In several States legal authority is given to the Board of Health to
order an autopsy whenever the health interests of the people demand
such an investigation. Autopsies performed under such orders against
the desire of the relatives should always be carried out with extreme
care and in the presence of proper witnesses.
State and charitable hospitals cannot be made liable for autopsy
performed by Coroner or Board of Health, when the consent of
the relatives is withheld. It is high time that all charitable
institutions in this country should require an autopsy from
all patients dying within their walls. The cards of admission
should contain a clause to this effect, and such cards should be
counter-signed by the nearest relatives.
Inasmuch as some life-insurance policies contain clauses requiring
the presence of a representative of the company at the autopsy or a
forfeiture of the claims, it is best to ascertain if such policies
exist in any given case, and to notify the company. The Supreme Court
of Missouri has decided that an autopsy made in ignorance of such an
insurance clause is no bar to recovery if the company be notified in
time for a re-examination of the body.
Supreme Court decisions also hold that consent for an autopsy implies
removal of organs and tissues for microscopic study, when such is
necessary to fulfill the object of the autopsy.
One of the great needs of this country is a uniform autopsy law
and the establishment of a proper medicolegal autopsy code, as in
Germany. As conditions exist at the present, crimes may be easily
concealed, the safety of the community endangered by failures
in diagnosis of communicable affections, and our morbidity and
mortality statistics become a shame and reproach to the nation.
The majority of our medicolegal autopsies are made by ignorant
and imperfectly trained coroners and coroners’ physicians, mostly
political appointees of inferior material. We need in our medical
schools a greater amount of attention paid to the teaching of
autopsy-technique and gross pathology. The community must also be
educated to a realization of the value of autopsies. It is the duty
of every physician and layman to work diligently for the improvement
of existing conditions. Had the ideas of a former Governor of the
State of Michigan been realized there would have been compulsory
autopsies upon the bodies of every person dying within the State,
and far-reaching results would have been attained. The economic
importance of tuberculosis and the venereal diseases would have been
made clear, the profession and laity alike educated, and the progress
of preventive medicine tremendously aided.
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