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Definition

An autopsy is a postmortem assessment or examination of a body to determine the cause of death. An autopsy is performed by a physician trained in pathology.

Purpose

Most autopsies advance medical knowledge and provide evidence for legal action. Medically, autopsies determine the exact cause and circumstances of death, discover the pathway of a disease, and provide valuable information to be used in the care of the living. When foul play is suspected, a government coroner or medical examiner performs autopsies for legal use. This branch of medical study is called forensic medicine. Forensic specialists investigate deaths resulting from violence or occurring under suspicious circumstances.

Benefits of research from autopsies include the production of new medical information on diseases such as toxic shock syndrome, acquired immunodeficiency syndrome (AIDS). Organ donation, which can potentially save the lives of other patients, is also another benefit of autopsies.

Precautions

When performed for medical reasons, autopsies require formal permission from family members or the legal guardian. (Autopsies required for legal reasons when foul play is suspected do not need the consent of next of kin.) During the autopsy, very concise notes and documentation must be made for both medical and legal reasons. Some religious groups prohibit autopsies.

Description

An autopsy can be described as the examination of a deceased human body with a detailed exam of the person's remains. This procedure dates back to the Roman era when few human dissections were performed; autopsies were utilized, however, to determine the cause of death in criminal cases. At the beginning of the procedure the exterior body is examined and then the internal organs are removed and studied. Some pathologists argue that more autopsies are performed than necessary. However, recent studies show that autopsies can detect major findings about a person's condition that were not suspected when the person was alive. And the growing awareness of the influence of genetic factors in disease has also emphasized the importance of autopsies.

Despite the usefulness of autopsies, fewer autopsies have been performed in the United States during the past 10-20 years. A possible reason for this decline is concern about malpractice suits on the part of the treating physician. Other possible reasons are that hospitals are performing fewer autopsies because of the expense or because modern technology, such as CT scans and magnetic resonance imaging, can often provide sufficient diagnostic information. Nonetheless, federal regulators and pathology groups have begun to establish new guidelines designed to increase the number and quality of autopsies being performed.

Many experts are concerned that if the number of autopsies increases, hospitals may be forced to charge families a fee for the procedure as autopies are not normally covered by insurance companies or Medicare. Yet, according to several pathologists, the benefit of the procedure for families and doctors does justify the cost. In medical autopsies, physicians remain cautious to examine only as much of the body as permitted according to the wishes of the family. It is important to note that autopsies can also provide peace of mind for the bereaved family in certain situations.

Preparation

If a medical autopsy is being performed, written permission is secured from the family of the deceased

Aftercare

Once the autopsy has been completed, the body is prepared for final arrangements according to the family's wishes

Risks

There are some risks of disease transmission from the deceased. In fact, some physicans may refuse to do autopsies on specific patients because of a fear of contracting diseases such as AIDS, hepatitis, or Creutzfeld-Jakob disease.

Normal results

In most situations the cause of death is determined from the procedure of an autopsy without any transmission of disease.

Abnormal results

Abnormal results would include inconclusive results from the autopsy and transmission of infectious disease during the autopsy.

Key Terms

Acquired immunodeficiency syndrome (AIDS)

A group of diseases resulting from infection with the human immunodeficiency virus (HIV). A person infected with HIV gradually loses immune function, becoming less able to resist aliments and cancers, resulting in eventual death.

 

Computed tomography scan (CT scan)

The technique used in diagnostic studies of internal bodily structures in the detection of tumors or brain aneurysms. This diagnostic test consists of a computer analysis of a series of cross-sectional scans made along a single axis of a bodily structure or tissue that is used to construct a three-dimensional image of that structure

 

Creutzfeld-Jakob disease

A rare, often fatal disease of the brain, characterized by gradual dementia and loss of muscle control that occurs most often in middle age and is caused by a slow virus.

 

Hepatitis

Inflammation of the liver, caused by infectious or toxic agents and characterized by jaundice, fever, liver enlargement, and abdominal pain.

 

Magnetic resonance imaging (MRI)

A diagnostic tool that utilizes nuclear magnetic energy in the production of images of specific atoms and molecular structures in solids, especially human cells, tissues, and organs.

 

Postmortem

After death.

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