Post-mortems do not determine guilt

Post-mortems do not determine guilt

Friday, November 20, 2020

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Dear Editor,

A post-mortem is a medical examination to determine the specific cause of death. It cannot determine negligence, malpractice, or culpability. It is usually performed when the cause of death is unknown and for scientific purposes for a clearer understanding of the pathological processes or abnormal changes occurring in medical disorders, such as cancers and COVID-19. It is also standard following violent deaths such as drowning, gunshot wounds, stabbing, road traffic collisions, and whenever foul play is suspected.

Relatives, for different reasons, also request post-mortems.

Whatever the circumstances, even in instances where the actual cause of death differs from that initially or officially stated, and even if someone has been charged, a post-mortem determines only the specific cause of death and cannot determine negligence or blame. Any departure from this principle is not only erroneous, but quite dangerous given the medico-legal and far-reaching implications.

The findings at post-mortem, for example, which reveal a massive stroke or heart attack cannot state whether the deceased was diagnosed with any medical condition which resulted in death or whether there was mismanagement. Clot formation in the brain or heart causing death will give similar findings independent of the social circumstances.

In relation to violent deaths, the pathologist, for example, can correctly conclude that the fatal wounds were inflicted by a sharp instrument, such as a machete. But even a highly trained and well-experienced pathologist, or any trained or untrained observer, would be wrong to further conclude that a farmer committed the act because one was suspected or charged.

One cannot conclude at a post-mortem, based on the type of bullets retrieved, who fired the gun. Similarly, death from poisoning or a bullet may be a homicide or suicide — post-mortems do not usually make such a determination.

Post-mortems play a crucial role but cannot determine guilt. Pronouncements are sometimes unfortunately made accordingly. Culpability is the prerogative of a coroner's inquest and the courts. To give a greater sense of balance and fairness, and to try to ensure peace, I remain firmly convinced the special roles of investigator, observer, juror, and judge should best be kept separate.

Daive R Facey

DR.Facey@gmail.com


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