Where are corpses being held?

Examination and autopsy - determining the cause of death

Immediately after a person dies, a doctor is called to carry out the post-mortem. This should determine the death, the time of death and the cause of death. If the doctor can clearly determine the natural cause of death after the regular post-mortem examination, an undertaker may collect the deceased and transfer them to a cold store or to a crematorium. If there are indications of a non-natural cause of death, the public prosecutor or a court orders a forensic autopsy.

© Stasique - fotolia.com

The inquest

In Germany, the funeral examination is regulated by the funeral laws of the federal states. In addition to the determination of death, the investigation of the dead can also reveal criminal acts. Depending on where the death occurred, you can call your family doctor, an emergency doctor or a doctor from the health insurance company. In the hospital, the doctor on duty takes over the post-mortem examination. Every doctor is required to conduct an inquest when called to report a death.

Procedure and costs of the inquest

The deceased must be completely undressed and viewed from all sides. The doctor can determine death and the time of death on the basis of external signs such as a missing pulse, death spots or rigor mortis. At the same time, the doctor must verify the identity of the deceased. If a natural cause of death can be clearly identified during the investigation, the doctor will record this on the death certificate (including death certificate or corpse certificate) and thus release the corpse for burial. The costs for issuing the death certificate must be borne by the relatives who are obliged to be buried. The amount of the costs is regulated in the doctors' fee schedule. Then an undertaker can pick up the body and transfer it to a cold store. At every cremation (except in Bavaria) a second examination of the corpse takes place in the crematorium by a medical officer to confirm the cause of death.

The autopsy

An autopsy is an internal examination or opening of a corpse. It is also called an autopsy or dissection and is used to determine the cause of death and to reconstruct the process of death. It is carried out by pathologists or forensic doctors. During an autopsy, the cause of death and previous illnesses of a deceased person are determined by an internal medical examination.

The clinical autopsy

In most cases, the last doctor treating the deceased applies for an autopsy. The prerequisites for a clinical dissection are that the next of kin agree and that death has occurred from a natural cause (e.g. heart attack, cancer, pneumonia). It not only serves for quality assurance in medicine, but can also be a relief for relatives (e.g. self-reproach that you did not notice symptoms in time). Furthermore, an autopsy can occasionally provide indications of familial risk factors (e.g. cancer or hereditary diseases). It is sometimes used for insurance issues (e.g. occupational illnesses that may have contributed to death or concealed previous illnesses).

Court-ordered autopsy

The public prosecutor's office or a court can also order forensic autopsy. This occurs when a non-natural cause of death, such as homicide, suicide or accidental death, is suspected or obvious. As a rule, a court-ordered autopsy is then carried out to find out or confirm the cause of death. The mere suspicion of an unnatural cause of death is sufficient to tick “Type of death unexplained” on the death certificate and to notify the police.

An autopsy must also be carried out if the identity of the deceased can not (no longer) be determined or if the doctor could not find the cause of death at the first investigation.

Procedure of an autopsy

In the forensic autopsy, a distinction is made between external and internal examinations. During the external investigation, a doctor carefully inspects the corpse at the beginning of an autopsy. He records e.g. size, weight, nutritional status and color of the skin. The position and color of the dead spots and the degree of rigor mortis are documented as well as skin changes such as scars, wounds, surgical wounds, pigment spots and tattoos. Particularly in forensic autopsies, great importance is attached to a precise external description, which, in addition to any injuries (such as gunshot or stab wounds), also includes clothing and other items (e.g. jewelry, wristwatch, etc.). Examining clothing, height, and dental status is particularly important for identifying unidentified dead. In addition, one can draw conclusions about possible external influences through the external inspection.

The internal coroner is divided into the opening of the cranial, thoracic and abdominal cavities. This is how the organs are exposed. The organs can be assessed according to size, shape, color and consistency, whereby changes deviating from the norm are included in the descriptive part of the autopsy report. Small samples are taken from important organs for further investigation. For forensic medical reports, the blood and urine of the deceased are also taken for the purpose of toxicological tests.

Following the internal inspection, the organs are returned to the deceased, whereby the organs or parts of organs removed from the autopsy can be processed and archived for clinical or scientific purposes. The incisions are sewn up and the body is washed. Laying out in an open coffin is therefore possible.

The autopsy report

All changes in the organs that deviate from the norm are recorded in the autopsy report. The autopsy report consists of a descriptive part, which can be equated with a picture description. Thus the descriptive part is an objective description of the organ systems. A list of the causes of death and the individual pathological-anatomical diagnoses is attached to this description.