Monday, October 9, 2017

PBS 1.3.1 Autopsy

Section 501.1
Coroners may find the following definition of forensic pathology useful to their work. Forensic pathology isthe branch of medical practice that produces evidence useful in the criminal justice administration, public health and public safety. Under this definition are three key elements: Cause of Death, Manner of Death and Mechanism of Death.
The cause of death related to the disease, injury or abnormality that alone or together in some combination initiates the physical and biological malfunctions that eventually leads to death. The cause of death can be thought of in terms of underlying or immediate cause of death. For example, a driver of an automobile dies in a single vehicle accident. The autopsy discloses that the driver had a blood alcohol level of 0.25 and the driver's heart had been pierced by a metal rod. The underlying cause of death would be penetrating trauma to the chest, the mechanism of death would be heart failure due to the penetrating metal rod, and acute alcohol intoxication would be listed as a contributing factor.
The manner of death pertains to the way the death occurred. Social relationships and personal causation are two elements involved in determining manner of death. Examples are the self-inflicted injuries of a suicide victim and the fatal injuries incurred as a result of an accidental fire in a home. The usual classifications of death are: natural, accident, suicide, homicide or undetermined.

The mechanism of death refers to the process of death, in which failure of one or more vital organs due to injury, disease or natural events. For example, the mechanism of death for many diabetics is kidney failure. Other body organs, such as the liver, are adversely affected by kidney failure and death may follow. The actual cause of death may be due to heart or liver failure, but the diabetes was responsible for initiating the death process.

Caution: The pathologist will, or may, offer both a cause and manner of death in his/her report of the post- mortem. However, the coroner is not bound by this report in determining manner of death. Often you will have additional information that was gathered at the death scene. This additional information and the results of the autopsy will often allow you to reach a more accurate determination of the manner of death.

Note: If there is a disagreement with the findings of the pathologist, the coroner and pathologist should strive to arrive at a consensual view. This is necessary, as such a disagreement could prove embarrassing to one or both parties, if it is brought out in court at a later date.

Note: The mechanism of death should not be noted on the death certificate. (It is unnecessary and could create
confusion or doubt in non-medical personnel.)

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