A private autopsy is an autopsy that is not performed by a medical examiner/coroner but by a board-certified doctor who specializes in clinical or forensic pathology.
Performance of autopsies in South Africa: Selected legal and ethical perspectives
In South Africa, academic and/or anatomical pathology autopsies are conducted in terms of the Human Tissue Act (Act 65 of 1983).
Lorraine du Toit-Prinsloo, MB ChB, DipForMed (SA)Path, FCFORPATH(SA), MMed (Path)(Forens)
Specialist, Forensic Pathology Service Pretoria and Senior lecturer, Department of Forensic Medicine, University of Pretoria
Lorraine du Toit-Prinsloo is responsible for conducting medico-legal investigations of death including scene visits, performance of autopsies and providing testimonies in court. She is involved in the co-ordination of the academic programme in the department and teaching of undergraduate and postgraduate students.
Gert Saayman, MB ChB MMed(MedForens)(Pta) FCForPath(SA)
Chief Specialist, Forensic Pathology Service Pretoria; Professor and Head, Department of Forensic Medicine, University of Pretoria
Gert Saayman is responsible for supervising and providing forensic pathology services in Pretoria and the northern region of Gauteng. This includes the medico-legal investigation of all cases of homicidal, suicidal and accidental deaths, as well as deaths which are sudden, unexpected or unexplained. He routinely advises the police and prosecuting authorities in forensic medical matters and acts as expert witness in inquests and in criminal and civil legal proceedings.
Correspondence to: Lorraine du Toit-Prinsloo (lorraine.dutoit@up.ac.za)
Autopsies (from the Greek word autopsia, meaning ‘to see with one’s own eyes’), have been performed for centuries, in one form or the other, to learn about the form and inner workings of the human body and to ascertain the cause of death in deceased individuals.
1 In time, two distinct settings for the autopsy have developed, with academic or anatomical pathology autopsies being conducted in order to establish the nature and extent of underlying natural disease, but also to enable academics to teach students and to perform research.
On the other hand, medico-legal autopsies are routinely performed in terms of statutory provisions which mandate the examination of bodies of deceased individuals who have died as a result of other than natural causes (or where the cause of death is not apparent or of an unexpected nature), in order to facilitate further legal decisions and proceedings.
Anatomical pathology autopsy
Anatomical pathology autopsies provide an opportunity to fully investigate the nature and extent of disease, associated complications and co-morbid conditions, and as such the autopsy is an excellent tool to inform clinicians and to arrive at a clinicopathological correlation.2 It may also provide valuable information for the next of kin and closure in cases of uncertainty, as well as providing information which may be of benefit to surviving family members (siblings and children, in cases of certain familial disease).
In addition, the regular performance of anatomical autopsies provides an excellent opportunity for individual and institutional quality control and clinical audit.3 Many published articles have shown that, despite recent advances in medical technology and diagnostic capacity, significant discrepancies still exist between clinical diagnosis and diagnosis made at autopsy.
The incidence of significant differences between autopsy findings and clinical diagnosis varies between 20% and 40%, suggesting that in one or two out of five deceased individuals upon whom autopsies are performed, the main clinical diagnosis is not confirmed or supported at autopsy. 4
It has been said that clinicians and health care institutions avoid requesting anatomical pathology autopsies, since such missed (or wrong) diagnoses may constitute grounds for subsequent litigation and/or legal proceedings. Interestingly, a review of 99 Appeals Court decisions in medical malpractice cases has shown that such proceedings were not instituted on the basis of autopsy findings, but rather on standard of care issues – and that the performance of an autopsy is not likely to precipitate malpractice proceedings.7
Indeed, it may be that the medical profession (individually and collectively) will be better served if autopsies are requested more often in cases where some uncertainties pertaining to diagnosis may exist.
What does a private autopsy cost in South Africa?
about R3 500
A private autopsy, arranged by a funeral home, costs about R3 500. * If the person passes away in a car accident: You will most likely be notified of the death once the body is already in the mortuary.
Do you pay for an autopsy in South Africa?
Yes, the family/relatives have the right to arrange that a doctor of their choice attend the autopsy on their behalf with the permission of the attending forensic medical practitioner (doctor). Any fees required by this private doctor should be negotiated and paid by the relatives.
How long autopsy results take in South Africa ?
An autopsy is much more than a physical examination of a deceased person, though, and as such, it takes approximately 6 weeks to get the final autopsy report. During this time important samples that were taken during the examination are processed by a laboratory to provide definitive results.
What are the steps for an autopsy in South Africa ?
How is an autopsy performed?
External examination. A pathologist starts an autopsy from the outside of the body and works inwards.
X-rays.
Internal examination.
Testing of body fluids.
Brain examination.
Final procedures.
Autopsy report and medical diagnosis.
What types of deaths require an autopsy in South Africa ?
Under What Circumstances Will an Autopsy be Performed?
The death is known or suspected to have been caused by apparent criminal violence.
The death is unexpected and unexplained in an infant or child.
The death is associated with police action.