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Find out about what happens during an autopsy, the history of autopsies and your rights as the next-of-kin for a deceased person.
What is an autopsy?
An autopsy, also called a post-mortem examination, is a detailed and careful medical examination of a person's body and its organs after death to help establish the cause of death. The word autopsy is derived from a Greek word autopsia meaning 'seeing for oneself'. A physician, called a pathologist, who specialises in the study of human diseases, performs the autopsy. Surgical techniques are used to remove and examine each organ, and some tissue samples are selected for microscopic examination or other special tests as required. (A small tissue sample is typically about 0.5cm thick).
An autopsy is usually carried out within 48 hours after the death of a person. An autopsy can be hospital-based (non-coronial) or coronial. Coronial autopsies are ordered by the state coroner, whereas hospital based autopsies may be performed at the request of the family of the deceased.
There are three levels of autopsy
- Complete - in which all body cavities are examined (including the head )
- Limited - which may exclude the head
- Selective- where specific organs only are examined.
Autopsies will usually include testing for any infections (microbiology), changes in body tissue and organs (anatomical histology), and chemicals, eg medication, drugs or poisons (toxicology and pharmacology).
In certain circumstances an autopsy might not be carried out if the coroner and a forensic pathologist can decide the cause of death from medical history and a police report.
History of the autopsy
Mortui vivos docent - the dead teach the living
A disease which is new and obscure to you, Doctor, will be known only after death; and even then not without an autopsy will you examine it with exacting pains. Boerhaave Hermann: Atrocis, nec Descripti Prius. Morbi historia. Translated in Bull Med Lib Assoc. 1955; 43:217
Autopsies are a source of valuable medical information that can improve health care for the living. There are very many diseases and conditions that have been discovered or greatly helped by the use of autopsies.
Greek physicians performed autopsies 2,500 years ago, but it wasn't until 1769 that the first comprehensive pathology text was written. The Italian physician Giovanni Batista Morgagni published his book: The seats and causes of diseases investigated by anatomy.
Dissection of the dead human body has been central to medical education since the Renaissance. Anatomists of the past went to great lengths to obtain cadavers for student use.
Can you object to an autopsy?
From the moment a death is reported the coroner is in charge of the body until it is released for the funeral. The coroner is responsible for finding the specific cause of death. It is their decision as to whether an autopsy or post-mortem is needed. The deceased's next of kin can make a formal objection to an autopsy. The state coroner will seriously consider any objections. Objections can be made on religious, cultural or personal grounds.
Hospital autopsies are different from coronial autopsies. A hospital autopsy is not performed without first seeking permission of the next of kin. Families have the right to say no and hospital staff will always have to respect the families wishes. A family may request a doctor to arrange for a hospital autopsy to help determine why the person died.
How to make an objection
- Ring the coroner's office as soon as possible after the death and let them know that you will be making an objection - an autopsy is usually carried out within 48 hours after the reportable death
- Then put your objection in writing to the coroner
- If the coroner still decides that an autopsy needs to be carried out you can apply to the Supreme Court for an order preventing it (this needs to be done within 48 hours of being notified that your object has been refused)
What further information can I get?
Once the state coroner has received the report outlining the cause of death, the next of kin should be formally notified of the official cause of death, as well as the status of any investigation that might be undertaken for the coroner. The next of kin is entitled to request a copy of the post-mortem report through your nominated local doctor, who can then help you to interpret its contents.
Are organs and tissues retained?
Some body tissue and organs require specialised examination. In many cases small samples of tissue will be taken for further analysis. It may also be necessary to retain entire organs for a more detailed examination. This is strictly limited to cases where such retention is necessary to determine or confirm the cause of death.
Retained organs may be returned for burial or cremation at a later date when the tests are complete, if the next of kin so desire. Alternatively, the state coroner can dispose of the organs in a dignified manner.