AUTOPSY

WHAT IS AUTOPSY
The word autopsy is derived from
the Greek word autopsia: "to see with
one's own eyes."

WHAT IS AUTOPSY
An autopsy is the examination of
the body of a dead person and is
performed primarily:
1. to determine the cause of death, to
identify or characterize the extent
of disease states that the person
may have had, or
2. to determine whether a particular
medical or surgical treatment has
been effective.
WHAT IS AUTOPSY
Forensic autopsies are
autopsies with legal implications and
are performed to determine if death
was an accident, homicide, suicide,
or a natural event.
Autopsy Room
Guidelines in the Performance of
Autopsies
1. Be it an official (medico-legal) or non-official autopsy, the
pathologist must be properly guided by the purposes for which
autopsy is to be performed. In so doing the purpose of such
dissection will be served.

2. The autopsy must be comprehensive and must not leave some
parts of the body unexamined. Even if the findings are already
sufficient to account for the death, these should not be a
sufficient reason for the premature termination of the autopsy.

3. Bodies which are severely mutilated, decomposing or
damaged by fire are still suitable for autopsy. No matter how
putrid or fragmentary the remains are, careful examination
may be productive of information that bears the identity and
other physical trauma received.

4. All autopsies must be performed in a manner which shows
respect of the dead body. Unnecessary dissection must be
avoided.

Guidelines in the Performance of
Autopsies

5. Proper identity of the deceased autopsied must be
established in non-official autopsy. An autopsy on a
wrong body may be a ground for damages.

6. A dead body must not be embalmed before the autopsy.
The embalming fluid may render the tissue and blood
unfit for toxicological analyses. The embalming may
alter the gross appearance of the tissues or may result
to a wide variety of artifacts that tend to destroy or
obscure evidence.

7. The body must be autopsied in the same condition when
found at the crime scene. A delay in its performance
may fail or modify the possible findings thereby not
serving the best interest of justice.

Mistakes in Autopsies

1. Error or omission in the collection of evidence for
identification

2. Errors or omission in the collection of evidence
required for establishing the time of death

3. Errors or omission in the collection of evidence
required for other medico-legal examination

4. Errors or omission result in the production of
undesirable artifacts or in the destruction of valid
evidence


Negative Autopsy
An autopsy is called a negative
autopsy if after all efforts, including gross
and microscopic studies and toxicological
analyses, fail to reveal a cause of death. It
is an autopsy which after a meticulous
examination with the aid of other
examinations does not yield any definite
cause of death.

This should be distinguished from
Negligent Autopsy wherein no cause of
death is found on account of imprudence,
negligence, lack of skill or lack of foresight
of the examiner.

Autopsies vs. Post-mortem Examination
Autopsy - indicates that, in addition to
an external examination, the body is
opened and an internal examination is
conducted.

Post-mortem Examination - refers to an
external examination of a dead body
without incision being made, although
blood and other body fluids may be
collected for examination.



Aims and Objectives of Medico-Legal
Autopsy:
To determine exact cause and manner
of death.
To establish identity of the deceased.
To determine time since death.
To collect trace evidence.
Reconstruction of the crime scene
A. Hospital or Non-Official Autopsy:
This is an autopsy done on a human body
with the consent of the deceased person's
relatives for the purpose of:

1. determining the cause of death;
2. providing correlation of clinical diagnosis and
clinical symptoms;
3. determining the effectiveness of therapy;
4. studying the natural course of disease
process;
5. educating students and physicians.
B. Medico-Legal or Official Autopsy:
This is an examination performed on a dead
body for the purposes of:
1. determining the cause, manner (mode), and
time of death;
2. recovering, identifying, and preserving
evidentiary material;
3. providing interpretation and correlation of
facts and circumstances related to death;
4. providing a factual, objective medical report
for law enforcement, prosecution, and defense
agencies; and
5. separating death due to disease from death
due to external cause for protection of the
innocent.
C. Anatomical or Academic Autopsy
performed by students of anatomy for
study purpose only

