An Illustrated History of the Los Angeles County Department of Coroner. New York: Four Walls Eight Windows, 2001. Print.

Burton, Julian L., and Guy N. Rutty. The Hospital Autopsy. New York: Oxford UP, 2001. Print.

Connolly, Andrew J., et al. Autopsy Pathology: A Manual and Atlas. Philadelphia: Elsevier, 2016. Print.

Dewan, Shaila. "Failed Autopsies, False Arrests: A Risk of Bias in Death Examinations, The New York Times, 23 July 2023, www.nytimes.com/2022/06/20/us/medical-examiners-autopsy-racism.html. Accessed 20 June 2024.

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