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Autopsy is a branch of pathology, known as forensic pathology, whose primary concern is determining the cause of death through examining a corpse. The term autopsy is derived from Greek “autopsia” meaning to see for oneself (Lanier, 2018). It is made up of two words, autos” which stands for self and “opsis” which means “eye’’ it is through an autopsy that this examination is conducted. A pathologist performs this action at the request of a medical examiner or a coroner. This is mainly done during the investigation of a crime or civil law case. The pathologists are not only responsible for determining the cause of death, but also confirming the identity of a corpse. According to Min et al. (2014), there are five different rulings of manner of death that can be used to classify autopsy, which include nature, suicide, homicide, natural or undetermined. Everyone, upon death does not normally receive an autopsy.
There are two main types of autopsy that are normally carried out when dealing with crimes, forensic autopsy, and clinical autopsy. Forensic autopsy is performed in the case where the cause of death is unknown, violent or there are suspicions concerning the cause of death. Clinical autopsy on the other hand takes place only on the consent of the deceased’s next of kin if he or she is interested in finding out the causes of death of their loved one (Di Vella et al., 2017). A pathologist normally carries this out. An autopsy can be restricted to a specific organ or region of the body.
It involves the opening up of the body and this is done in a manner that does not interfere with the open casket service. An autopsy begins with a complete extermination of the external parts of the body. The weight and height of the body are recorded and any mark on the boy is identified or marked. These marks could be scars or tattoos. In certain cases, pictures of findings may be taken for future references (Draper et al., 2015). Some tissues may also be frozen; this will help in future diagnostic or for purposes of research. After the completion of the study, a detailed report is prepared which describes the autopsy findings and procedures. It gives a clear list of medical diagnoses and summary of the case. Emphasis on the relationship or correlation between pathologic findings and clinical findings are emphasized on the report. Pathological findings are those that are made from the report while clinical findings are the doctor’s examinations, radiological findings, laboratory test and many others (McFarquhar, 2011).
Autopsy can be carried out in two ways. For instance, there is the psychological autopsy, which is a type of autopsy that is often carried out after a person has taken their own life. It is normally known as a procedure where the suicidal death is reconstructed through interviews with survivors. Through this inferences about the deceased behaviors can be drawn, his or her thoughts and emotions (Goodman, 2011). This can be done through talking to those who knew the deceased and even analyzing the documents or letters that they may have left. This is dome mainly to try to make sense of their psychological environment immediately before their death. Criminology autopsy is normally taken to determine what caused the murder of an individual or rather who caused the murder. It is normally carried out in occasions when a crime of murder, homicide needed to be solved (Turvey, 2011). This kind of autopsy is normally done on the deceased to see if it can give any clue on what happened or who carried this action out.
There are four different types of autopsies. There is the Medico-Legal Autopsy, Forensic or coroner’s autopsies, which is a type of autopsy that seeks to find out the cause and manner of death with the aim of identifying the decedent. This type of autopsies is normally performed as instructed by the law that is in case of violent, sudden death, suspicions, during deaths without medical assistance or during surgical procedures (Becker et al., 2018). The second type of autopsy is clinical autopsy, which is carried out to determine, give clarity or confirmation to medical diagnosis that were not known prior to the patient’s demise. Anatomical is the third type of autopsy. It is also called academic autopsy, and it is a type of autopsy, performed by students only for study purposes. The last type of autopsy it the virtual autopsy or medical imaging autopsy. This kind of autopsy is normally performed through the utilization of imaging technology only (Williams, 2014). They are normally two; primarily magnetic resonance imaging (MRI) and computed tomography (CT).
An autopsy can also be called a post mortem examination, this is a dissection of a corpse that is carried out to help determine what caused the death and help in the examination of the effects caused by the disease. Autopsy was often viewed negatively, throughout history, and was even prohibited due to religious laws. This act caused many delays in the advancement of this technique and even went a notch higher and prevented any development in this field foe over a century (Maeda et al., 2014). Greek physician known as Galen of Pergamum completed the earliest records of autopsy in history. Galen had studied the symptoms of a patient and examined the affected body parts. He managed to make the connection between what the patient feels, what he could actually see and what came up during the dissection. Glen had this belief that there were four circulating humors that diseases were connected to and they included; blood, black vile, yellow vile and phlegm. This theory went on for 1400 years where it was believed that disease was connected to the fluids in the body. This crippled medical science (Miller & Wright, 2013).
