There may be no more need to open up bodies of deceased persons to determine the cause of death, thanks to a major research breakthrough made by pathologists and radiologists at Leicester University, UK. The findings were published in Lancet in a research led by Prof Guy Rutty.
Professor Rutty explained: “Over the years there have been several attempts to develop alternative approaches to the invasive autopsy to limit the extent to which the cadaver is dissected. Although these techniques have been published, the invasive examination remains the standard adopted approach.”
A previous study of Post Morterm Computed Tomography (PMCT) published in the Lancet in 2012 showed promise for using medical imaging to investigate the cause of natural death, but with a major weakness: the inability to diagnose coronary artery disease, the most common cause of natural death.
“Here at the University of Leicester we developed a quick and minimally invasive approach to improve diagnostic accuracy.
Instead of dissecting the cadaver, they inserted a catheter, similar to that used to perform routine tests on patients.”
The result? Cause of death could be determined in 9 out of 10 cases.
Professor Morgan added: “We have shown that a significant number of deaths could be investigated without the need for an invasive autopsy.”
The novel method was found to be superior at identifying trauma and haemorrhage, whereas autopsy was superior at identifying pulmonary thromboembolism. Both tests had different strengths and weaknesses in heart and lung disease.
In conclusion, Professor Rutty cautioned: “Both autopsy and PMCTA have different strengths and weaknesses as investigative approaches. When a higher burden of proof is required the ‘gold standard’ of death investigation should include both PMCT and invasive autopsy.” Read more at Science daily.
Frequently asked questions about Autopsy
What is an autopsy?
This is a very thorough medical evaluation of a body after death to learn about the how and why a person died. It is done by a specially trained doctor called the pathologist. While the ultimate aim of an autopsy is to determine the cause of death it also helps improve the quality of care for future patients. Autopsies help to determine the cause of death, the manner of death (which is required in potentially criminal cases) as well as the identity of the deceased, time of death etc.
When is an autopsy necessary?
Family members may request for an autopsy if:
- Their relative dies of an unknown illness
- They suspect medical negligence
- Their relative dies suddenly and unexpectedly
- There are recurrent deaths in the family (possibly inherited genetic disease)
An autopsy is required by law if:
- Death is sudden and unexpected
- Death is due to any form of accidents or drug ingestion
- The circumstances of death are suspicious
- A patient is brought in dead to the hospital or death occurs within 24 hours of admission
- Death is suspected to be due to homicide or suicide
How long does it take?
Usually two to four hours. During this period, the pathologist examines and obtains tissue samples for further investigations. The pathologist also tests the urine, blood and other bodily fluids if needed. While an initial report may be available in 24 hours, it may take 2 to 3 months for a final report to be released.
Will an autopsy significantly disfigure the body?
No. Most incisions are easily concealed by clothing, which minimally interferes with burial process. After examination, all organs are returned to the body which is then sewn up in preparation for any funeral rites. Cultural and religious views are given due consideration.
Can I request for an autopsy if my relative dies outside the hospital?
Is an autopsy possible after embalmment or burial?
Yes. However, timeliness is critical. A delay may significantly interfere with toxicology and other studies which may affect the outcome of the procedure.
Who pays for the autopsy?
The family or state depending on who initiates the request
Can the pathologist perform an autopsy without my consent?
Yes, if it is based on the coroner’s request.
Although, relatives and clinicians are reluctant to have autopsies done, it is important to know that it is the bedrock of advances in the care of patients.
According to Giovanni Battista Morgagni:
‘’Physicians who have done or seen many autopsies have learned at least to mistrust their diagnosis; the others who don’t confront themselves with the often discouraging findings of autopsies, live in the clouds of a vain illusion,’’
Reviewed By Dr Donatus Sabageh FMCPath (Consultant Histopathologist)