[Unnatural deaths and medicolegal autopsy system--consented autopsy and its future]

We actively examine the causes of non-criminal unnatural deaths here at the Department of Legal Medicine in Kitasato University School of Medicine. We dealt with 3565 cases of unnatural deaths during the ten years from 1994 to 2003 (postmortem examinations, 1741 cases; consented autopsies, 1824 cases; autopsy rate, 51.2%).

deaths by diseases, 2291 cases (64.3%); deaths from external causes or others, 1274 cases (35.7%). The autopsy rate of deaths by diseases is 60.7% and that of deaths from external causes or others is 34.0%. Cardiopulmonary arrest on arrival (CPAOA) accounts for about half of total cases (50.8%), that is 1811 cases. Especially, consented autopsies in cases of non-criminal unnatural deaths performed under the permission (autopsy consent) of the bereaved family are highly significant, since they can contribute to society as greatly as judicial appraisal, and can also contribute to undergraduate and postgraduate medical education. Consented autopsy is a procedure that enhances people's recognition of legal medicine in the society and universities. We expect that other universities will establish their own methods of medicolegal activities in the future by referring to our Kitasato University system as a model.