Autopsy

What is an autopsy?

An autopsy is a medical examination of a body after death to find out why — and, sometimes, how — the person died. A pathologist examines the person’s external body and internal organs, and then writes a report to give to healthcare providers.

Types of autopsies

There are two main types of autopsies: forensic and clinical.

• Forensic autopsies: Forensic pathologists perform forensic autopsies when the death is suspicious, sudden or possibly involves a crime. It happens as part of legal or criminal investigations. It can also happen when the death is associated with medical procedures or surgery. Law enforcement, coroners or judges order this type of autopsy.
• Medical autopsies: A hospital pathologist performs a clinical medical autopsy to understand the cause of a natural death due to illness or medical conditions. A natural death happens due to an internal factor that causes your body to shut down. There’s no injury or trauma involved. Examples include cancer, a heart attack and an infectious disease. The deceased person’s next of kin (family members) or a healthcare provider typically requests this type of autopsy.

Ideally, autopsies happen as soon as possible. After about 24 hours, organs and body tissues start to deteriorate, which makes it more difficult to perform certain tests. Forensic pathologists can still do autopsies on decomposed or exhumed (removed from the ground) bodies.

Who performs an autopsy?

A pathologist performs autopsies. Pathology is the branch of medicine that involves the examination of body tissues. You may also hear that a medical examiner performs autopsies. A “medical examiner” is usually a forensic pathologist who works for the government.

What is done during an autopsy?

The process of an autopsy can vary depending on the reason for it. Forensic autopsies are often very thorough, examining every part of the body. They also typically include crime scene investigation and toxicology — detection of poisons, drugs and chemicals in the body.

Medical autopsies may only investigate certain parts of the body. They typically don’t do toxicology as part of the autopsies.

In general, the steps of an autopsy may include:

1. The pathologist lays the body out carefully on an examination table in a lab.
2. They thoroughly look at the outside of the body. They take notes of anything that looks unusual or may be related to the death.
3. They may take or request photographs and/or X-rays of the body.
4. The pathologist uses a scalpel to cut the body from the collarbone to the lower abdomen to examine the inside of the body. They may remove all or specific internal tissues and organs.
5. They take small tissue samples from organs to look at under a microscope.
6. The pathologist may cut through the scalp and skull to examine the brain.
7. They may request various tests on body fluid, tissue and organ samples. They’ll also collect and test any “unnatural” materials in or on the body (like debris or bullets) in forensic autopsies.
8. After a forensic autopsy, the pathologist places the organs back inside the body, except for the brain, and stitches the skin closed again. After medical autopsies, the pathologist doesn’t place the organs back in the body.

Once they’ve completed all their examinations and tests, they will provide an autopsy report, which will contain all the information they found.

The goal of all autopsies is to find or confirm how someone died. But forensic autopsies have additional goals or objectives, including:

• Establishing the identity of the deceased person if it’s unknown. Fingerprints and/or DNA testing may help with this.
• Assisting in confirming the manner of death (like homicide or accident) based on medical evidence.
• Estimating the time of death.

How long does an autopsy take?

It usually takes a pathologist two to four hours to examine a body during an autopsy. They may be able to release early preliminary results within two to three days of the autopsy. But the full results of a medical autopsy typically take six weeks to prepare. Forensic autopsies usually take longer to complete.

What are the risks and benefits?

Autopsies are important for determining the truth about someone’s death. Autopsy findings can provide closure to the families. Forensic autopsies are especially helpful when investigators are suspicious of a crime. They can also help improve healthcare and protect public health.

Potential benefits of autopsies include:

• Preventing more deaths: In the past, forensic pathologists have identified public health emergencies, like the anthrax terrorist attacks. Forensic autopsies have led to the discovery of other public health hazards, like defective cribs or car seats that contributed to infant deaths.
• Improving medical care: Information from clinical autopsies can improve healthcare providers’ understanding of diseases and how they affect our bodies. It can improve future medical care and treatment for others with a similar cause of death.
• Discovering genetic conditions: In some cases, autopsies reveal that a deceased person died from an undiagnosed genetic condition. This can help biological family members learn more about their risk of having the condition.
• Providing legal evidence: Forensic autopsies often help with the prosecution of criminal cases like homicides. But there are other ways they can provide legal evidence, which may have grounds for a lawsuit.

There are minimal risks to autopsies, but possible risks include:

• Emotional distress: Families and friends may feel upset about the process, especially if they have cultural or religious beliefs about autopsies. Some may feel uncomfortable with the thought of their loved one getting examined.
• Damage to the body: There could be minor damage to the body after an autopsy. This could have an impact on funeral arrangements.
• Delay in funeral or burial: An autopsy could delay services for the deceased person, which can prolong grieving and add additional distress to loved ones.

What’s in an autopsy report?

A forensic autopsy report includes details about everything they found during the examination and testing. It typically states the cause of death and the manner of death. The forensic pathologist lists the manner of death as one of five categories:

• Accident
• Natural causes
• Homicide
• Suicide
• Undetermined

While pathologists have extensive knowledge and training, it’s important to remember that they’re human just like the rest of us. They may make mistakes or be unable to determine what happened. In these cases, family members or legal authorities may request a second autopsy of the body by a different pathologist.