One of my friend was admitted in a government hospital with fever. He was in the hospital for almost a month. They did hundreds of test and the doctors could not find out the exact disease. Unfortunately, he passed away while in the hospital. Then the doctors forced us to do post-mortem. I want to know, after a person is dead what are they going to achieve by performing a post-mortem?
Post-mortem is essentially a part of the death investigation. The rules governing this investigative system may slightly differ between countries or regions. The outcome of this could be useful for several parties including registrar of births and deaths, judicial officers, medical officers, insurers, public and living family members of the deceased. There are many indications for post-mortem examination. This includes death due to violence, accident, suicide, suspicious death, medical negligence, natural disaster and so on.
The question posed here describes a scenario where a person has died in the hospital without an established diagnosis. This death is not related to any unnatural incident such as violence. So the important question that we need to answer is; “diagnosing the illness by post-mortem examination even if possible, will it serve any purpose?”
Discussing about all the benefits of post-mortem examination is beyond the scope of this article. Therefore, the following is an attempt to provide an explanation specific to the given scenario.
- Establishing the cause of death – Ascertaining the cause of death is the responsibility of the treating doctor. In some situations, the cause of death may not be apparent. In which case the doctor is legally bound to refer the death to judicial medical officer (JMO). The JMO has the authority to decide if an autopsy is required to confirm the cause of death. “Cause of death” is important section to be furnished while registering a death. Registering death according to country’s regulation is vital due to various reasons.
- Preventing infections – Certain diseases are infectious (e.g. illnesses caused by influenza, corona or Ebola virus) and may harm those who handled the deceased. Sometime it may spread to the general public as well. Therefore, diagnosing these infections will be help to halt the spread of those infections.
- Understanding about diseases – Sometimes post-mortem examination helps doctors better understand about some rare diseases. This can aid treating any future patient with same type of illness.
- Genetic conditions and the implication on family members – Certain diseases run in families. They are transmitted through genes from parents to their children. Identifying a genetic disease in a dead person may prompt the doctors to look for the same illness in other family members. Some of those conditions are better managed if diagnosed early.
- Medical errors – Some deaths can occur due to errors in medical treatment. The autopsy may help determine if medical error or negligence is involved or not. This will help the victims to receive compensation and the healthcare personals to rectify their mistakes in the future.
- Occupational health hazards – Certain deaths can result from exposure to toxic agent at workplace (e.g. asbestos exposure – lung cancer). Diagnosing these conditions can help compensate the victims. They also provide information for government authorities to implement laws to minimise such occupational diseases.
- There had been some deaths where the doctors failed to diagnose the illness due to unusual presentation. Later it turned out to be due to some poison or medicinal product. In such situation the relatives may not have any suspicion regarding the death. But the treating doctor may not be able to come to a conclusion without post-mortem examination.
These are the possible reasons for performing post-mortem examination in your friend’s case. The doctor who treated this patient would give the exact reason for performing post-mortem if inquired. The same reason would have been recorded in the post-mortem report given to the relatives of the deceased.
Islamic perspective of performing post-mortem
Islam considers human body to be sacred even after death. Prophet Muhammad (PBUH) has said; “Breaking the bone of a dead person is similar to breaking the bone of a living person.” (Sunan Abu Dawud, Sunan Ibn Majah and Musnad Ahmad)
However, majority of the scholars agree that post-mortem is permissible in certain situations. This includes determining the cause of death, diagnosing an illness – especially if it is contagious and investigation of a criminal case. Some consider dissecting the dead body for educational purpose is acceptable under the following conditions;
- The deceased should have given permission to dissect his/her body prior to the death, or the family of the deceased must give permission after the death.
- The dissection should be limited to whatever is necessary. Should not tamper unnecessarily with the body of the deceased.
- The bodies of women should be dissected by females only. If there is no qualified female available, a male can perform the dissection.
- Islam Question and Answer. 2007. Dissecting dead bodies in order to learn medicine. January 26. Accessed October 09, 2019. https://islamqa.info/en/answers/92820/dissecting-dead-bodies-in-order-to-learn-medicine.
- Islam Question and Answer. 2015. Ruling on taking samples from the deceased for the purpose of testing. January 15. Accessed October 09, 2019. https://islamqa.info/en/answers/114834/ruling-on-taking-samples-from-the-deceased-for-the-purpose-of-testing.