Clinical Autopsy Pathology
In case of a clinical autopsy as performed by Pathology-DNA in one of the affiliated hospitals, the body of the deceased is inspected for outside abnormalities and subsequently examined internally. During this internal examination, the chest and abdomen are opened and all organs inside are inspected and examined. For each organ and for all abnormalities found during this examination, a tissue sample is kept and preserved in a formaldehyde solution, to be studied further under the microscope (see histopathology).
An autopsy is not only important to determine the correct diagnosis and cause of death, but it also plays a role in the education of residents in training for Pathology or other medical specialties, and is an important hospital tool for quality control.
Within Pathology-DNA clinical autopsies are performed- in case of a natural cause of death– to investigate illnesses and medical causes of death. Pathology-DNA does not perform forensic autopsies. In case of forensic autopsies unnatural causes of death are considered, and the corpse is confiscated by the legal authorities. These autopsies are only performed by forensic pathologists of the Netherlands Forensic Institute (NFI).
Autopsies on children and fetuses
Autopsies can also be performed on children, newborn babies or still-born fetuses. It can be very important for parents to know what caused their baby or child to die. Furthermore, the results of these investigations can have consequences for future pregnancies of the parents, or even for their brothers or sisters, or other family members when genetically inherited diseases are at play. The investigations during these autopsies are comparable to those on adults, but because illnesses and inborn abnormalities are so different from those in adults, and because they occur far less frequently, these autopsies on children, babies and stillborn fetuses are performed by pathologists who have special expertise in this field and who go through special training to keep up to date. Moreover, besides autopsies on babies and stillborn fetuses, it is also important to examine the placenta; in a substantial percentage of cases the cause of death can be found in the placenta.
Giving information and asking for permission
The pathologist can only start an autopsy when it is certain that next of kin have given permission to do these investigations and when there is certainty that death was not due to unnatural causes. Family doctors or medical specialists have to ask the next of kin of a deceased person for permission to do an autopsy. By signing the autopsy request form they indicate that informed consent has been obtained (it is unnecessary for next of kin to sign the form themselves). It is an important duty of the referring doctor to inform the next of kin in an adequate manner which procedures take place during the process of an autopsy.