When someone dies and it’s not clear why, a doctor usually conducts an exam of the body. That’s called an autopsy.
If you and your family are dealing with the sudden loss of a loved one, you may find comfort in getting answers at this difficult time. But you should also know that autopsies don’t always have to be done. If you do need one, it’s usually both a medical and a legal process.
You can ask for an autopsy if you have questions about how a family member died. And sometimes doctors will ask your permission to do one if they have questions.
Coroners and Medical Examiners
Every local government has an official who records deaths. They’re called either a coroner or a medical examiner.
All but a handful of states require medical examiners to be doctors. Coroners may be doctors as well, but don’t have to be.
Coroners are usually elected officials. Many of them have no medical training. When an autopsy needs to be done, they rely on a medical examiner.
What Happens In an Autopsy?
A doctor examines the remains inside and out. They can remove internal organs for testing and collect samples of tissue or bodily fluids such as blood.
The exam usually takes 1 to 2 hours. Many times, experts can figure out the cause of death in that time.
But in other cases, you might have to wait until a lab can do more tests to look for signs of drugs, poisons, or disease. That can take several days or weeks.
In 20 states and the District of Columbia, a pathologist -- a doctor who specializes in the study of disease and injury -- has to do the autopsy.
Once it is finished, the doctor will report an exact cause of death and how they think it happened -- whether someone died from natural causes, an accident, homicide or suicide.
When Is One Required?
Although laws vary, nearly all states call for an autopsy when someone dies in a suspicious, unusual, or unnatural way.
Many states have one done when a person dies without a doctor present. Twenty-seven states require it if the cause of death is suspected to be from a public health threat, such as a fast-spreading disease or tainted food.
When Is It Optional?
A doctor might ask you to allow an autopsy if your loved one died of an unexpected illness.
They’re usually trying to learn more about what happened, either to ease your mind, to learn whether other family members might be in danger of the same thing, or to find out something that might help other patients.
In some cases, a condition that a person had in life can only be diagnosed after they die. For instance, doctors can learn for certain that someone had Alzheimer's disease only after they examine the brain in an autopsy. It’s up to the family to decide whether to allow it.
The dead person’s next-of-kin also can ask for an autopsy if there are some concerns about why someone died. In addition to public officials, some private firms do them for a fee.
Family Wishes and Faith
Some religious traditions discourage autopsies, believing a person’s body should be kept whole or otherwise left alone after death. Or they say burial should not be delayed.
Many states have laws that honor religious objections. Medical examiners sometimes change the way they do an autopsy out of respect for the family’s beliefs. But states still require one when it’s needed to investigate a crime or head off a threat to public health.
Most examinations shouldn’t delay a funeral or prevent a viewing of the body during a service. Funeral directors are usually able to hide any signs of the autopsy with clothing.