Taking Steps Before Performing an Autopsy
Understand what an autopsy is. An autopsy is a detailed examination (and dissection) of a human body after death. It is used to determine the likely time and cause of death, as well as to evaluate the presence of disease and/or injuries. An autopsy is conducted by a pathologist, which is a doctor with specialty level training in how to do the procedure and how to effectively analyze the tissues and body fluids. If the person's death is being investigated forensically, an autopsy may be legally mandated. Similarly, if the person's death occurs during a medical clinical trial, an autopsy will likely be required to provide the study with information on the cause of death. Otherwise, it is the family's choice whether or not they would like an autopsy for their loved one. Common reasons to get an autopsy include uncertainty around what caused the person's death, the worry of a genetic condition that may affect other family members, or a desire to advance medical knowledge.
Obtain permission. Normally permission for an autopsy is given by the deceased person's family. However, if there are legal or forensic concerns surrounding the cause of death, an autopsy may be mandated by the courts or by a coroner. Obtaining permission is a serious issue, and most often requires a consent form signed in the presence of a witness.
Gather the appropriate data before commencing the autopsy. There are many factors that can play into a person's death, and it is important to have their full medical history, as well as a full history surrounding the events preceding their death in order to make your investigation and the dissection of the body as helpful as possible. The police may play a role in investigating the "crime scene," if there is one, and further look into evidence that could support a potential cause of death. Depending upon the suspected cause of death, an autopsy may only need to be done on certain body parts, and not necessarily on the whole body. It varies depending upon the case. For instance, in someone who died of lung disease, an examination of the lungs alone may be sufficient to confirm the cause of death.
Performing the Autopsy
Begin with an examination of the outside of the body. First, note the height, weight, age, and sex of the body. Note any distinguishing characteristics like birthmarks, scars, or tattoos as well. You should also take fingerprints at this point, as they may be needed in police investigations. Check the clothing and skin for any marks that look out of the ordinary. Note any droplets of blood, organic materials, and any residues found on clothing. Also make note of any bruises, wounds, or marks on the skin. Photographs may be helpful as well, to document the appearance of the body and any significant findings or unusual things you notice amidst your investigation. Take photographs both with clothes on, as well as nude. Either document your findings with pen and paper notes, or through a dictation device that records what you say and is later typed up by a medical transcriptionist.
Perform an X-ray. An X-ray will help you to find any broken or fractured bones, or medical devices, such as a pace-maker. These records can also be used to identify the subject. Check for any dental work. Dental records are often used to identify bodies.
Check the genital area for any signs of rape. Bruising and tearing are common in such cases.
Take a blood sample. It can be used for DNA purposes, or it can help to determine if the victim was on drugs, had been using alcohol, or whether there was poisoning involved. A urine sample should also be taken from the bladder using a syringe. Just like blood, the urine can be used in tests to detect drugs or poisons.
Open the body cavity once the initial examinations are complete. Using a scalpel, make one large "Y" shaped incision from each shoulder across the chest, then down to the pubic bone. Spread open the skin and check to see if any ribs are broken. Split the ribcage using rib shears, open it up, and examine the lungs and heart. Note any abnormalities, then take a second blood sample directly from the heart.
Examine each organ in the chest cavity individually. Weigh each organ, record anything notable, and take a tissue sample in case further examination is needed. You can also sub-dissect many of the major organs by opening them up and examining them to look for disease. Next, repeat the same process for the organs in the lower body, like the spleen and intestines, as sometimes partially digested food is used to determine the time of death.
Observe the eyes carefully. The presence of a petechial rash (tiny, broken blood vessels) can be a sign of choking or strangulation.
Look at the head. Check for any trauma to the skull, including fractures or bruises. Then remove the top of the skull, and remove the brain. Follow the same procedure as with all other organs. Weigh it, and take a sample.
Finish your notes or your dictated recording after the autopsy is complete. State the cause of death, and the reasons that brought you to that conclusion. Mention any details, no matter how small, as they may be the final clues needed to stop a murderer or to put a family member's mind at ease. Based on your findings (assuming you're a licensed pathologist), the Chief Medical Examiner will issue a Death Certificate. The body will then be returned to surviving family members for funeral arrangements.
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