D. Virtual or Medical Imaging Autopsies
performed utilizing imaging technology
only, primarily magnetic resonance
imaging (MRI) and computed tomography
(CT)
PRESIDENTIAL DECREE No. 856
SECTION 95 provides:
Persons authorize to perform:
1. Health officers;

2. Medical officers of law enforcement
agencies; and

3. Members of the medical staff of
accredited hospitals.
Autopsies shall be performed in the
following cases:
1. Whenever required by special laws;
2. Upon orders of a competent court, a mayor
and a provincial or city fiscal;
3. Upon written request of police authorities;
4. Whenever the Solicitor General, provincial or
city fiscal as authorized by existing laws,
shall deem it necessary to disinter and take
possession of remains for examination to
determine the cause of death; and
5. Whenever the nearest kin shall request in
writing the authorities concerned to ascertain
the cause of death. (Presidential Decree No,
856)

The Civil Code states who is the rightful
person to give such consent.

Article 294 provides that the consent shall
be obtained from: 1) the spouse; 2) the
descendants of the nearest degree; 3) the
ascendants, also of the nearest degree; 4)
the brothers and sisters.

Article 305 provides that in case of
descendants of the same degree, or of
brothers and sisters, the oldest shall be
preferred. In case of ascendants, the
paternal shall have a better right.
Autopsies may be performed on patients
who die in accredited hospitals subject to
the following requirements:
1. The Director of the hospital shall
notify the next of kin of the death of the
deceased and request permission to
perform an autopsy.

2. Autopsy can be performed when the
permission is granted or no objection is
raised to such autopsy within 48 hours
after death.
Autopsies may be performed on patients
who die in accredited hospitals subject to
the following requirements:
3. In cases where the deceased has no
next of kin, the permission shall be
secured from the local health authority.

4. Burial of remains after autopsy After
an autopsy, the remains shall be interred
in accordance with the provisions in this
Chapter.
Section 2, paragraph 2, that the Provincial
Fiscal shall also cause to be investigated the
cause of sudden deaths which have not been
satisfactorily explained and when there is
suspicion that the cause arose from the lawful
acts or omissions of other persons, or from foul
play. For that purpose, he may cause autopsies
to be made and shall be entitled to demand and
receive for purposes of such investigations or
autopsies, thed of the medico-legal section of
the National Bureau of Investigation or of the
District Health Officer and the different
presidents of the sanitary divisions of the
province.
SENATE P. S. R. No. 182
Introduced by Senator Miriam Defensor Santiago
RESOLUTION
DIRECTING THE SENATE COMMITTEE ON HEALTH AND
DEMOGRAHY TO CONDUCT AN INQUIRY, IN AID OF
LEGISLATION, ON THE NEED TO STRICTLY IMPLEMENT
THE CODE ON SANITATION OF THE PHILIPPINES WITH
REGARD TO THE GOVERNMENT'S INTEREST ON
CONDUCTING AUTOPSIES IN THE PURSUIT OF JUSTICE,
AND DRAFT A LAW ADDRESSING THE NEED FOR
MANDATORY AUTOPSY IN CERTAIN CASES
PROVIDES:


An autopsy is necessary to determine the
cause and manner of death of a deceased; in
sensitive cases such as this one (in the recent hostage
crisis where a former police officer killed eight people, an autopsy was
conducted only on five of the eight victims; the other three victims were
not autopsied since the families refused based on religious grounds;
despite such refusal, the Chinese government conducted an autopsy on
all of the victims' bodies) the only way to refute any
argument of the other party which has
conducted an autopsy would be to present
one's own findings on the matter;
Findings of an autopsy will also
certainly be beneficial in either
exculpating or imprisoning the accused;

Religious concerns should not
prevent law enforcement agencies from
conducting their investigations; instead,
the government should provide adequate
measures to address the religious
concerns of the victim's family;


The legislature should consult forensic
pathologists and study the methods employed by other
countries with regard to imposing a mandatory autopsy
on victims who have been killed due to criminal actions
or accidents considered dubious by law authorities;

