Postmortem examination

It is done by a specialised medical doctor called a pathologist. In general most countries classify deaths into five different classes, natural, accident, homicide, suicide and undetermined.
In some jurisdictions, the “Undetermined” category may include deaths in absentia, such as deaths at sea and missing persons declared dead in a court of law. In some countries, such deaths are classified under “Other”. Following an in-depth examination of all the evidence, a medical examiner or coroner will assign a manner of death and detail the evidence. Autopsies are either performed for legal or medical purposes and they are forensic or coroner’s autopsy and clinical or academic autopsy.
Forensic autopsy
Forensic autopsy is carried out when the cause of death may be a criminal matter. It is used to determine the cause of death so as to establish grounds for litigation. Forensic science involves the application of the sciences to answer questions of interest to the legal system and the process seeks to establish the cause and manner of death. They are generally performed, as prescribed by applicable law, in cases of violent, suspicious or sudden deaths, deaths without medical assistance or during surgical procedures. Remember the late eighties to early nineties, when newspapers reported widely about the Anaesthetist Richard Mc Gowan who allegedly performed experiments on his patients without their consent and had court proceedings instituted against him.
Clinical autopsy
Clinical autopsies serve two major purposes. They are performed to gain more insight into pathological processes and determine what factors contributed to a patient’s death or for research purposes. They aim to determine, clarify, or confirm medical diagnoses that remained unknown or unclear prior to the patient’s death. Clinical autopsies are also performed to enhance or maintain the standard of care at hospitals and can yield insight into how patient deaths can be prevented in the future.
Throughout the world, clinical autopsies can only be carried out with the consent of the family of the deceased person as opposed to a medico-legal autopsy instructed by a Coroner (an official responsible for inquests into violent sudden or suspicious deaths) to which the family cannot object.
Autopsies can be further classified into internal or external examinations.
Internal is where the body is dissected and internal examination is conducted. An external autopsy also called a “view and grant” is sometimes done were the medical records and history of the deceased and circumstances of death have all indicated as to the cause and manner of death without the need for an internal examination. Permission from the next of kin may be required for internal autopsy in some cases.
In Zimbabwe, for example, any sudden deaths or hospital deaths occurring within 24 hours of admission or within 24 hours of a major surgical procedure will undergo mandatory autopsy.
History
The term “autopsy” derives from the Ancient Greek word autopsia, “to see for oneself”, derived from autos, “oneself” and opsis, “eye”. Around 3 000 BC, the ancient Egyptians were one of the first civilisations to practice the removal and examination of the internal organs of humans in the religious practice of mummifications. Autopsies that opened the body to determine the cause of death are attested at least in the early third millennium BC, although they were opposed by many in ancient societies where it was believed that the outward disfigurement of dead persons prevented them from entering the afterlife. In 44 BC, Julius Caesar was the subject of an official autopsy after his murder by rival senators, and the physician’s report noted that the second stab wound Caesar received was the fatal one. 
The modern autopsy process derives from the anatomists of the Renaissance. Giovanni Morgagni (1682-1771), celebrated as the father of anatomical pathology, wrote the first exhaustive work on pathology, The Seats and Causes of Diseases Investigated by Anatomy, 1769. The two great nineteenth-century medical researchers Rudolf Virchow and Carl Von Rokitansky built on the Renaissance legacy to derive the two distinct autopsy techniques that are used today which still bear their names. Their demonstration of correspondences between pathological conditions in dead bodies and symptoms and illnesses in the living opened the way for a different way of thinking about disease and its treatment.
Purpose
The principal aim of an autopsy is to determine the cause of death, the state of health of the person before he or she died, and whether any medical diagnosis and treatment before death was appropriate. In most Western countries the number of autopsies performed in hospitals has been decreasing every year since 1955. Critics have charged that the reduction in autopsies is negatively affecting the care delivered in hospitals, because when mistakes result in death, they are often not investigated and lessons therefore remain unlearned. When a person has given permission in advance of their death, autopsies may also be carried out for the purposes of teaching or medical research. In Zimbabwe as in other countries an autopsy is frequently performed in cases of sudden death, where a doctor is not able to write a death certificate, or when death is believed to be due to unnatural causes. These examinations are performed under a legal authority and do not require the consent of relatives of the deceased. The most extreme example is the examination of murder victims, especially when medical examiners are looking for signs of death or the murder method, such as bullet wounds and exit points, signs of strangulation, or traces of poison. Many religions such as Judaism and Islam usually discourage the performing of autopsies on their adherents.
In medicine
Autopsies are important in clinical medicine. Recent studies have shown that half of the autopsies performed produced findings that were not suspected before the person died. Postmortem examination is far more common in veterinary medicine than in human medicine. An important component of the autopsy is the reconstitution of the body such that it can be viewed, if desired, by relatives of the deceased following the procedure. The body may be wrapped in a shroud and it is common for relatives of the deceased to not be able to tell the procedure has been done when the deceased is viewed in a funeral parlour after embalming.
 
– Philip Mataranyika is the CEO of Nyaradzo Funeral Assurance Company. He can be contacted at mavmat67@hotmail.com