Advocating the Need for Autopsies in Every Death

Need for Autopsy in every death –

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While delving with recompense the striking importance of Autopsy prevalent in our country, it was demonstrated that in the present era, Autopsy is performed only under Sections 174; or, 176 of the Criminal Procedure Code (CrPC); both the sections having its own legal jurisprudence, and is restricted to reported unnatural deaths. However, a systematic review of studies of the autopsy has confirmed that in about 25% of autopsies, a major diagnostic error was revealed. A large meta-analysis suggested that approximately one-third of death certificates are incorrect and that half of the autopsies performed produced findings that were not suspected before the person died.

Moreover, as per legal jurisprudence, Autopsy meaning “to see for oneself” usually is a thorough examination of a corpse by dissection to determine the cause, mode, and manner of death; or the exam may be performed to evaluate any disease or injury that may be present for research or educational purposes.

It has been reiterated that, for Foul-Players, the confusion, distraction and vulnerability stemming from crises spells opportunity, and we have seen that there are several instances where the treating doctor, the hospital management furnishes a death certificate later establishing to be a faustian contract.

On the contrary, a genuine Autopsy can identify a naïve’ s religious identity, upholding Article 21 of the most learned constitution.

It is praise-worthy that medico-legal autopsies are often indispensable towards getting justice in the criminal justice system, but unfortunately, reporting the final opinion after medico-legal autopsies is often plagued by undue delays, and as it is often quoted that the Forensic Medicine fraternity in India stands majestically caparisoned with false dichotomy fallacy, and in such scenarios, the legal maxim “Justice delayed is justice denied” becomes woefully evident. These inordinate delays often stem from overburdening of facilities in Government Medical Colleges and the perceived lack of Forensic Medicine experts in the country; the reason in 2014, the Madras High Court had suggested the State Government to explore the feasibility of permitting private medical colleges to perform autopsies. They made this suggestion with the aim of relieving the congestion and workload in the mortuaries of Government hospitals with the noble cause of –

• providing training opportunities for students in private medical colleges.
• relieving congestion in mortuaries in government hospitals.
• ensuring immediate post-mortem examinations for all unidentified bodies.
• preventing private doctors from issuing bogus post-mortem certificates;

a “prep” which is supposedly to be made compulsory, so the executed misadventures can be curtailed”.

Unsafe abortion, risks of maternal morbidity and mortality have found to be catapulted in our country, although we boast of being literate & educated. On a larger perspective every death due to abortions should be included under the purview of a clinical autopsy – which would despise anyone who culminates an arrogant contempt for womanhood.

Furthermore, from the elaborate studies it has been reiterated that:

• the radiographic method of using pulp/tooth ratio of mandibular canines and premolars is a useful technique to estimate dental age of an adult individual, as it helps forensic odontologist to develop a profile of a dead individuals as well as serve in determining age in living subjects.

• The study of ‘fractures’ have led to the conclusion that fracture of bone is a common form of mechanical injury which may sometimes be the only cause or a contributory factor in the cause of death. Usually, fractures occur accidentally, though they may also be present in suicidal or homicidal deaths.
• as per World Health Organisation, almost twenty lakh women worldwide die as a result of pregnancy each year, and out of which approximately 25% of all pregnancy and delivery related maternal deaths occur in India. The reasons, why a woman die in pregnancy, and during child birth are many. Beside the direct, indirect, and co-incidental causes, other factors are – lacuna in the health care system, lack of proper communications, shortage of manpower and apathy towards patient care.

• While exploring the clinical diagnosis, a question that which had bothered us is – “Did the patient receive the correct treatment for the correct disease?”. We have found that 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.

• When DNA analysis could be the most accurate procedure for identification of the stature of an unidentified body, however, it lacks in terms of reasonableness, affordability and time consumption in India. Hence, the identification from anthropometry involving hand measurements to estimate stature could be reasonable, convenient and simple. The procedure of measuring hand length, in the use of determining the stature is simple in mass disasters or accidents, where fragmented or mutilated remains are recovered.

• Cheiloscopy, a scientific study of the lip prints – can be a valuable adjunct in forensic investigations for individualisation and identification of a person in criminal as well as civil investigations like assaults (physical and sexual), thefts, burglaries, homicides etc. They are unique, stable and permanent features of an individual, except in identical twins, and have significant sexual dimorphism noticeable in pattern types in different genders.

Why do the writer advocate for the “Need for Autopsy in every death”?

The wonders that Autopsy have been successful in achieving have been spoken of; on the other side, in several cases it was found that a timely Autopsy would have rendered justice in its jurisprudence.   

In our country, an autopsy is not generally necessary when the death is known to be the result of known medical conditions/diseases, adequate medical history exists, and there are no signs of foul play. But the overruling of “what are not foul-plays” is not always carried out by the relevant authorities, resulting in several scrupulous acts which we have showcased in this article for the past few days.

Moreover, while interacting with different sections of the society, the writer has come across questions like:

• There are no laws in support to this claim. However, a proper representation can amend such laws when the broader gains of the Autopsies can be well defined by the respective representatives.

• There is a scarcity of centres & experts who can conduct these examinations. In this context it is well understood that the learned High Court has given a landmark judgement where it has advocated the use of relevant services in the Privately Owned Hospitals.

• The Police Station & Officers are overburdened with maintaining the Law & Order in the society, along-with the present number of Police Personnel are short of this mammoth task. Well, for the broader interest of mankind, additional deployment of police personnel can be an important judiciary adjunct.

It is of omnipotent importance, when the judicial system enforces stringent rules & regulations to uphold the learned law & order, the communities and its members becomes dispensable to the justice system. A flawless stringent system holds free the community members from Foul-Players, who spells opportunity from the confusion, distraction and vulnerability stemming from crises.

Writer Suvro Sanyal

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