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Guide to Autopsy Regulations in the United States

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An autopsy is an examination of a body after death to evaluate disease or injury and to determine the cause of death.  There are a number of situations where such a medical examination is required; and others where it is advisable. 

Autopsies, also known as postmortem examinations or necropsies, have been performed by doctors as early as the fifth century B.C.E by the Greeks and the Egyptians between 350 and 200 B.C.E.  The first recorded autopsy in the “New” World was conducted in 1533 supposedly to determine whether Siamese twins had one soul or two.  Well into the twentieth century, physicians sometimes performed autopsies on their patients, often in the deceased patient’s home.

Currently, in the United States, the majority of autopsies are performed by pathologists who have been specifically trained to conduct such procedures. 

Performance of an autopsy on a deceased individual will depend on the circumstances of the death, where the death occurred, desires of the next of kin, and, occasionally, the desires of the deceases or requirements of insurance policies.  The 1954 Model Post-Mortem Examination Act, which has been adopted by most U.S. jurisdictions, recommends that autopsies be conducted in all cases of deaths that (1) are violent, (2) are sudden and unexpected, (3) occur under suspicious circumstances, (4) are employment related, (5) occur in prison or to psychiatric inmates, (6) constitute a threat to public health, or (7) are persons who bodies will be cremated, dissected, buried at sea, or otherwise unavailable for later examination.  In some cases, patients who die within twenty-four hours of anesthesia being administered are also autopsied.

In cases where doctors want to perform autopsies not involving the aforementioned situations, survivors or next of kin must usually give consent.

While the law that prevails in most jurisdictions permits authorities to conduct autopsies under certain circumstances, statistics indicate that medical examiners in the United States autopsy only about 59 percent of all blunt and penetrating trauma deaths, with homicide and trauma deaths in metropolitan areas being done most often.  Some states honor religious objections to autopsies, but officials retain the right to do so over such objections if it is determined that it is in the public interest to do so.

In addition to determining the manner and cause of death, pathologists are often called upon to conduct post-mortem examinations of decomposing or partial remains to determine the identity, and if possible, the cause and date of death.  The latter, while it figures prominently in TV shows and movies, is actually seldom done, unless there is a legally compelling reason to do so.

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