Question 1: Joe B. is found expired in his residence, without any sign of foul play, or self-inflicted injury. Who makes the determination as to whether or not Joe is subject to a post-mortem examination?
Question 2: Given that a death certificate must be completed by a physician, are said certificates a matter of public record, such that one may determine the causal agent(s) of Joe B.'s demise?
It depends upon the law in the particular jurisdiction. Here’s a general answer.
The relevant part is: “Under the laws of most states, autopsy can be ordered by the government. A coroner is a political position, while a medical examiner is a physician, usually a pathologist. Exactly who makes the decisions, and who just gives advice, depends on the jurisdiction. Autopsies can be ordered in every state when there is suspicion of foul play. In most states, autopsy can be ordered when there is some public health concern, i.e., a mysterious disease or a worry about the quality of health care. In most states, an autopsy may be ordered if someone dies unattended by a physician (or attended for less than 24 hours), or if the attending physician is uncomfortable signing the death certificate.”
Question 2: Given that a death certificate must be completed by a physician, are said certificates a matter of public record, such that one may determine the causal agent(s) of Joe B.'s demise?
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Google “autopsy law” (without the quotation marks) and you’ll find a bunch of references to a Florida law concerning the release of autopsy information. According to the cites, GW is opposed to thre release of autopsy photos.
There are some details here about coroner’s inquests in New South Wales. In particular:
However, a Coroner, must conduct an inquest where:
If the person died while in custody, while escaping or while attempting to escape from custody, an inquest must be held by the State Coroner or one of the Deputy State Coroners.
Joe would have an autopsy unless it can be determined that he died while under a physician’s care; for example, Joe died at home while being treated for cancer. An autopsy can still be performed at the family’s or physician’s request (with consent of the family), but it wouldn’t be mandatory unless there were signs Joe died of something other than natural causes. If he did die of natural causes, his physician signs off on the death certificate.
Death certificates are generally public record, although privacy concerns have made them harder to get. In some jurisdictions, you have to explain why you want Joe’s death certificate.
Robin
In some states, a temporary death certificate can be filed if there’s doubt about the actual cause of death (e.g. the doctor was treating Joe for cancer, but he actually died of a heart attack when nobody was with him to describe what happened.) In that case, the cause would be indicated as “pending” or similar, and would be amended after the autopsy report becomes available.
In Michigan, where I practice now, I had one occasion to make out a death cert on a patient of mine who died on the medical ward. I postponed filling out the form until the results of the autopsy had become available. It was only a few days. That was pre-computerized records database. It might be a much shorter time today.
It should be remembered, though, that often the cause listed on the certificate is the conclusion of the attending physician, which might be inaccurate. The doctor can also deliberately omit details that would embarrass the family, such as “GI bleed secondary to liver cirrhosis” with no reference to alcoholism.
Gil Grissom. 