Autopsy

Autopsy
Name	Autopsy
Caption	A modern autopsy room.
ICD9	89.8
MeshID	D001344

Autopsy. Also known as a post-mortem examination, it is a specialized surgical procedure performed to determine the cause, mode, and manner of a person's death. Conducted by a specialized physician called a pathologist, it involves a thorough external and internal examination of the human body. The findings are critical for medical jurisprudence, advancing medical science, and providing closure in cases of unexplained death.

Definition and purpose

The primary purpose is to ascertain the precise cause of death, which can resolve medical, legal, or public health questions. In hospital settings, it serves an audit function, evaluating the accuracy of clinical diagnosis and the effectiveness of treatments. For forensic science, it is indispensable in investigations of homicide, suicide, accident, or undetermined death. The procedure can also identify hereditary diseases, contributing to family health knowledge, and plays a vital role in epidemiology, such as tracking novel diseases like COVID-19.

Types of autopsy

The two principal categories are the forensic or medicolegal autopsy and the clinical or academic autopsy. A forensic autopsy is performed under legal authority, as dictated by statutes like the Coroners and Justice Act 2009 in the United Kingdom, often in cases of suspicious death. The clinical autopsy requires consent from the next of kin and aims for educational or research purposes within a hospital setting. More specialized forms include the psychological autopsy, used to reconstruct a decedent's mental state, and the minimally invasive autopsy, which may utilize medical imaging technologies like computed tomography.

Procedure

The standard procedure begins with a detailed external examination, documenting identifiers, wounds, and medical implants. The internal examination, or evisceration, follows the Y-shaped incision from shoulders to pubic symphysis. Organ systems are removed, examined, and dissected, with tissue samples preserved for histopathology. Toxicology tests on blood and vitreous humour are routine in forensic cases. Specialized techniques, such as the Virchow method or the Rokitansky method, may be employed. The final report synthesizes all findings for the coroner, prosecutor, or attending physician.

History

The practice has ancient roots, with early descriptions found in the Egyptian Edwin Smith Papyrus. Systematic study began in Hellenistic period Alexandria with figures like Herophilus and Erasistratus. During the Renaissance, anatomists such as Andreas Vesalius advanced knowledge through dissection, depicted in works like Rembrandt's *The Anatomy Lesson of Dr. Nicolaes Tulp*. The 19th century saw its formalization in medical education, influenced by Rudolf Virchow's cellular pathology. The establishment of the Office of the Chief Medical Examiner in New York City under Charles Norris marked a pivotal moment for modern forensic pathology.

Legal and ethical considerations

Legal authority derives from entities like the coroner or medical examiner, with procedures governed by laws such as the Human Tissue Act 2004 in the UK. Ethical issues center on informed consent, particularly for clinical autopsies, and respect for religious beliefs; for example, Judaism and Islam generally oppose the procedure. Controversies arise in high-profile cases, like the examination of President John F. Kennedy, or in mass fatality incidents managed by organizations like the International Committee of the Red Cross. The handling of DNA samples and tissue retention, as highlighted by the Alder Hey organs scandal, remains a sensitive area.

In popular culture

It is a frequent plot device in television series such as *Quincy, M.E.*, *CSI: Crime Scene Investigation*, and *Silent Witness*. The procedure is central to films like *The Autopsy of Jane Doe* and forms the backdrop for literary works by authors like Patricia Cornwell featuring Kay Scarpetta. Documentaries, including those on Netflix and from the BBC, often demystify the process, while its imagery influences genres from horror films to true crime podcasts.

Category:Medical procedures Category:Forensic pathology Category:Death customs