There was no advancement to medical science in the beginning of the middle age this is because dissecting the human body without decree from religious leaders was considered a crime. This shifted during the Italian Renaissance when known artist Leonardo da Vinci and Michelangelo began carrying out their own dissections on human body for anatomical study. Other physicians emerged during this period such as, Morgagni, who did away with the four-humor theory with tangible evidence that illness could be traced through the body (Geberth, 2016). These observations by these physicians who were also noted, and the increasing support of religious organizations opened the door for continues study. Herophilus of Chalcedon, a Greek physician was the first anatomist to perform autopsy on animals and humans. He did this on a regular basis in Alexandria and had records on human anatomy. He came up with numerous scientific terms that are used to this day, medical scientific terms, these terms are used in the description of anatomical phenomena he was also responsible for the discovery of the anatomical distinction between arteries and veins (Becker et al., 2018). He was also the person who came up with the existence of the motor and sensory nerves and the differences between them.
The performance of autopsy became increasingly popular in 1800’s. This was also due to the more regulated practices of established medical examiners. Karl Rokitansky of Vienna was the pioneer of the introduction of modern day autopsy. Karl had completed more than 30,000 autopsies and supervised almost 70,000 autopsies in the course of his career. He was the first to thoroughly examine ever body part with a systematic approach. Even though, it was his immediate competitor Rudolf Ludwig Karl Virchow, who first used the microscopy in the examination of each body organ (Fottrell & Byass, 2010). With the use of a microscope, Virchow could prove that the basis of understanding disease was through cellular pathology. In the modern times, the study of general pathology has flourished while that of autopsy has declined. The introduction of technology to this activity has made the clinical autopsy out dated. The feeling of many physicians is that post mortem examination would not reveal any conditions that are new that were not detected clinically (Hill & Anderson, 2016).
It is during the reign of Holy Roman Emperor II. Frederick, that the first law to authorize human dissection was established following a decreed by the Emperor. He decreed that the medical students receive at least two bodies only of executed criminals. This was to be done early for their study and demonstrations. Teachers and students did not perform this process themselves, as it was during the renaissance (LeDuff, 2014). They watched when “lay dissector” opened the cadaver, as they congregated in an operating theater. Leonardo da Vinci and Michelangelo were responsible for these autopsies. They performed a number of autopsies by dissecting corpse and observing the anatomy unseen by the naked eyes.
The first autopsy in the modern world took place when there was an order from the Catholic Church to perform an autopsy on the conjoined infant twins, Joana and Melchiora, who passed on just eight days after their birth. This autopsy was being performed mainly to determine if the twins shared a soul. The priest even took precautions to baptize them separately because he was not sure whether they were a representation of two souls and two bodies or just a soul and a body. This was in 1533 (Goodman, 2011). In 1539, a Paduan Judge granted physicians the right to dissect corpses but only those of executed criminals because he also shared interest in anatomy mainly in Professor Andreas Vesalius’s work. Later on Vesalius published his accurate documentation of human anatomy titled De Humani Corporis Fabrica Libri Septem meaning the Seven Books on the Structure of the Human Body. Through this book, he disapproved the theory of the four humors (McFarquhar, 2011).
French physician Xavier Bichat, who was considered the father of histology and also of tissue pathology, became the very first person to take a deeper look than the organs. He looked past dissecting of the organs and analysis of the tissues that comprises these organs. He concluded that, it is in 21 parts that the human body can be broken into (Draper et al., 2015). These 21 parts comprises of different tissues, structural elements making up organs and the vital functional. It is through autopsy that Dr. Dorothy Reed Mendenhall proved that Hodgkin’s disease was not a form of tuberculosis. She even when a notch higher and discovered the blood cell disorder characteristics that comprises the disease (Turvey, 2011). One of the first high-profile murder cases that involved autopsy was that of Bernard Spilsbury a forensic pathologist who linked George Smith to murdering his three wives each in a bathtub.
