Lois & Clark Forums Forums Fan Fiction Fanfic Related FFQ: Accidents and Post Mortems

When Is an Autopsy Required?

An autopsy is not performed as a part of every death investigation. In most cases, the determination of the need to perform an autopsy is a discretionary responsibility of the coroner or medical examiner. The issuance of a death certificate does not require an autopsy and only a death certificate is needed to qualify for most insurance and death benefit programs. The coroner or medical examiner may determine that no autopsy is required in any situation where there is sufficient evidence to make conclusive determinations on the cause and manner of death. An autopsy is not always necessary in a coroner/medical examiner’s case. Each case is evaluated independently to determine the cause and manner of death. If the coroner/medical examiner is unable to determine the cause and manner of death, the law may require an autopsy to establish the cause and manner of death. In this case, the family’s permission is not needed. If an autopsy is not ordered, the family always has the right to have one done at their own expense. For coroner-ordered autopsies, taxpayers pay for those services: these expenses are included in the coroner/medical examiners's annual budget.

Many coroners and medical examiners have limited the number of autopsies performed because of cost and time constraints. Fiscal pressures have increased as the number of death investigation cases has increased, particularly those involving violent deaths. The cases in which an autopsy is most likely to be omitted include those where there is a known and undisputed cause of death without suspicion of criminal activity.

Medical examiners or coroners investigate about 20% of deaths in the United States, although the percentage varies from state to state. Although these guidelines for which deaths to investigate also vary from jurisdiction to jurisdiction, most jurisdictions require that these deaths be investigated:

* Deaths due to homicide, suicide, or accidental causes such as motor vehicle crashes, falls, burns, or the ingestion of drugs or other chemical agents.
* Sudden or suspicious deaths, deaths from sudden infant death syndrome (SIDS), and unattended deaths.
* Deaths caused by an agent or disease constituting a threat to public health.
* Deaths that occur in the workplace.
* Deaths of people who were in custody or confinement.
* Deaths of other people institutionalized for reasons other than organic disease.
* Deaths of people to be cremated.
* Unusual death or suspicion of injury, foul play, or violence
* Sudden, unexpected, unexplained death
* Admitted unconscious, or death within 24 hours after admission, to a hospital.
* Delayed effect of injury, e.g., pulmonary embolism after hip fracture, post-traumatic seizure
* Anesthesia, postanesthesia, postoperative.
* Death related to medical procedure
* Infant or fetal death due to any of above, or possible maternal drug abuse or unlawful abortion. Also, apparent stillbirth/infant death occurring outside of hospital.

The thoroughness of death investigations (and as a result the completeness of death investigation records) also varies from case to case. An autopsy is not always required--sometimes a postmortem examination may consist of only an external examination of the body or review of pertinent medical information. The record of a complete death investigation, however, would include the following:

* The initial report of the death made to the ME/C office (e.g., by a family member, police officer, or attending physician).
* A determination of circumstances surrounding the death. Findings of a scene investigation.
* Findings of a postmortem exam or autopsy.
* Results of laboratory tests to determine the presence of drugs, toxins, or infectious agents.
* Certification of the cause and manner of death.

That said, I still like to know what's happening in the background of my stories even if I'm not writing specifically about it (am I the only one who's weird like that?)