Autopsy: How understanding death helps the living
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Helping the living understand death
The death of a loved one is one of the most devastating events in a person's life. Whether death is expected because of disease or illness or happens suddenly, the bereaved are often left with unanswered questions about the exact cause of death. Shock and grief may cloud the decision as to whether to request an autopsy. Factors such as cost, pending funeral arrangements, religious beliefs, perceived social stigma and misunderstanding may stand in the way of a family member's willingness to request an autopsy.
Advances in medical technology, sophisticated imaging techniques and new laboratory methods have led to the perception by many that autopsies are not as necessary as they once were. Yet, as genetics play a deeper role in a wide range of medical conditions, autopsies may provide valuable information about medical conditions, allowing surviving family members to make necessary lifestyle changes and get critical medical tests to increase the quality of and prolong their lives.
What is an autopsy?
The word autopsy literally means "to look for oneself." An autopsy involves a complete medical examination of the body, both external and internal. Performed by a pathologist - a physician specially trained in the procedure who is able to recognize the effects of disease on the body - the initial procedure generally takes four hours to complete. Synthesizing data from microscopic examination (small biopsies of tissue taken during examination) and specialized consultations result in a final report.
This report is usually issued within a month of the procedure, which allows the pathologist time to review medical records, discuss the decedent's clinical course with clinical physicians, study tissue sections and perform additional studies as needed. In rare instances, the report may be finalized after two months. The report is made available to the deceased's attending physician, and if desired, to the legal next-of-kin.
An autopsy can answer specific questions about illness, the cause of death and whether other co-existing conditions may have contributed to the person's death. The autopsy can also provide specific information on inherited diseases that may be useful to family members.
How an autopsy is performed
The autopsy room is regarded as an important place for gathering medical knowledge. The body is treated with respect and dignity. The family's wishes are observed at all times.
An autopsy begins with the pathologist gathering as much information as possible about the person who died and the events leading to death. This includes reviewing medical records and consulting with the deceased person's physicians about previous medical problems. Information may also be gathered from family members.
A surgical incision opens the body cavity to allow examination of organs and tissues. Small samples of each organ are taken for microscopic examination to look for malignancies, infections or other disorders. Other tests may be performed to study genes and check for drugs, chemicals or other toxic substances.
Once the autopsy is completed, the incisions are closed. The body is then prepared for family viewing, should that be the family's wish. An autopsy does not disfigure the body and does not preclude viewing. Pathologists perform autopsies in a way that does not interfere with burial or cremation.
What are the benefits of an autopsy?
According to the College of American Pathologists, autopsies can help families in the following ways:
- Confirming a cause of death.
- Discovering inherited or familial diseases that may help in genetic planning as well as in the diagnosis and treatment of other family members.
- Providing evidence of occupational hazards or exposure.
- Providing information that can be used in settling insurance claims.
The community may also benefit from an autopsy in the following ways:
- Providing information about the causes and course of an illness and the effects of different types of treatment.
- Disclosing evidence of environmental hazards.
- Providing explanations for injuries and accidents.
When should an autopsy be performed?
Autopsies may be warranted in the case of:
- Deaths resulting from high-risk infections, contagious diseases, environmental or occupational hazards.
- Sudden, unexpected or suspicious deaths, including those that might involve foul play.
- Deaths due to homicide, suicide or accidental causes such as a car accident, fall, burn or drug overdose.
- Deaths resulting from the delayed effect of an injury.
- Deaths that occur in the workplace.
- Deaths in persons admitted unconscious to a hospital, or those occurring shortly after admission
to a hospital when the cause of death is unknown or uncertain.
- Death related to a medical procedure, occurring during or post-anesthesia or post-operatively.
- Deaths of persons in custody, confinement or who have been institutionalized.
- Deaths of persons to be cremated.
- Obstetric, prenatal and pediatric deaths.
- Any death in which it is believed that an autopsy would disclose a known or suspected illness that may affect family members or organ transplant recipients.
Other facts about autopsies
For patients who die in a hospital, autopsies are generally performed at the hospital's expense; however, when death occurs elsewhere, the expense must often be incurred by the family. Private autopsy is not covered by insurance or Medicare at this time.