Emphasising the importance and evaluation of contributions of pre-morbid disorders to death in medicolegal autopsies

Abstract

Background: The role of the anatomical pathologist is very crucial in the investigation of deaths in suspicious circumstances. It entails thorough dissection, scrutiny of organ changes and sound intellectual processes to guide legal authorities to take proper decisions based on medicolegal reports of autopsies. Aims and Objectives: The aim of this study was to establish the presence of pre-morbid conditions in deceased persons during medicolegal autopsies and to ascertain the contributions of pre-morbid diseases to the process of death. Materials and Methods: A retrospective analysis of medicolegal autopsy records over eleven years (2007-2017) was done and the data was analyzed by simple descriptive statistical methods. The inclusion criteria were disorders that predated the medicolegal event resulting in death. Conditions known to be pathophysiological components of the medicolegal event were excluded from the study. Results: A total of 246 cases were considered but only 10 cases met the inclusion criteria. The manner of death in four of the cases within the inclusion criteria were accidental deaths, including three cases of road traffic accident and one case of aircraft crash. There were three cases of infective illness, one case of gunshot injury to the head, one case of death from occupational hazard and one case of death due to injuries from machete cuts. The pre-medical conditions in most of the cases on strict morphological assessment were incidental findings and were not deemed to be contributory in any way to the process of death. Conclusion: It is very important for the anatomical pathologist to probe meticulously for the cause of death and explain the role of every lesion seen at autopsy in the process of death. This is necessary so as to avoid doubts, the insinuations of incomplete autopsies and unnecessary controversies in medicolegal cases.