The Need for an Autopsy
| Date | 01 January 1961 |
| Author | Keith Simpson |
| Published date | 01 January 1961 |
| DOI | 10.1177/0032258X6103400103 |
| Subject Matter | Article |
KEITH
SIMPSON,
M.D.
(Lond.)
In this article Dr. Simpson draws upon his great experience to put
into proper proportion a subject upon which a great many wild
statements have been made at various times.
The
Need
for
an
Autopsy
FOR MANY CENTURIES the need for an investigation of all violent
and unexpected deaths has been evident to everybody. In England
the Normans levied a 46-mark district fine called a murdrum on
any unexplained death unless
"Englishry"
were
proved-the
English were
expendable-and
it was
not
until the mid-13th century
that this fine was restricted to felonious killing, or where an assailant
had fled. The deodand or object responsible for death was forfeit.
These procedures must have required some skill and experience
for fair decision, and
"crowners"
(who had by then existed for
200 years) might well have been expected to seek professional advice
on the interpretation
of
the findings in the dead body. They did
not, for medicine and science had not advanced very far at the time.
For
another 500 years coroners still regarded the inquiry as a
means of levying a fine on a community, of amercing individuals
or confiscating goods and chattels. They were not paid, and the
rewards of their living rested with their decisions at inquests. All
too little attention was paid to the development that medical
sciences were by now making, and the part they could have played
in the development of a sounder, less lay and circumstantial,
coroner's inquest in England. The body was never opened, wounds
were not explored, poison was sometimes observed,
but
it was
never
sought-surface
marks were all that counted: the help
of
the barber-surgeon or chemist was seldom, if ever, requested.
Little or nothing was yet known of many of the natural diseases
that we now show by autopsy to be such common causes of death
-often
in cases where the circumstances have already aroused
grave suspicion. Much injustice must have resulted.
Several hundreds
of
years were to elapse before coroners called
for medical help in unravelling their inquest problems, and, even
when they did, another difficulty was put in their way: they were
not, at first, authorized to pay any fees, and for a time had to
seek magistrates' authority for payments for expenses incurred. Of
course the system failed, for magistrates and coroners viewed each
other's authority and privileges with dislike and did all that was
possible to frustrate each other. Ultimately, however, the inevitable
change
took
place: in 1836 legislation at last provided for payments
for medical witnesses, for post-mortems and even for special toxico-
January-February 1961 13
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