An autopsy (post-mortem examination) is an examination of a dead body. This is done in most cases to determine the cause, mode and manner of death. Other purposes of autopsy are to confirm or disprove pre-death diagnosis, evaluate drug strategy and for legal requirement. This procedure is usually carried out by a pathologist. The 4 types of autopsy are clinical or hospital autopsy (diagnosis of diseases), medicolegal or forensic autopsy (for legal issues, e.g. homicidal cases), family autopsy and academic autopsy
In Nigeria, there are some reservations about autopsy mainly due to cultural and religious beliefs. Many people believe a dead body should not be desecrated. Some religious beliefs demand immediate burial while some think autopsy provides opportunity for ritualists.
In reality autopsies are very important
From a clinical perspective, an autopsy has broad usefulness. During an autopsy, all organs in the body from the head to toes including body fluids are thoroughly physically examined, microscopically studied and in some cases toxicologically analyzed. From this procedure, any medical issue may be detected and reported in the autopsy report; this could include but not limited to undiagnosed hereditary medical issues which could in turn save a family to help them manage those who are alive.
From the medicolegal perspective, forensic examination after an incident is necessary to ensure all circumstances are documented. Indeed an assumed obvious death might not be that obvious. For example, someone could have been involved in a car crash which led to death, ruling the death as an accident could be wrong, but with an autopsy it could be found that the person had a heart attack which led to the crash; this could be correlated with other forensic analysis such as forensic toxicology which would indicate if the deceased was under the influence of any substance; forensic accident analysis to know if there were any mechanical fault or bad driving behavior that resulted in the accident.
There are instances when someone dies in an accident but during autopsy, one of the findings was that the deceased had HIV/AIDS, when the wife is given the report and sees the diagnosis, although devastated, this will help her get tested and perhaps if positive, she commences treatment, thereby extending her life span.
Guy Rutty, the Chief Forensic Pathologist at University of Leicester has carried out some researches and works on non-invasive autopsies, using medical imaging to investigate cause of natural death, which could be an alternate approach for a highly cultural and religious society like Nigeria, however, a major limiting factor of this process is its inability to diagnose coronary artery disease which is the most common cause of natural death in the world and an increasing cause of death in Nigeria.
Although the non-invasive autopsy could appear favorable to Nigerians, but I am sure pathologists may not be favourable to this procedure in view of the fact that it could potentially pose a threat to their job apart from the obvious limitation of the procedure. In addition, the admissibility of this process in court, especially convincing the judge who is familiar with the traditional invasive method could pose an issue.
In Nigeria, we have phenomenal forensic pathologists like Profs. William Odesanmi and John Obafunwa who have carried out several forensic autopsies and presented their evidences in court to help explain circumstances of death. I previously worked with the latter and his team. It was such a great experience helping people understand known and unknown circumstances.
It is important that Nigerians embrace the concept of autopsy as one of the processes of a forensic investigation into an incident as this would help provide evidence to seek justice and could also help with the diagnosis of any hereditary disease to save a family and most importantly, it could help to provide closure.
