American Medical Association Family Medical Guide - American Medical Association [312]
Autopsy
An autopsy (also called a postmortem examination) is a detailed examination of a body after death that may be performed for a variety of reasons. For example, if no doctor cared for the person during his or her final illness, if the cause of death is not known, or if a death may have been caused by violence, an autopsy is usually required. Depending on where you live, either a medical examiner or a coroner is authorized to investigate unexplained or violent deaths.
Autopsies are usually performed before a body is embalmed, and a body cannot be cremated until a cause of death has been determined. A death certificate is issued only after a cause of death has been determined.
If an autopsy does not reveal a cause of death or if the death was violent, unnatural, or resulted from an injury, there may be an inquest (public court hearing). After the inquest, the medical examiner or coroner issues a death certificate and releases the body to the funeral director.
Medical/legal autopsy
A medical/legal autopsy is ordered by legal authorities to establish a cause of death and to determine if a death was the result of a crime. Medical/legal autopsies are also sometimes performed to investigate possible industrial hazards or contagious diseases that may endanger public health or to establish a cause of death for insurance purposes.
A medical/legal autopsy can range from a simple examination of the appearance of a body and the situation in which it was found to a study of the entire body and all its parts (including the structure of individual cells), depending on what is being investigated. A pathologist (a doctor who performs autopsies and studies tissues and organs) makes detailed notes and keeps a record of everything that is done during an autopsy in case the information is needed as evidence.
Medical/educational autopsy
A medical/educational autopsy may be requested by a hospital staff member or by the person’s family and is usually performed in the hospital where the person died. The family’s permission is required. In most cases, a medical/educational autopsy is performed to determine the exact cause of death or to provide the family with information about any contagious diseases or inherited medical conditions. Sometimes information about genetic diseases (see page 953) can be obtained from an autopsy. Medical/educational autopsies are sometimes performed so doctors can learn more about a particular disease or condition.
In some cases, medical/educational autopsies are performed to check the accuracy of a diagnosis or the appropriateness of medical treatment. If a person died unexpectedly or if his or her symptoms were puzzling, a doctor or the person’s family may request an autopsy to look for a possible cause of death.
If you are asked to give permission to perform a medical/educational autopsy, you can agree to a limited autopsy (that is, you can specify that only particular parts of the body can be studied).
The Mourning Process
Immediately after the death of a loved one, many people feel numb. Some may, for a time, go on with their life as if nothing has happened, until they are eventually overcome by intense grief. Grief is an essential process that cannot be rushed.
During the period immediately following a death, delusions of seeing the person are common. There is a tendency to forget that the person is dead and even act as if he or she were still alive. It is also common to idealize the dead person and feel guilty for not doing more for the person when he or she was alive. Guilt and intense grief occur frequently when a person has died unexpectedly. When death occurs after a long illness, the bereaved person has usually been able to anticipate the loss and may have been able to provide care, which can lessen feelings of guilt and grief. Also, it is normal for close friends or family members to feel relief once the death has occurred, especially if the death was a long, difficult, or painful one. This sense of