by E. J. Wagner

The medical examiner’s post mortem is one of society’s most potent weapons in the struggle against preventable danger to the public.  Hazards to the community first established in autopsy rooms include lead poisoning, asphyxiation due to plastic bags, faulty appliances, side effects of certain drugs and surgical procedures, and noxious substances of all kinds.

The word “autopsy” is derived from the Greek “to see for oneself” and the first step is careful visual examination of the external body.  Unusual findings are noted and the body is weighed and measured.

The internal examination starts with a Y-shaped incision which begins in the front of the shoulders, joins under the breast, and continues in a straight line down to the pubis.  The skin and tissue immediately adhering to it is folded back to reveal the abdominal cavity.  The sternum is removed to allow access to the heart and lungs.  The internal organs are observed and weighed.  Small samples are taken for further study.  Specimens of blood and urine are collected.

An incision is made in the back of the scalp.  The scalp is then drawn forward over the face and a part of the skull is removed.  The brain is studied in place, then delicately detached from nerves and blood vessels, and removed for more complete examination.  The scalp is slipped back into place and sewn closed.  The internal organs are returned to the body and the incisions sutured.  When dressed, the body shows no sign of the post mortem.

This procedure, frequently misunderstood and maligned, is not a violation or assault upon the dead, but an intensely human and humane act of concern.  It takes place because, as compassionate beings, we recognize the unique value of individual life.  It is performed because, as a caring community, we need to know the reason when a life comes prematurely to an end.

It should be noted that autopsies performed in hospital settings are usually performed to assess the accuracy of prior diagnosis.  The recent medical history of the deceased and the immediate circumstances of death are known and considered in the findings.

Post-mortems performed in Medical Examiners’ offices are often done with much less background information.  The body may need identification.  Medical history may be missing.  Age, race, and even gender may be obscure.  The circumstances surrounding the death may be falsified.  As a result, medical examiner’s autopsies sometimes require additional procedures and longer retention of some tissue.

© 1985 and 2002 E. J Wagner

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This page was last revised on 23-March-2007.

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