ET–20 will cover the autopsy, also known as necropsy or thanotopsy, a postmortem examination performed to confirm or determine the cause of death. Performed by a pathologist, it is a meticulous study of the body by surgical dissection after death. The cells, tissues and organs are visualized and studied by their appearance microscopically and macroscopically to identify any predisposing and immediate causes of death.
    Samples of tissues and body fluids are used for laboratory analysis and to determine the extent of the disease process or toxicology testing. At one time, the autopsy was a part of the accreditation process for training/teaching hospitals.
    Rationale:

• P.M. examinations increase knowledge and high quality medical practices
• P.M. confirms medical diagnoses for death certificate
• P.M. supports medical research
• P.M. supports public health and the care of the living patient
• P.M. determination of possible criminal act causing the death
• P.M. adds to the preparation time of the body
• P.M. examinations benefit the practitioner in specific causes of death

    Permission for an autopsy is the responsibility of the hospital personnel. The embalmer/funeral director is not part of the family’s decision process nor should be negative toward the process.
    Any involvement on the part of the decision may make you liable for damages. It’s the responsibility of the hospital/medical examiner or coroner to verify the authorization prior to the release of the body.
    The autopsy permission must come from the next of kin, husband or wife, father or mother, son or daughter, or individual responsible for final disposition. The same holds true with the donor program. Review the laws concerning permission for autopsy or organ donation.
    The coroner or medical examiner has the jurisdiction in all medicolegal situations and may authorize an autopsy.
    The embalmer should be aware of those situations which may require an autopsy:

• Natural deaths where individuals were not attended by private physician in home or home
• Newborn children within the first 24 hours after birth
• Predisposing and intermediate injuries
• Unknown causes of death
• Suspicious deaths
• Abortions
• Violent deaths – stab wounds, burns, electricity, shootings, and lightning
• Accidental deaths – drowning, strangulation (hanging)
• Sudden deaths
• Homicides
• Suicides
• Poisoning
• Stillborn
• Premature infants

    An autopsy may be conducted in the preparation room within the funeral establishment. This is at the discretion of the pathologist. This may be a support function of the local funeral home when other facilities are not available.
    If this option is utilized by the pathologist you must require universal precautions in your facility. Prior to the autopsy the doctor would have some idea of the predisposing conditions which led to death. Embalmers may only have common sense as their guide.
    Street clothes with an apron and gloves are not proper protective clothing while working in the preparation room. Guidelines to standard operation procedures must be in writing.
    The body lying on the preparation table continues to require us to have consideration, dignity and respect. To handle the body gently and compassionately is the mark of a professional. The genital region should be covered at all times unless a procedure such as examining, washing, packing of the rectum or vagina, or tying of the penis necessitates exposure.
    There must be no eating or smoking in the preparation room at any time. Doing so provides a medium for cross contamination (fingers) of hepatitis, tissue gas organisms and staph infections.
    The preparation should be private, only licensed personnel should be admitted during any procedure.
    A preparation room should be in the order of a hospital operating room, designed to provide a clean, safe working environment. Air exchange should be a minimum of 12 times per hour.
    ET–21 will continue with the autopsy and will cover autopsy procedures.