Autopsy

What is an autopsy?

An autopsy is a medical examination of a body after death to find the cause — and sometimes manner — of death. A pathologist trained to perform autopsies thoroughly examines the inside and outside of the body.

The word “autopsy” comes from the Greek word “autopsia,” which means “to see for oneself.” People sometimes call an autopsy a post-mortem, especially in the U.K. “Post-” means “after,” and “mortem” means “death.”

When is an autopsy performed?

There are two main types of autopsies based on the reason for them: forensic autopsies and clinical autopsies.

Forensic autopsy

Forensic pathologists perform forensic autopsies (medicolegal autopsies) as a part of legal investigations. “Forensic” means “related to scientific methods of solving crimes.”

States in the U.S. and countries across the world each have specific legal criteria for when a death requires a forensic autopsy. But in general, this type of autopsy is typically necessary when a death is:

• Unnatural (homicide, suicide or accident).
• Sudden or unexpected (especially in an infant or child).
• Suspicious.
• Unknown.
• Violent.
• Unwitnessed.
• Due to an acute (sudden and severe) workplace injury.
• Related to industrial hazards (like fires and toxic waste).
• Associated with medical or surgical treatment in which there’s alleged medical negligence.
• Associated with anesthesia (such as from a surgery or procedure).

The legal authority that requires or directs a forensic autopsy varies across the world. Examples include the:

• Coroner or medical examiner.
• Magistrate.
• Police.
• Procurator fiscal.

Clinical autopsy

A hospital pathologist sometimes performs a clinical autopsy (pathological or hospital-based autopsy) in cases of natural death to find and/or better understand the cause of death. A natural death happens due to an internal factor that causes your body to shut down. Examples include cancer, a heart attack and an infectious disease. It means there was no external reason for the death, such as a fatal injury or drowning.

The deceased person’s next of kin (family members) may ask for this type of autopsy. Or a healthcare provider may ask the next of kin for their consent to do a clinical autopsy.

How long after death can an autopsy be done?

Pathologists can do autopsies on bodies any time after death. However, the sooner, the better. After 24 hours, organs and other body tissues start to deteriorate, which makes it more difficult to perform certain tests and assess their accuracy.

Forensic pathologists can still do autopsies on decomposed or exhumed (removed from burial in the ground) bodies. But the detail and extent of information (and/or evidence) they can gather may be limited.

Who performs an autopsy?

A specialist called a pathologist performs autopsies. Pathology is the branch of medicine that involves the laboratory examination of samples of body tissues for diagnostic or forensic purposes.

Pathologists who perform autopsies are medical doctors. They have expansive knowledge and specific training on the human body. It usually takes about 11 to 13 years to become a pathologist.

You may hear or read that a medical examiner performs autopsies. The title of “medical examiner” is usually the job title of a forensic pathologist who works for a 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 — the branch of science that explores the nature, effects and detection of poisons.

Clinical 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.
2. The pathologist thoroughly looks 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 in a laboratory, like chemical or toxicological analyses. 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. In clinical autopsies, the pathologist doesn’t place the organs back in the body. Pathologists aim to restore the body to the best possible cosmetic condition.

The pathologist may need to keep some organs for further examination or retain organs as permitted on the consent form. Once they’ve completed all their examinations and tests, the pathologist will provide a detailed report.

Forensic autopsy objectives

The goal of all autopsies is to find the cause of death. But forensic autopsies have additional goals or objectives, including:

• Establishing the identity of the deceased person if unknown. Fingerprint and/or DNA testing may help with this.
• Assisting in confirming or refuting the alleged manner of death (like homicide or accident) based on medical evidence.
• Estimating the time since 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 preliminary (early) results within two to three days of the autopsy. But the full results of an autopsy typically take six weeks — or longer — to prepare.

Certain factors can extend the length of the results, like:

• If it’s a forensic or clinical autopsy.
• The complexity of the death and/or evidence.
• If the pathologist needs the results of other tests, like blood or DNA tests.
• How many autopsies the pathologist has at a given time and how many pathologists are available in the area.

What’s in an autopsy report?

An autopsy report includes details of all the observations, examinations and tests of the body.

It typically states the cause of death and the general manner of death. Based on scientific and medical evidence, the pathologist lists the manner of death as one of five categories:

• Accident.
• Natural causes.
• Homicide.
• Suicide.
• Undetermined.

In some cases, a pathologist can’t find the cause of death despite a thorough autopsy. This is called a negative or obscure autopsy. Advanced laboratory techniques that become available in the future may help eventually determine the cause of death.

What does an autopsy report mean?

An autopsy report contains scientific observations and test results of a deceased person’s body and anything on their body. A forensic autopsy alone can’t confirm how a person died. The Court of Law in most countries has the final say on this matter. Detectives and other legal representatives use the information in forensic autopsies, along with other evidence that they’ve gathered, to infer how a death unfolded.

While pathologists have extensive knowledge and training, it’s important to remember that they’re human just like the rest of us. Like everyone else, they may make mistakes. Or they may not be able to uncover the exact cause of death. In some of these cases, family members or legal authorities may request a second autopsy of the body by a different pathologist.

What are the benefits of an autopsy?

Potential benefits of autopsies include:

• Expanding medical knowledge: Clinical autopsies can enhance healthcare providers’ understanding of diseases and how they affect our bodies. This contributes critical medical knowledge that can inform future medical care.
• 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.
• Discovering genetic conditions: In some cases, autopsies reveal that a deceased person died from an undiagnosed or misdiagnosed genetic (hereditary) condition. This can help biological family members learn more about their risk of having the condition.
• Providing legal evidence: Autopsies often help with the prosecution of criminal cases like homicides. But there are other ways they can provide legal evidence, like in cases of workplace deaths, environmental hazards or medical malpractice. These causes of death may have grounds for a lawsuit.
• Solving uncertainties: When clinical autopsies provide answers as to the cause of death, they often provide closure or solace for family members and loved ones by confirming that the diagnosis and treatment they received were appropriate. Having answers instead of uncertainties may help you grieve and cope with the death of your loved one.

What is the cost of an autopsy?

There’s no charge for most clinical autopsies that pathologists perform at a hospital. Autopsies that fall under the jurisdiction of the medical examiner or coroner are also provided at no cost. There may be a charge for transporting a body to and from a hospital facility. In addition, you may have to pay for genetic testing of inherited conditions.