India - December 17, 2024

Deploring the Autopsy Statistics – Has Justice been delivered?

December 17, 2024

0 12 min read

Need for Autopsy in every death –

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Deploring the Autopsy Statistics – Has Justice been delivered?

To explore the rate of crime in a particular area, deploring the pattern & magnitude of the autopsy cases is an important phenomenon. The socio-economic & psychological study amongst the netizens of a society reveal the pattern of suicidal deaths. Similarly, shortcomings in discipline & awareness leads to the happening of the accidental incidences. A detailed insight has observed that many common diseases such as cirrhosis, acute endocarditis, bronchopneumonia, and acute nephritis were missed in clinical diagnosis in more than fifty percent of the cases.

Although clinical medicine has been proven to be successful much before our Independence, but some clinicians believe that the present sophisticated diagnostic examinations have out flawed the purport of the autopsy. However, many pathologists have agreed to the fact that Autopsy is a scientific marvel which is void of any lacuna when performed in its jurisprudence, as several “major discrepancies” were demonstrated between the autopsy findings and clinical diagnosis. Hence, a post-mortem analysis would have probably paved the path for improving the survival of the patient. These studies raised the important question, “Did the patient receive the correct treatment for the correct disease?”

Autopsy records has been an essential tool for quality control of medical care, and for enhancing the quality of cause-of-death information reported on the death certificate.

In any case of injury or ailment, in which investigations by the law enforcing agencies are required to ascertain the cause, is known as Medico Legal Case, which are an integral part of medical practice. Basically, all cases of medico-legal examination are divided into two broad categories:

medico-legal examination of the living, which is frequently performed by registered Medical Officers working in the Casualty Department of any hospital;
medico-legal examination of the dead, which is known as autopsy or post-mortem examination, conducted by the Forensic & Toxillology Department of a government hospital in general.

Forensic Experts not only deal with suspicious, accidental and suicidal deaths, but with a wide range of deaths from natural causes. Many of these are sudden, unexpected, clinically unexplained, or obscure otherwise, even though there may be no such fundamental evidence of unnaturalistic in their cause. The most widely accepted definition of sudden death is a death which is not known to have been caused by any trauma, poisoning or violent asphyxia, and where death occurs all of a sudden or within 24 hours of the onset of the terminal symptoms. When sudden natural death, occurs in an apparently healthy person, it attracts a captivating impact on the society. Hence, certain sudden natural deaths significantly undergo autopsy for investigating the cause of death.

A comprehensive report, on the detailed case studies conducted across different states, observed that:

One-half of the number of cases around 52.1% belonged to the middle class, followed by lower class about 31.5%. The Upper class constituted only 9%;

In majority of the cases which is 50.9%, the symptoms radiated when the patient was engaged in the routine day to day activity, which ultimately lead to sudden death;

while in 31.1% cases, symptoms erupted when the deceased was resting; while only in 7.1%,

symptoms started radiating during strenuous activity;

The history of alcohol intake was dominant in 45%; smoking in 35% & chewing tobacco in 20% of the cases; most surprisingly alcoholism was absent in 46.4%; non-smokers were 50.9% & 67% were found to be void of tobacco intakes;

In the report it was registered that 45% were known cases of diabetes, while 55% were known cases of hypertension;

In majority of the cases, 65%, time of onset of symptoms was seen during 06.00 hours to 12.00 noon, while the least number 35% of the cases reported during 00.00 hours to 06.00 hours;

17% of those found dead were unknown/ unidentified; while, 43% died within 01 hour or were brought dead to the hospital & 40% died within 01 – 06 hours;

Majority of the victims around 55% were on mixed diet, while 45% were pure vegetarians.

This concludes that sudden death can happen during day-to-day activity as well as during rest/sleep, which is very well highlighted in the present study. So, we can say that, strenuous activity does not always exaggerate sudden death. The more preponderance amongst the middle-income group, and lower-income group families are due to minimum affordability to medical facilities. Due to financial problem, they might not get regular medical check-ups for early detection of their diseases or even treatment for their diseases.

In the report, it was well documented that hypertension has caused 55% of the fatalities due to cardio vascular system involvement. Moreover, Diabetes increases the risk of coronary artery disease, a condition that is commonly found in association with sudden death. However, there may be diabetes specific accelerated forms of atherosclerosis with enhanced thrombogenicity.

On the other side, saturated and trans fats in the diet tend to increase LDL cholesterol in the blood. LDL cholesterol can lead to plaque formation on the arteries. Common sources of saturated fats include animal products (butter, meat fat, beef, lamb, chicken skin and full cream dairy foods), and processed foods like pastries and biscuits. So, mix-diet person is presumed to be at increased risk of cardio vascular diseases leading to sudden death.

Health policies are aptly implemented by the government, but some of the mechanisms of Western health educational interventions are likely to be applicable but require adaptation to the needs of each community’s sociocultural milieu. But there has been a delimitation in the integration with other chronic disease control programs. Although, tobacco control and diet are clearly on the agenda of several lifestyle-related disease control programs, however, the need for tobacco control

currently assumes the highest priority, both because no context-specific scientific validation is needed to establish its risk factor status as a program prerequisite and because of the wide ranging benefit that will accrue for a whole host of chronic diseases.

Keeping in views the captivating effects of a sudden death in our society, it is strongly urged that an autopsy would be of volumous importance in ascertaining the cause, and to rule out every possibility of a foul act of putting an end to someone’s life which is a state stake.