An autopsy is a medical examination of a body after death. They’re performed after some, but not all, deaths in order to learn what caused their death or to get more information about their death. Other terms for an autopsy are post-mortem examination and necropsy.
An autopsy is typically performed by a pathologist, who has training in examining dead bodies and making conclusions based on their evidence. But a pathologist isn’t the only professional who might do an autopsy. It might also be performed by a teacher in a medical school who is demonstrating techniques and providing information for students.
Types of autopsies
There’s more than one type of autopsy:
1. Complete autopsy. This is an examination of the entire body, including the external body and organs such as the brain, heart, lungs, and liver.
2. Partial autopsy. Only some part of the internal body is examined here – maybe a specific organ is examined, or a region of the body such as the head and neck. The entire external body will still be examined.
3. Observation autopsy. When a pathologist or teacher performs an autopsy with others looking on, it’s called an observation autopsy.
4. Exhumation autopsy. If a body has already been buried but there are pressing questions about the death that may be answered with an autopsy, it may be dug up for further examination.
5. Second autopsy. Sometimes a second autopsy is ordered if the initial autopsy appears to have been inconclusive or untrustworthy.
Ordering an autopsy
Often, an autopsy is ordered by the coroner or medical examiner. They do not always need the family’s permission to order an autopsy. It may be that they choose to order an autopsy based on information that has been provided to them by someone who is concerned about the circumstances behind the death, such as medical staff or law enforcement personnel. When an autopsy is ordered by an authority, this is considered a “reportable” death.
The family can request that the coroner or medical examiner order an autopsy. This doesn’t necessarily mean the authority will make the order. If they believe that the family’s concerns about the cause of death are worth investigating, they will order the autopsy.
If the family wants an autopsy and the authority doesn’t agree it’s necessary, the next of kin can still have an autopsy performed. While the cost of an autopsy will typically be covered in the event of a reportable death, it is unlikely to be covered if an authority doesn’t order it. The family will be responsible for the costs.
Autopsy fees vary, but it typically costs at least $1,000 and up to several thousand dollars. There may be an additional charge for transportation of the body. Autopsy fees aren’t covered by Medicare, Medicaid, or most insurance plans.
There are many reasons why a coroner, medical examiner, or family member might request an autopsy:
1. Uncertainty about the cause of death. It’s sometimes assumed that this is the only reason to perform an autopsy, and it’s certainly a common reason. If a death was udden and unexpected, and the cause isn’t obvious, it’s likely there will be an autopsy.
2. Work-related illness or injury. If a person dies in a situation that may have been related to their work, an autopsy may need to be performed to determine if there will be any compensation for the family.
3. Possible public health threat. If a person may have died due to tainted food or a contagious disease, there may be an autopsy to see if that cause can be confirmed. In some states, it’s required by law in this situation.
4. A condition that can only be diagnosed after death. Alzheimer’s disease is one condition that can only be conclusively diagnosed with an examination of the brain after death. If a family wants to be sure of the cause of death when something like Alzheimer’s is suspected – perhaps to clarify their family health history – they may request an autopsy.
5. Suspected murder, accident, or suicide. An autopsy may help pin down the cause of death when it appears to have been due to murder, accident, or suicide.
6. Death that happens shortly after admission to the hospital. If a person dies within 24 hours of entering the hospital, an autopsy may be ordered to confirm the cause.
7. Death in police custody. When death occurs while a person is in the custody of a police officer, an autopsy may be performed to look into the cause of death.
8. Death on the operating table. If a person dies while being operated on or receiving another medical procedure, an autopsy can help determine liability for the death.
What happens during an autopsy
Clothes are removed from the body before the autopsy begins, so the pathologist can do a thorough external examination. This entails checking the skin and hair for any information that may be found there. The pathologist may be looking for marks or scars that can provide clues, or if murder is suspected, there may be external signs like foreign tissue or fluids present on the body. The pathologist will closely examine the entire external body.
Before the internal examination begins, the body will be washed and weighed. Then, if a complete autopsy is taking place, the pathologist will make a Y-shaped cut on the torso in order to access the internal organs. They will remove each internal organ and examine them for information that can help make conclusions. Some of the organs may be retained for further testing, which sometimes happens in a lab elsewhere. The pathologist may also take samples of bodily fluids and tissue for testing.
The brain may also be examined. The pathologist will cut or break the skull and remove the brain for examination.
After all organs have been examined, the pathologist may return them to the body, or they may be preserved and kept outside the body. The incision on the body is sewn up, and if the organs remain outside the body, it may be stuffed with batting before being sewn up. The body is then returned to the morgue or transported to the funeral home. If the organs are left outside the body, they will likely be placed at the foot of the casket, where they can be buried with the body but not seen in an open-casket funeral.
The whole process of the autopsy should take a few hours to complete, but some tests performed on organs, blood, or tissue can take quite some time to be returned.
There’s generally no problem with having an open-casket funeral after an autopsy has been performed. The incision on the torso can be covered by clothing, and any cuts made to the skull are also likely concealable. The funeral director will have experience with this and will know how to conceal any autopsy marks.
The autopsy is also unlikely to delay the funeral, as it is typically performed as soon as possible after the death.
What is included in an autopsy report
After the autopsy is completed, the pathologist will write up a report with their findings and conclusions. It may be several weeks or months before this report is available, depending on any additional testing that needed to be performed on organs, tissues, ad fluids. Copies of the report will be provided to the family as well as to the authority who ordered the autopsy and any other interested parties.
The autopsy report will include the pathologist’s detailed findings, with results of any tests that were performed and observations made during the procedure. If it was possible for the pathologist to determine the cause of death conclusively, this will be specified in the report.