The autopsy began by the opening of the body (in contrast to the virtopsie), to extract the organs that are inspected, weighed, and dissected. Histological (or pathological) tests can also be carried out in the laboratory.
The main incision for the review of the abdomniales viscera and chest consists of a long incision in the base of the neck to pubic hair. We also practice the incision in there; It consists of an incision as its name suggests, from two branches spaced on the torso to one with the approach of the pubis. The brain is examined after removal of the scalp, and opening of the skull with a small circular saw. The other parts of the body (face and members) are rarely reviewed by dissection. After the organs in place, the incisions are sewn as carefully as possible, for the lifting of body and the funeral of the deceased.
Medical autopsy aims to establish the cause of death (issue senior, and indirect causes if there is), to determine the State of health of the subject prior to her death, and whether any treatment received were well chosen. Today, the lengthening of life expectancy and the polypathologies are often an individual died of illnesses (6 to 15). In these cases, the cause of death is not always obvious, and the autopsy is sometimes to establish the reality of the facts. Thus, an autopsy may reveal up to 25% error diagnostics, one-quarter of these that can significantly change the support of the patient.
Fetal autopsies are performed in two indications: death in utero fetal and after medical termination of pregnancy for fetal malformations. In the first case it allows to determine or clarify the diagnosis, additional information, to correct an estimate of the probability of recurrence during subsequent pregnancy. In the second case, autopsies, rarely normal, allow a diagnosis of quality of prenatal diagnosis, estimate a risk of recidivism (Amendment of advice to a pregnancy).
A second type of autopsy is those carried out by medical students on the body of individuals giving their bodies to science, to learn human anatomy.
Finally, the autopsy that practice the medical examiner is requested in the case of sudden death or suspected, at the request of justice. The caricature case is probably made up in suicide, homicide where the autopsy will determine if objective physical evidence to prove that the individual was murdered and not suicide.
In Western countries, the number of autopsies performed is in steady decline since the 1950s. In France, for example, the necropsies rate rose from less than 15% in 1988 less than 4% in 1997. The rate is variable depending on the country, significantly more important in Scandinavia, it is 12.4% in the United States (1993). Many doctors and scientists are denouncing the abandonment of Haematology practices, which tends to deteriorate the quality of care by providing more this objective eye on taking medical care had the deceased today.
It depends on the country and the goal (forensic or scientific).
The autopsy in medical or scientific purpose is authorized in certain countries (Hungary, Austria…) without the need to have the consent of the family, most however require the agreement of the [REF. necessary] relatives.
The conservation of the post-mortem tissues also raises legal problems.
In France, the medical autopsy performed for therapeutic or scientific purposes, requires the absence of refusal of the deceased, explicitly formulated, or reported by his family (section L1232-1 paragraph 2 of the Code of public health). If the deceased was a minor or a major protected (that is placed under guardianship or curatorship), the written agreement of each of the holders of parental authority or the guardian (in the case of the major protected) is required (article L1232-2 of the Code of public health). In all cases, “the family must be informed of levies made»(article_L1232-1_alinéa_3_dele_de_Code_de_la_Santé_publique), and medical protocols must be forwarded to the Agency of biomedicine (section L1232-3 of the Code of public health).
With regard to the return of the body to relatives, the obligations of the physician-law clerk differ according to the nature of the autopsy:
- If it is a medical autopsy, the doctor is required to ensure that the “best possible restoration of the body” before (article L1232-5 of the Code of public health).
- If it is a judicial autopsy, no legal provision for the restoration and the return of the body is however provided. As a result some drifts were observed. The Ombudsman of the Republic, notified of these problems, has applied to the Ministry of Justice of these legal gaps.