Autopsy

An autopsy is an examination of the body after death to determine the cause of death. An autopsy is performed by a physician trained in pathology.

Most autopsies advance medical knowledge and provide evidence for legal action. Medically, autopsies determine the exact cause and circumstances of death,discover the pathway of a disease, and provide valuable information to be used in the care of the living. When murder is suspected, a government coroneror medical examiner performs autopsies for legal use. This branch of medicalstudy is called forensic medicine. Forensic specialists investigate deaths resulting from violence or occurring under suspicious circumstances.

Benefits of research from autopsies include the production of new medical information to help understand and better treat diseases such as toxic shock syndrome and acquired immunodeficiency syndrome (AIDS). Organ donation, which saves the lives of other patients, is also another benefit of autopsies.

When performed for medical reasons, autopsies require formal permission fromfamily members or the legal guardian or the deceased. Autopsies required forlegal reasons when a crime is suspected do not need the consent of next of kin. During the autopsy, very concise notes and documentation are made for bothmedical and legal reasons. Some religious groups prohibit medical autopsies.

An autopsy involves the examination of a deceased's body with a detailed examination of the person's remains. This procedure dates back to the Roman era when few human dissections were performed. Autopsies were utilized, however, to determine the cause of death in criminal cases. At the beginning of the procedure the exterior body is examined, and any scratches, bruises, or penetrations of the skin are noted. Next the internal organs are removed and studied.Tests may be done on the blood to determine if a person was using alcohol, illicit drugs, or prescription medications at the time of death. If poisoningis suspected, additional tests are done. The stomach contents may be analyzedto determine what and when the patient last ate. Conditions such as pregnancy or the presence of diseased tissue are noted. In cases where the person hasdied by criminal action, the nature of the wounds and their exact location are recorded.

Some pathologists argue that more autopsies are performed than necessary. However, recent studies show that autopsies can detect major findings about a person's health condition that were not suspected when the person was alive. The growing awareness of the influence of genetic factors in disease has also emphasized the importance of autopsies.

Despite the usefulness of autopsies, fewer autopsies have been performed in the United States during the past 10-20 years. A possible reason for this decline is concern about malpractice suits on the part of the treating physician.Other possible reasons are that hospitals are performing fewer autopsies because of the expense or because modern technology, such as computed tomography (CT) scans and magnetic resonance imaging, can often provide sufficient diagnostic information. Nonetheless, federal regulators and pathology groups have begun to establish new guidelines designed to increase the number andquality of autopsies being performed.

Many experts are concerned that if the number of autopsies increases, hospitals may be forced to charge families a fee for the procedure, as autopsies arenot normally covered by insurance companies or Medicare. Yet, according to several pathologists, the benefit of the procedure for families and doctors justified the cost. In medical autopsies, physicians limit the examination to only as much of the body as permitted according to the wishes of the family. In some cases, the findings from autopsies can provide peace of mind for the bereaved family.

Once the autopsy has been completed, the body is prepared for final arrangements according to the family's wishes.

There are some risks to the pathologist of disease transmission from the deceased. Some physicians may refuse to do autopsies on specific patients becauseof a fear of contracting diseases such as AIDS, hepatitis, or Creutzfeld-Jakob disease. In most situations the cause of death can be determined from autopsy, although occasionally the results are inconclusive.

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