Need for medico legal examination in case of unnatural deaths

To quote from Professor Stephen Cordner's article published in the Lancet, "Substantial
delay between injury and death, non-fatal injury precipitating death in a relatively short time
from natural causes, a peculiarity of the victim rendering a survivable injury fatal 1" are
realities often encountered in forensic autopsies .Unnatural death would refer to any situation
whereby the cause of the death is not ascertained and the factual matrix of the circumstances
of the case points to a direction filled with unascertained conclusions and deductions. In all
such cases, it becomes imperative to conduct a medico legal examination of the bodies
associated to such unnatural deaths. This inquest can be effectively concluded only after due
inquiry as to the cause of the death that is whether it was accidental, natural or homicidal 2.
Such an inquest would not form a part of the trial or judgment but is a series of investigating
events to ascertain the cause of the death. In cases where the cause of the death is in question,
the Code of criminal Procedure expressly enumerates the course of the Investigation that is to
be strictly adhered to by the Investigating authorities in charge of such cases. Unnatural
deaths unlike natural deaths have to be examined with greater precision owing to the tag of
ambiguity attached with the former. Therefore, in cases where the death has been reported as
being associated with an unnatural cause, a legal authority such as the Police, Magistrate or
the Prosecutor Fiscal may give legal instructions that are to be followed during the conduct of
the medico-legal or forensic autopsy of the body concerned. Such medico-legal examination
or forensic autopsy differs from one country to another and is primarily aimed at the
following

1. establishing the identity of the dead individual

2. confirming or refuting the manner of the concerned death of the individual
3. to establish the actual cause of the death
4. In order to come up with the time interval between when the death had been
caused and when the autopsy was conducted.

In cases where the unnatural death has been subjected to a neonate, a medico-legal fetal
autopsy has to be conducted to establish and estimate

1. the neonatal age of the foetus

2. if it was born alive or dead. This can only be done if it stands as a viable option
1
Cordner SM. Deciding the cause of death after necropsy. Lancet. 1993 Jun 05;341(8858):1458-60.
2
Nadesan K. The importance of the medico-legal autopsy. Malays J Pathol. 1997 Dec;19(2):105-9
 3. the manner of the death
4. the cause of the death
5. the survival time after birth.

In cases where the body is recovered from under water, autopsy is imperative to
determine whether the death had resulted from drowning or whether the body had been
disposed of into the water after the completion of commission of a crime. Furthermore, in the
recent past cases of homicide have been given the disguise of suicidal death. In all such cases
only medico legal examination can be of crucial help to ascertain what the grounded truth is.
Similarly, in case involving burns3 as the cause of the death, an autopsy or medico legal
examination helps to establish and differentiate the ante-mortem and post-mortem burns that
may have accrued to the deceased.

3
Hirsch CS, Adelson L. Absence of carboxyhemoglobin in flash fire victims. JAMA. 1969 Dec
22;210(12):2279-80.