In order to understand how an autopsy works, it helps to first understand what they are and why they are done.
An autopsy is the medical examination of a dead body to determine the cause of death. Autopsies are performed when someone dies suddenly and unexpectedly while in apparently good health. Autopsies may also be performed at the request of the family of the deceased.
There are two types of autopsies:
The forensic autopsy or medical-legal autopsy is the kind you most often see on TV and in movies. According to Dr. Kiesel, "The forensic autopsy spends almost as much time on the external surfaces of the body as it does on the internal surfaces, 'cause that's where evidence is." Forensic autopsies try to find answers to the cause of death as part of an overall police investigation.
On TV shows like CSI or The X-Files, medical examiners seem to be a major component in the investigation and can use DNA evidence for just about everything. Dr. Kiesel commented on some of the more common TV-driven misconceptions:
We don’t go out and do the entire investigation. We are not the police... We’ve got our part, the police have their part. The autopsy doesn’t always tell you all of the answers. Somebody’s who committed suicide -- the autopsy’s going to tell you why they died, what killed them -- but it won’t necessarily tell you why they did it. So, all of the answers aren’t going to be there...
We can’t do DNA on every case and match up every little thing. Even though it happens on TV, it’s not within our capabilities. Very often it’s not within the lab’s capabilities. Sometimes there are financial constraints on what we can do.
The clinical autopsy is usually performed in hospitals by pathologists or the attending physician to determine a cause of death for research and study purposes. Dr. Kiesel explains:
They're really interested in the disease processes that are going on, and they're interested ... in making that clinical-pathological correlation. A person came in with these symptoms, here's the treatment they got and here are my findings. They try to put the whole package together to help inform people of what happened or may have happened.
In the eyes of the law, all deaths fall into one of five categories of causes. In the next section, we'll look at the five manners of death.