The new technology continues to improve the current life expectancy and development of new information about various pathologies through diagnosis and treatment; this is due to the progressive evolution in medicine. It only in extreme cases or during forensic investigations that the autopsy is used to investigate (Becker et al., 2018). It is through an autopsy, that an accurate and complete diagnosis can be made. The autopsy is viewed as a compulsory part of medicine. It does not only establish the final diagnosis but also relates the cause of death to the associated pathologies and explains the connection between the two. It is through an autopsy that the evaluation of the presence of human disease in a patient and understanding the extent of the disease is made possible (Williams, 2014). The effectiveness of therapeutic procedures this is for the benefit of the patient families, the staff performing the autopsy and even for future practice of medicine, an autopsy is important.
Autopsy’s by nature are diagnostic, and can be used by the family to learn more about what caused the demise of their patient. For instance, it is through an autopsy that an unknown primary cancer could be identified. It can even allow an examination that were not feasible when the patient was alive to be carried out. Moreover, it is regarded as the best forum place, or action that can allow the clinical get the best opportunity to obtain a complete understanding of why a patient passed (Miller & Wright, 2013). It is through autopsies that clinicians, forensic science interns, medical students, assistant students and other staff members, are able to gain more knowledge on the various diseases processes and their manifestation in the body. These tissues will help in the, in certain programs, to further the education of the student. It is through this activity that an in-depth understanding on the rate and complicated cases can be gotten. Hence helps in coming up with solutions to these cases or even preventive measures (Geberth, 2016). A good example is the emergence of HIV/AIDS. If autopsy was not being carried out, then probably this disease would not be known and a lot of lives would have been lost.
The existing diagnostic tools normally do not provide 100% certainty on the existence of the entity of a specific disease this is according to the imperfect correlation between pre and post mortem findings. Important information concerning the rate of discrepancies between histology and clinical diagnosis is gotten through autopsy. The accuracy of existing diagnostic tools can be checked trough autopsy (Fottrell & Byass, 2010). Autopsy can be used in the understanding of pathophysiology. There are numerous examples of the importance of autopsy in elucidating pathophysiological mechanisms of diseases in the ICU. Extensive research has shown a consistent, almost close relationship between glucose level in hospitalized patients and adverse clinical outcome. This has been seen even in patients without diabetes that has been established (Hill & Anderson, 2016). The clarity of whether glycaemia serves as a mediator of adverse outcome or just as a marker of illness. According to earlier studies it is suggested that, a clinical benefit from strict glucose control during critical illness. Just recently, the beneficial findings of tight glycemic control were questioned. Autopsy is the only way that might be of help in elucidating the potential toxic effects of hyperglycemia on various organs. Through the autopsy, the physicians managed to come up with a conclusion. Autopsy can be used as an integral part of the safety analysis of a new drug (LeDuff, 2014). Natalizumab, a novel antibody directed to the adhesion molecule a4 integrin, was marked as a factor risky for the development of progressive multifocal leukoencephalopathy in patients with crohn’s disease. This was so through the use of autopsy.
The use of autopsy benefits the society as a whole. An autopsy is useful in the evaluation of diagnostic tests. It is through autopsy that an evaluation of new diagnostic tests and assessment can be done on new therapeutic interventions, such as drugs, devices and surgical techniques, and also the investigation of occupational and environmental diseases. Through the data, acquired from autopsy, the valid mortality statistics can be known. This can be proven by the differences in the data derived from death certificates in the absence of an autopsy data, which has often been proven to be inaccurate. The new medical knowledge on new existing diseases that is known through autopsy-based research is important to everyone. This information is essential in getting to know necessary precautions against such diseases and even get started on ways of coming up with the cues to such diseases. The rate at which new diseases are emerging is alarming and this can only be fully investigated through autopsy.
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