Autopsy: methods, findings, and clinical applications

Autopsy

The word autopsy originates in the Greek term 'autopsia', which means "to observe from a first person perspective." An autopsy is a post-mortem examination process involving a surgeon investigating a corpse with the purpose of determining the cause of death. Surgeons in charge of autopsies are typically specialized doctors that are experienced in pathology. An autopsy typically entails a complete physical examination of the deceased person and can extend to examining internal organs. In situations when people die in hospitals physicians ask for the family's permission to perform an autopsy. Such a procedure can also be performed as a result of the family's request for the physician to do so.

Although it has been customary for some cultures to perform the removal and observation of organs consequent to a person's death, it has not been until recent centuries that physicians actually realized the importance of analyzing a deceased person's organs with the purpose of understanding the cause of death to a greater degree. Autopsies were performed on humans for thousands of years, with the Ancient Egyptians having discovered methods they could use with the purpose of determining the reason behind someone's death. "Furthermore, in old Egypt in the 17th century B.C., knife wounds were distinguished and broken skull was described in another person who had no trauma symptoms." (Erer & Duzbakar, 2006, p. 40) The Egyptians were thus unhesitant about adopting controversial strategies as long as they believed that their actions would reflect positively on their ability to understand the human body as a whole.

Christianity was especially damaging for medical science during the Middle Ages, as church authorities considered that it would be wrong for doctors to attempt to even touch the dead. Even with this, a series of breakthroughs took place throughout the first half of the second millennia in the field of medicine and autopsies became more common. "Bodies of executed people were used as anatomy materials used in medical education in Europe." (Erer & Duzbakar, 2006, p. 40)

The majority of states require accurate documentation accompanying a death and the autopsy is in many cases the most effective solution of obtaining this information. Physicians need to obtain written consent from the deceased person's family or from established authorities in order to be able to go through with the autopsy.

Most autopsies occur because the authorities want to determine the cause of death, as such information can assist families, physicians, and law enforcement officers as they attempt to discover what the exact cause for the patient's death was. In some situations the patient's death is known but there are other reasons why physicians would want to perform an autopsy. An autopsy can assist doctors in gaining a more complex understanding of how effective particular substances were in fighting a disease. Also, the process can assist physicians and the deceased person's relatives in finding whether or not the reason for his or her death has hereditary implications. This can be essential in some situations. For example, a child's autopsy can assist physicians in determining if it would be safe for the family to continue to make children.

When considering a hospital and its interest in performing an autopsy, the process is important because it can help physicians improve the quality of the services they provide. "Studies indicate that physicians are surprised by the results of an autopsy in about 20% of cases. Furthermore, clinicians are not able to predict those cases in which they are likely to learn of significant unexpected findings." (Autopsy Service) This makes it possible for someone to understand the importance of performing autopsies, taking into account that they play an important role in preventing future maladies and disorders from affecting the social order.

An autopsy can largely be considered to be a public health procedure and it can provide physicians with important information that they would otherwise have little to no access to. The first step in performing an autopsy is to analyze the patient's medical records and information concerning his or her death. Such information can assist the practitioner in coming up with a particular version with regard to why the death occurred. Also, it can help him or her concentrate on significant problems that might have interfered with the autopsy if he or she would have been unacquainted with it. Tissues and fluids are collected throughout the autopsy and are being used in order to perform chemical and toxicological examination. This can determine whether the patients consumed certain drugs and substances that might have triggered death.

The second step in the autopsy involves physicians performing an external examination of the body. This is relatively similar to a normal external examination performed on a living patient. The fact that numerous internal diseases are visible when looking at a person's skin is important at this stage, as this too can contribute to the physician understanding of a person's death.

The internal analysis of the body is performed as a more complex surgical technique. Most of the instruments performed during the autopsy are similar to instruments normally used during an operation or are derived from such instruments. "Some pathological examinations may require the involvement of other pathology specialists such as neuropathologists, cardiac pathologists, immuno-pathologists or pediatric pathologists." (WHAT IS AN AUTOPSY?, 4)

The last phase of an autopsy is the autopsy report, which consists of all the results associated with the procedure. Results obtained during the autopsy and results coming from particularized tests are presented to the Coroner.