Autopsy: Aiding the Living by Understanding Death

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When someone you love dies, you may be faced with an overwhelming list of pressing choices to make and things to do. At a time when you may feel emotionally devastated, you will be asked to make quick decisions about matters that you may never have considered before. One of the questions you may be asked to consider is whether or not you want to request an autopsy. This article is designed to provide you with some basic facts about autopsies that we hope will help you make an informed decision.

Why perform an autopsy?

Hospital autopsies are done for a variety of reasons. First and foremost, an autopsy can provide answers for bereaved family members. Even if your loved one had a thorough medical evaluation and comprehensive treatment, you may still have questions about what happened. (“What was the cause of death?” “Could this illness have been prevented or detected earlier?” “Does this illness have implications for my family?”) An autopsy can help answer these questions.

The people who took care of your loved one may also have questions. An autopsy is a way for them to confirm their diagnoses and assess the effectiveness of their therapy. The information gained from an autopsy provides lessons that can be valuable when treating future patients. It provides a means to improve the quality of care they give their patients.

Finally, autopsies have the potential to benefit society in general. Information from autopsies has led to the discovery of new diseases and has helped provide new insights into known diseases.

What is an autopsy?

A complete autopsy is an external and internal examination of the body after death using surgical techniques. The examination is performed by a pathologist, a medical doctor who is specially trained in this type of procedure and who is able to recognize the effects of disease on the body. The procedure typically takes about two to four hours to perform. This examination may be comprehensive or may be limited to a particular organ system. However, limiting the scope of the autopsy may reduce what can be learned. Regardless of the extent of the examination, a standard autopsy will not interfere with an open-casket viewing.

The body is treated with dignity and respect, and the wishes of the family are observed at all times. The organs are examined and samples are taken for microscopic examination to look for disease such as cancer or infection. Other tests that may be performed include studying genes and checking for chemicals or toxic substances. When the examination is completed, a written report is issued. The final report takes at least several weeks to prepare due to the detailed studies and information gathering that may be performed. The report becomes a permanent part of the patient's medical record. The findings may be discussed with the patient's doctor.

Who requests an autopsy?

In some cases, the law may mandate that an autopsy be performed. In all other cases, permission is required from the legal next-of-kin. In some cases, the patient may have indicated their wish for an autopsy in discussions with the family or by signing a personal directive for autopsy. When giving consent, the family may make any restrictions, limitations, or special requests.

How families can benefit from the autopsy

  • Discovering inherited or familial diseases may help you through early diagnosis and treatment, and in family planning
  • Discovering an infectious disease, which may lead to early diagnosis and treatment of family members and close contacts
  • Uncovering evidence of a work-related disease, which might lead to compensation for the family
  • Providing crucial information for the settling of insurance claims or death benefits
  • Confirming a specific cause of death may simply ease the stress of the unknown
  • Finding that diagnosis and treatment was appropriate may be comforting
  • Knowing that information gained by the autopsy may help someone else to live longer may ease the profound sense of loss experienced by families

Common concerns about autopsies

Is there a charge for the autopsy?

The autopsy is important to providing an understanding of the quality of patient care. Many hospitals, particularly teaching hospitals, do not charge for autopsies on patients who died within the hospital. However, there are institutions that do find it necessary to charge for this service because of the labor, expertise, and cost involved. In some cases, there is a charge for transportation of the body to and from an autopsy facility.

Will the autopsy affect funeral arrangements?

The performance of an autopsy typically does not delay a funeral. Funeral directors are familiar with the preparation of bodies following autopsy, and the autopsy procedure will not affect an open-casket viewing.

Does the pathologist retain any organs?

The pathologist may retain some organs for more detailed examination, research, or educational purposes. The length of time organs may be retained is variable and related to the purpose of the retention. Families may require that organs be released to the funeral home with the body by giving specific instructions in the written autopsy consent form. However, immediate return of the organs may reduce what can be learned.

Are there religious, spiritual, or cultural conflicts?

You may worry that performance of an autopsy may conflict with your religious, spiritual, or cultural beliefs. These decisions are always personal. You may want to discuss the decision to have an autopsy performed with other family members and religious or spiritual advisors.

Questions

Additional questions about the autopsy or organ and tissue donation can be directed to the health care provider team, doctor, nurse, or chaplain. They can arrange for you to speak with the appropriate contact person in the pathology department.

We hope this article has been helpful in answering some of the questions you may have about the autopsy. This procedure has been known throughout history as a way of helping families understand what has happened to their loved one. It is a means of increasing medical knowledge, which in turn benefits you, your family, and the community.


Prepared by the College of American Pathologists Autopsy Committee