When to Autopsy: Idealistic and Realistic Considerations

Abstract

The decision to perform an autopsy depends on many things, but at the least, it rests with local statutory responsibility and the competent forensic pathologist's perceived needs of the specific case. Although cause and manner of death are at the heart of the mission of the forensic pathologist, there are other obligations that should be considered, such as: questions that could arise later, as well as the impact of an incorrect opinion on the affected family and society. Standards have been developed by the National Association of Medical Examiners (NAME) which state when an autopsy should be performed. The autopsy has value in nearly all cases; however, the indiscriminate use of the autopsy does not supersede the detailed gathering of pertinent investigative history. It cannot be performed in a vacuum. Idealistic virtues of the autopsy, even if based on experiential merit, must still meet the hard realism of budgets and staffing when it comes to categorical case selections for autopsy. Resources must be allocated rationally. The purpose of this discussion/review is to review considerations about whether or not to perform an autopsy, from an idealistic, and from a realistic viewpoint. The intent is not to promulgate dogma or zealous overindulgence in testing which could overburden death investigative systems that already have critical limitations in budget and staffing. The conscientious role of the physician pathologist is emphasized.