G. Autopsy 1. General principles 148. Paragraph 25 sets out the aims of an investigation into a potentially unlawful death. To achieve these aims, the necessity for an autopsy should be considered. With the exception of identifying possible witnesses, all of the aims rely to some extent on an autopsy being performed, so helping to achieve them becomes a key duty of the forensic doctor, who must be well trained and experienced. 149. While the duties of clinical doctors are generally understood by the public, this is not the case with respect to forensic doctors.105 The duties of forensic doctors in relation to death investigations are: (i) to help ensure that the identity of the deceased is established; (ii) to help ensure that the cause and circumstances of the death are revealed; and (iii) to exercise care and skill in this work. The discharge of these duties requires an understanding of the basic aims of the autopsy. These aims are to: (i) discover and record all the identifying characteristics of the deceased (where necessary); (ii) discover and record all the pathological processes, including injuries, present; (iii) draw conclusions about the identity of the deceased (where necessary); and (iv) draw conclusions as to the cause of death and factors contributing to death.106 In situations where the circumstances of death are unknown or in question, a forensic doctor should apply the autopsy findings and conclusions to the reconstruction of those circumstances. If possible, the doctor should attend the scene of death, preferably with the body in situ.107 150. A forensic doctor should record the positive and relevant negative observations and findings in such a way as to enable another forensic pathologist at another time to come to his or her own conclusions about the case independently. As forensic pathology is essentially a visual exercise, this involves a dependence on good quality – preferably colour – photography. 151. The autopsy report may be used by the authorities and others to help determine if the deceased was assaulted (including whether they were tortured or maltreated), and if the injuries either caused or contributed to death. On this basis, the autopsy report must not only include a list of the findings and injuries, it must also provide an interpretation of them. If the forensic doctor believes that specific injuries have been inflicted by a particular mechanism, such as might occur during torture, for example, then he/she is strongly encouraged to provide that opinion in writing in the autopsy report. In addition, if a group of injuries, when considered together, imply a certain pattern of inflicted maltreatment, this should also be clearly stated in the autopsy report. While the forensic doctor may not make the final determination of whether the deceased was assaulted (or tortured), it is his/her duty to interpret and explain, if at all possible, how the injuries occurred. If the connections between the observed injuries and the mechanism of infliction are not made by the forensic doctor, then the main value of actually performing the autopsy – helping to find the truth behind the death – may be lost. 152. The Detailed Guidelines on Autopsy should be followed to the extent possible given the resources available. The forensic doctor should request additional resources if they are regarded as necessary or desirable in the circumstances of the case. Use of the Guidelines will permit valid and reliable conclusions to be reached, thus contributing to the correct resolution of controversial cases. It will also thwart the speculation and innuendo that are fuelled by unanswered questions in the investigation of an apparently suspicious death. 153. The Detailed Guidelines on Autopsy include guidance on the detection of torture as an aidememoire for forensic doctors who may not be experienced in the assessment of such cases. The Detailed Guidelines on Autopsy are supported by the Detailed Guidelines on the Analysis of Skeletal Remains. 105 In this document, forensic pathologist, forensic doctor and prosector are used interchangeably. The last term refers to the person undertaking the autopsy. 106 See, e.g., M. El-Nageh, B. Linehan, S. Cordner, D. Wells and H. McKelvie, Ethical Practice in Laboratory Medicine and Forensic Pathology, WHO Regional Office for the Eastern Mediterranean, Alexandria, Egypt, 1999, pp. 38–39, at: www.emro.who.int/dsaf/dsa38.pdf. 107 This excerpt relates to the duties of the prosector in a forensic autopsy generally, not specifically one involving a potentially unlawful death. In the latter case, the expectation will be that, if possible, the forensic doctor will attend the scene of the death, usually at the request of the police. 27

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