•  We'll get a lot of questions about autopsies and whether or not people should have one done on their loved one, or if they have to have one done. Back in the day, they used to do autopsies, I would say just about on everyone. Of course, there's always those exceptions. But now, because of the population, it is absolutely impossible to do an autopsy, a full autopsy on everyone. The medical examiner is mandated by law to investigate deaths, and the ME, or the medical examiner, is the one that determines if an autopsy is necessary... But if a family doesn't want an autopsy, then they're really good about honoring the family's objection, and our office in particular has a form that the family can fill out asking that it not be done. Of course, they have to sign it, and it asks the reason. Most often, it's religious reasons. That form is reviewed by the doctor, not all of them are honored in cases of infant homicide or sudden death of someone with no medical history, or a young person, those are things that really need to be investigated. Again, in cases where the doctor does agree not to do it, they will still do an external exam, which is where they will review the body and look for signs of trauma. They'll look for bruises, scratches, petechiae in the eyes. Anything that looks abnormal, or anything that throws up red flags. And then they'll also do toxicology to rule out overdose, whether it be accidental or a suicide, and then they'll do some ancillary studies. (00:30)

•  The Amish are generally pretty open to it. So we do have to take those religious beliefs into consideration whenever a family member asks that an autopsy not be done. At the same time, we have people who want an autopsy, and that's even if their loved one has a pretty extensive family history, because they want to know exactly what caused the death. Many times, they will go have a private autopsy done after the medical examiner determined that it's not necessary to be done in our office. So, they may hire a private pathologists. They may pay upwards of $3000-$4000 to have a private autopsy done, because they want more answers. I know that a lot of people believe that an autopsy is going to show exactly, but many times, if it's a sudden cardiac death, you're not really going to be able to see on an autopsy exactly what happened at the time of death. (04:05)

•  Of course, if there are suspicious circumstances, then those are going to require further investigation, and most likely an autopsy. Employment-related accidents, of course, like I said before, deaths from diseases that can cause a public health risk or threat, we also, and I'm sure all offices do actually investigate if a cremation is requested because we want to make sure if it's a death that doesn't have to be reported to our office, or even if it's one that was reported to your office, that there are absolutely no signs of foul play and no reason for the doctor to look at the body before we allow that cremation to take place, because obviously, once it does, there's absolutely no chance for an autopsy. And we do need to make sure that nothing was overlooked. So when a cremation is requested, all of those requests are reviewed by our office, as I'm sure they are all offices, just to make sure that there is no foul play, there's no need for toxicology, that no falls took place, and the death couldn't have possibly been an accident. So all those are also investigated, not always, like I said, by autopsy, but many times we may get a death certificate sent to us by a funeral home along with the request for a cremation, and then the death of the certificate will say subdural hematoma due to fall. And if that death wasn't reported to us, we have to call the agency where the deceased was and get some more information, because if that is in fact the reason for death, then we need to do further investigation, because it's probably an accident versus a natural death. So there are a lot of reasons to do an autopsy, and there are many, many reasons not to... All states are different. (08:27)

•  Now, while you're living, go to a doctor and establish your medical care with one particular doctor. Go yearly for physicals, have lab work done, if you do have a medical problem, get it diagnosed, take the medications if they're necessary, and then if something does happen and we come to investigate, your family is going to know who your doctor is, pretty much when the last time you went was, and because we are exempt from HIPAA, we are able to contact that physician and they're going to give us a copy of your medical records. Which means we can review those, and we can look to see what you've been diagnosed with in the past, what medications you're on, and it makes it a lot easier for us to say, Oh, okay, this person has been ill, or this person has been diagnosed with diabetes. Maybe your doctor documented that you weren't compliant with your insulin, that is significant because it may be an issue with your diabetes that caused the death. So the absolute best way to avoid it would be to seek medical care often. If you have an issue and go to the same physician, and of course, if you're ever referred to a specialist by that physician, they're going to have documentation as to who they sent you to for further testing or whatnot, and then we will know which other doctors you went to, and we can also go to those doctors and request information. So that will help our doctors or our investigators determined that your death was most likely natural related to those issues. (14:05)

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