THAT THE CAUSE OF DEATH MAY BE CRYSTAL CLEAR: AN OVERVIEW OF AUTOPSY
Death is said to be the common pathway of all human irrespective sociocultural or religious inclinations. However, some deaths are quite sudden, unexpected and raises a lot of suspicion. As such, a lot of efforts and resources are invested into unearthing the possible cause. This practice dates far back as the ancient civilization and has evolved to what is known as autopsy today.
Autopsy, also known as post mortem is derived from the ancient Greek word autopsia, which means to see for oneself. It is a specialized surgical procedure used to determine the cause and the manner of death. The cause of death is the medical reason explaining why a patient died while the manner of the death is the circumstance surrounding the demise of the deceased. To simply put, it aims to unravel the puzzle surrounding the death of anyone.
TYPES OF AUTOPSY
There are largely two types of post mortem: forensic and clinical.
Forensic autopsy (also known as medico-legal and coroner’s autopsy) is generally performed as prescribed by applicable law in cases of violent, suspicious or sudden death, deaths without medical assistance or during surgical procedure. It is legally ordered by the coroner and does not require the consent of the next of kin.
Clinical autopsy (also known as pathological autopsy) on the other hand is aimed at determining the nature of the disease which caused the death of the patient if it remained unknown or unclear prior to death. It is also done to study the nature of the disease, even when the cause of the death has been established. Unlike forensic postmortem it does requires the consent of the next of kin.
THE PROCESS OF AUTOPSY
Autopsy is usually carried out by a pathologist, a medical professional who have specifically studied the science of diagnosing disease by examining a patient’s organs and tissues. The process of autopsy involves several steps. These are as follows:
1. Getting background information about the deceased, usually from the medical records, doctors that managed them, family and friends. This is what is called verbal autopsy.
2. Examine the external body which include inspecting the skin, measuring the body, checking the weight.
3. Y-Incision: the pathologist using a scalpel to create a Y shaped cut in the subject chest, this allows access to the major internal organs.
4. Removal of organs: next the major organs are carefully removed so that they can be examined and weighed. The state of the organ often helps the examiner to determine the cause of death or severity of a disease. DNA and toxicology are also performed at this stage.
5. Sample collection: samples from organs and body fluids like urine, blood are obtained for analysis.
6. Head and brain examination: the examiner may examine the head and brain for any abnormalities that give a clue to the cause of death.
7. Conclusion: after the examiner has completed the autopsy, the organs are placed back into the body and the incisions closed. However, sometimes parts of organs may need to be preserved for later use and to find more answers.
COST OF AUTOPSY IN NIGERIA
It is very important I discuss this. This is because, apart from cultural and religious beliefs, one of the reasons Africans especially Nigerians still frown at autopsy is because if the cost-it is assumed to be very expensive. Well, the cost (price) of autopsy in Nigeria is around N10,000 to N15,000 Naira but forensic autopsy is a little bit on the high side, it may cost as high as 300,000 Naira(most times forensic autopsies are requested by the court of law).
Our society is rife with superstitions and false claims of the evil forces of witchcraft killing another when in reality the dead may have been suffering from a chronic disease responsible for the death. Autopsy may bring such false claims to an end and establish a clear medical cause. Also, some conditions run in families, autopsy help to expose this so that living family members can be aware and take appropriate measures.
Furthermore, some deaths may be of public health importance and as such autopsy may help inform government to take necessary steps to protect the populace. Sadly, some people’s existence is cut short abruptly by the wicked actions of others. Forensic autopsy helps to unravel this and provides strong evidence in persecuting such offenders. In all, postmortem helps all to see for themselves so the cause of death become crystal clear.
There will be a separate article on religion and post mortem next week.
Written by Oshodin Osamudiamen (MBBS Benin)
Your article says alot of how far behind we are in the area of applicability of this aspect of medical practice in Nigeria. It has however, exposed the fact that not all deaths are as a result of reasons/causes hitherto purportedly claimed.