Maverick Story's - 3 days ago

“The Silent Causes: Why Some Autopsies Can’t Reveal the Truth”

0 13 min read

Need for Autopsy in every death –

[The article is drawn from a true incidence, and is designed to provide information and motivation to our readers. The publisher is not engaged to render any form of psychological, legal or any kind of professional advice. The content of the article is the sole expression and opinion of the author, and not necessarily that of the publisher. No warranties or guarantees are implied by the publisher’s choice to include any of the content in this article. Neither the publisher nor the author shall be liable for any physical, psychological, emotional, financial, commercial damages. Our views and rights are the same: You are responsible for your own choices, actions & results.]

[Readers are adviced to sought medical guidance]

Autopsy is a paraphernalia, performed by a forensic expert specialised entrusted with a range of very complex responsibilities. Indeed, the quality of forensic autopsy activity is always questioned in courts of law; incorrect assessments are dangerous because they can jeopardise the validity of a criminal investigation and thus affect the outcome so that a real culprit may be acquitted or an innocent person convicted. Nonconformities also discredit the professionalism of the specialist who performs the autopsy.

The primary objective of a forensic autopsy depends on the specific case. The first priority is always to determine the cause, manner, and time of death for the legal system, along with the identity of the deceased, but a medical examiner may also set the following objectives:

to establish the pathological consequences of drug or toxin use or abuse,
to determine whether any natural disease might have increased susceptibility to the effects of a drug or toxin,
to collect trace evidence or any other evidence in order to reconstruct and interpret a chain of events, to assess whether death is due to acute workplace injury,
to ascertain if there has been a lack of surveillance by a public health or federal institution,
to verify if death is a result of complications associated with surgery, and to evaluate possible health malpractice.

While discussing about the need for autopsy in every death, it was observed that while complying with the procedural guidelines to guarantee the correct development of an investigation, certain often going overlook, poor considerations exhibit major repercussions in the context of a legal investigation. Given the potential for a forensic specialist to commit any one of a list of nonconformities (minor or major), in this article we intend to identify seven key errors that may occur in forensic autopsy practice, with irreversible judicial consequences.

Oversights in Autopsy Technique: –

Though the actual performance of an autopsy is fairly uniform whatever the nature of death, there are a number of associated matters that vary according to the circumstances. For example, the procedural precautions required following a murder are not necessary in the case of a sudden natural death, and the dissection in a criminal abortion or fatal rape is different from that performed on a drowned body. every effort should be made to document the presence of pathologies and/or injuries in detail. While this may not seem necessary to establish the cause of death, key information about circumstances and concomitant factors may be lost if comprehensive details are not recorded during the examination. In the early stages of an investigation, it may difficult to ascertain – how much attention should be given to some signs of harm. Moreover, some pathologies, which could be studied more carefully during the autopsy, emerge only after the body has been released (either through the examination of the attending physician or through the recovery of previous health documentation). A systematic approach will allow the necessary information to be recorded for later analysis; considering the fact, a severely traumatised and/or burnt body, which may present a daunting prospect to those not accustomed to dealing with such cases.

In the case of an addiction, a complete autopsy is necessary to ascertain the definitive or most likely cause of death. Incomplete autopsies, including needle autopsies, or endoscopic autopsies that are comparatively less invasive, or non-invasive, are not routinely part of forensic practice.

Finally, clinical data can be of immense importance, in an instance, where a deceased person has undergone medical treatment for some time prior to death. Medico-legal expert can pen-picture the circumstances of death. All of this information is useful to the pathologist in planning the best approach with minimal risk of error. A perfect sector-specific technique that adheres to the established guidelines contributes decisively to the provision of a detailed written post-mortem examination report of the autopsy findings, and all inferences drawn must be based on scientific reasoning.

Improper Photography and Video Contents: –

Post-mortem imaging may provide an efficient guide to supplement a conventional autopsy, especially in view of the different techniques currently available, such as post-mortem X-rays, post-mortem computed tomography, multiphase post-mortem computed tomography angiography, and post-mortem magnetic resonance imaging.

Apart from a complete and meticulous dissection of the dead body, photographs and video films should be taken for future evidential use in a court of law. Photographs and videos often allow forensic experts to see signs of micro lesions or other particular necroscopic aspects that may escape during the autopsy procedure. Even when a specialist photographer takes the photographs, it is ultimately the responsibility of the forensic expert to ensure that enough photographs of sufficient quality has been taken.

The photographer must have an adept understanding of the related requirements on three levels: technical, medical, and legal. Autopsy photography must be extremely reliable, as the images are not repeatable. The photographs can be submitted later with the post-mortem report or preserved as part of the medico-legal report, to be produced whenever required by a court of law. The following set of photographs should be taken: full body shots from above with clothes intact; full body shots, front and back, after clothes have been removed; close-up photographs of each single external and internal lesion including an indication of scale, such as a ruler, in the image; photographs of organs, tissues, and liquids that are taken as samples for subsequent investigations. Care must be taken to ensure that photographs and videos are not editable and the exact date and time must be set on the camera, otherwise such material can fall foul, and liable to be contested as evidence.

Unauthorised Gathering while conducting the Autopsy: –

Observing a post-mortem is likely to foster broader differential diagnosis, and augment a better understanding of the associated problem-solving methodologies for investigation with more accuracy. However, in the case of forensic autopsy, attendance is limited to autopsy assistants, medical professionals, appropriate trainees, magistrates, inquirers into sudden death, and people from relevant investigative agencies. If this protocol is not adhered to, the unrepeatable assessment could become voidable in the context of a hearing. Furthermore, while conducting autopsies of any accidents involving persons, any unauthorised person allowed to attend the autopsy could not only adulterate forensic evidence but also lead to the civil or criminal liability of the medical sector. For this reason, in a criminal or suspicious case, the forensic expert should try to limit the number of those present at the autopsy to a minimum, which will reduce the risk of loss of confidentiality. In addition, when too many people descend on the morgue, with hardly any room to move, the examiner may well lose concentration during the autopsy or neglect to examining protocols.

To be continued…………………