Since there is no special law requiring an
autopsy to be done on victims who have suffered from
crimes or from dubious accidents, i.e. accidental
poisoning of children, and death of children from abuse
but cause of death is claimed differently by parents,
then the legislature should also create measures to
flesh out those instances when an autopsy should be
mandatory;


Congresswoman Darlene Antonino-
Custodio filed House Bill No. 265 to
make Autopsies Mandatory
According to Antonino-Custodio, she finds it
rather strange that families or relatives of those who
died from criminal violence, accidents and other
mysterious circumstances to conveniently and easily
deny or interfere with the State's prerogative to have
the body examined by a mere refusing to submit the
cadaver for autopsy.
"No government investigators can fully
ascertain the proximate and contributory causes of
death of victims if their bodies are not autopsied or
when such examinations are not conducted as timely
as possible because of the refusal of their family or
relatives," she said.
NOTE:
If an autopsy determines a death to be the result of
a work or environmental hazard, it may lead to
compensation for family. If an autopsy reveals
evidence of medical malpractice, it may be the
grounds for a lawsuit.

In cases which require a medico-legal autopsy, the
dead body belongs to the state for the protection of
public interest until such time as a complete and
thorough investigation into the circumstances
surrounding the death and the cause thereof has
been completed. The physician entasked to perform
such autopsy is considered to be the authoritative
agent and representative of the state who has the
"property right" of the dead body.

NOTE:
If the person who issues a death certificate
has any reason to suspect or if he shall
observe any indication of violence or crime,
he shall at once notify the Municipal Trial
Judge, if he be available, or the municipal
mayor, who shall take proper steps to
ascertain the circumstances and cause of
death; and the corpse of such deceased
person shall not be buried or interred until
permission is obtained from the provincial
fiscal, if he be available, and if he be not
available, from the mayor of the municipality
in which the death occurred.
NOTE:
The body submitted for autopsy was identified by
Godofredos son, Edgardo.14 Pictures of Godofredos body, taken
by Armando Mancera during the autopsy, likewise establish the
identity of the victim. Moreover, the entries found in the assailed
Autopsy Report should be deemed prima facie evidence of the
facts stated therein, as there had been no proof of any intent on
the part of Dr. Lagat to falsely testify on the identity of the
victims body.
Thus, entries in the Certificate of Identification of Dead
Body are deemed prima facie evidence of the facts stated therein,
i.e., that a body has been properly identified as that of Godofredo
Ariate. This prima facie evidence of identification cannot be
rebutted by an extremely meticulous fault-finding inquiry into the
chain of custody of the body of the victim, as such body cannot
be easily replaced or substituted by ill-minded persons. [Suerte-
Felipe vs. People, 547 SCRA 462(2008)]
NOTE:
The embalming may alter the gross appearance of the
tissues or may result to a wide variety of artifacts that tend to
destroy or obscure evidence. Thus, in the case at bar, even if the
cadaver of the victim may not have started decomposing at the
time of the re-autopsy, all the same, the fact that such had
already been embalmed, any examination will likely lead to
findings or conclusion not at all accurate as to the true status of
the tissues of the body of the victim. [Yadao vs. People, 503
SCRA 496(2006)]
Sample request Format of Medico-Legal Examination
(Autopsy)


Republic of the Philippines
Department of the Interior and Local Government
NATIONAL POLICE COMMISSION
PHILIPPINE NATIONAL POLICE
_________________________________________
___________________________

MEMORANDUM

FOR : Director, PNP Crime Laboratory

FROM :

SUBJECT : Request for Autopsy Examination

DATE :

1. Request conducts medico-legal (autopsy) examination on the
accompanying specimen to determine the cause of death.

a) NATURE OF CASE :

b) VICTIM :

c) SUSPECT :

d) T D P O :

e) SPECIMEN SUBMITTED :

2. Further request that this Office be furnished a copy of medico-legal
examination result for our reference.

3. For consideration.



____________________________
(CHIEF OF OFFICE)