5 Lesser-Known Facts About Autopsies

Essential Insights

According to alleged witnesses, Peter Howseley was fatally attacked. The incident occurred in 1690, when Howseley, a London resident, died under suspicious conditions. Some city dwellers claimed to have witnessed two men striking him on the head with a sword and a cane. He allegedly succumbed to his injuries within a month.

Such testimony would typically be incriminating. However, when a group of doctors and surgeons inspected Howseley's skull, they discovered no signs of head injuries. The professionals determined that his death was due to natural causes and was "nonviolent."

Post-mortem examinations date back to ancient times, but during Howseley's era, they were still rare. Over the next 300 years, advancements in medicine made them standard practice in many regions worldwide.

In the U.S., the responsibility of examining deceased individuals to determine their cause of death falls on forensic pathologists, medical examiners, and coroners. Filmmakers often sensationalize this work with graphic scenes of bloodied bullet extractions. However, many aspects of autopsies rarely make it to the big screen.

Autopsies include mundane tasks like fecal matter removal — a detail that doesn’t translate well to cinematic drama. Additionally, the costs can be surprisingly high, particularly when not covered by government funding. From bodies undergoing multiple examinations to revealing dietary evidence, here are some intriguing and lesser-known facts about autopsies.

5: Organs Are Weighed

Before an autopsy begins, the body's weight is recorded while still intact. Following this, each organ is carefully removed and weighed on its own. This process is crucial as certain conditions can alter organ sizes. An abnormally heavy heart or stomach, for instance, might provide critical clues about the cause of death.

To access the chest cavity, a rubber block is positioned under the torso to elevate the ribcage. A Y-shaped incision is then made, starting at the base of the sternum and extending down to the pelvis, with two diagonal cuts reaching up to the shoulders. Tools like rib cutters, bone saws, or even pruning shears are used to remove the ribcage, exposing the body's primary organs. (The brain is removed through a different procedure.)

The coroner may extract vital organs individually, though in certain cases, removing them in groups or blocks is more practical, preserving their connections for further examination.

Each organ must be meticulously weighed and measured. While this may seem laborious, it’s often the most effective method to detect specific conditions. For instance, an unusually heavy heart could suggest myocardial hypertrophy, while kidney size variations may indicate chronic progressive nephropathy.

Determining abnormalities requires a baseline of normalcy. Medical examiners refer to tables or charts detailing the average weights and sizes of organs. Age is a critical factor, as organ dimensions differ significantly between infants and adults.

4: They're Not Cheap

Who covers the cost of an autopsy? Usually, the requesting party finances the procedure. In cases of suspicious deaths, a state or county may order a forensic autopsy, with taxpayers bearing the expense. If the government doesn’t mandate one, the deceased’s family can request it, though they might need to pay privately.

As reported by Frontline, most insurance policies exclude autopsy costs, forcing families to hire private autopsy services. Alternatively, they can pay the local medical examiner or coroner’s office for a detailed examination. However, private autopsies can cost between $3,000 and $6,000.

Hospitals may offer a more affordable solution. While some charge high fees, others provide autopsies for former patients free of charge. However, these hospitals might lack the necessary facilities and instead outsource the procedure.

Before the 1970s, U.S. hospitals were mandated to perform autopsies on at least 20 percent of deceased former patients. This requirement was abolished in 1971.

The decline in hospital autopsies over the past 50 years can be partly attributed to this policy shift. (Another factor was the advancement of body-scanning technologies.) In the 1940s, approximately 50 percent of deaths in U.S. hospitals were followed by an autopsy. By 2017, this rate had plummeted to 5 percent nationwide. Today, many hospitals in the U.S. no longer conduct autopsies on-site.

3: Families Can Block Autopsies

According to New York State law, if a surviving family member or friend claims that an autopsy violates the deceased’s religious beliefs, the procedure cannot be performed unless there is a "compelling public necessity."

What does this entail? Essentially, coroners and medical examiners in New York can override religious objections to an autopsy, but only under specific conditions: a) if it’s part of a criminal investigation, b) if the death is tied to a significant public health crisis, or c) if a court approves a formal petition, citing a "demonstrable need for an autopsy or dissection."

States like Louisiana, California, Maryland, Ohio, New Jersey, and Rhode Island have similar laws. Minnesota adopted comparable regulations in 2015 after a medical examiner attempted to perform autopsies on an Ojibwe man and a Chippewa woman who died in separate car accidents. This action deeply upset their communities, as it violated the Midewiwin religion’s traditional burial practices. (Orthodox Jews often share similar concerns about posthumous body alterations.)

In states such as Florida and New Hampshire, religious objections to autopsies are evaluated individually. However, a universal rule across all states is that families cannot block an autopsy on religious grounds if authorities suspect foul play or believe the death poses a public health risk, such as a dangerous disease.

2: Your Last Meal (and Your Poop) Can Contain Forensic Clues

If you’ve never been told to "run the bowels," consider yourself lucky. This term refers to one of the messiest tasks in an autopsy: opening the intestines. Once removed, these organs are sliced horizontally. Given that the combined length of an adult’s small and large intestines is approximately 25 feet (7.6 meters), this process is far from simple.

While extracted feces are typically flushed down a medical sink, they can sometimes aid in diagnosis. Hardened stool may signal fecal impaction, a dangerous condition where the colon becomes blocked. Beyond feces, examining the intestines can uncover polyps, tumors, and other findings valuable to pathologists.

Undigested food also plays a role. Food usually remains in the stomach for about four to six hours before passing into the intestines. If identifiable food is found in the stomach during an autopsy, it suggests the individual died shortly after eating.

This type of evidence can be invaluable. In 2010, two masked men attempted to rob an Oregon coffee kiosk at gunpoint. The situation escalated when the barista drew his own weapon, resulting in one attacker’s death and the other’s escape.

During the examination of the deceased gunman’s stomach, a half-eaten french fry was discovered. Potatoes are quickly digested, typically breaking down within an hour. This indicated the man had eaten his final meal shortly before dying. Additionally, an expert identified the partially intact fry as one from Wendy’s. Investigators reviewed security footage from a nearby Wendy’s, leading to the identification and arrest of the surviving suspect.

1: One Body Can Undergo Multiple Autopsies

An autopsy isn’t comparable to repairing a car. While a mechanic can reassemble a steering wheel perfectly, once a deceased person’s ribs are cut, they cannot be restored to their original state.

Performing a second or even third autopsy on a previously dissected body poses significant challenges. Fluids removed during the initial examination are often not preserved for further analysis. Additionally, the rearrangement of organs can complicate the process, leaving the second pathologist to piece together a complex puzzle. Photographs and detailed notes from the first autopsy are invaluable in such cases.

Despite these obstacles, experienced pathologists can often accommodate requests for additional autopsies. Follow-up examinations may reveal new evidence, such as insights from molecular-level dissections not conducted initially or a deeper investigation into overlooked areas of the body. By comparing new findings with the original autopsy results, investigators can gain a clearer understanding of the events leading to the individual’s death.

Experts note that while subsequent autopsies may uncover new details, they rarely contradict the conclusions of the first examination unless it was poorly conducted. However, a second autopsy can serve as a quality check and offer peace of mind to the deceased’s family.