External examination of the corpse in practice

Background and Objective: The quality of the external examination of corpse s has repeatedly been criticized. This study provides information on the pe rformance of the external examination of bodies in practice which is necess ary for improving the quality of the examination. Methods: 1000 randomly selected medical practitioners from the "Arztekammer Westfalen-Lippe" were sent a questionnaire concerning personal data, the p erformance of the external examination of bodies and possible influencing o f the decision on the manner of death (i.e. natural, unnatural or uncertain ) by a third person. In addition reports of four typical cases were present ed and a classification of the manner of death was requested. Results: The return rate of the questionnaires was almost 30%, 289 question naires were evaluated. Although most doctors stated that the external exami nation took them 20 to 30 minutes, only 25% undressed the body completely. Almost 50% of the doctors had been influenced by a third person in the deci sion on the manner of death at least once, most often by the police. The fo ur short cases were incomprehensibly often classified as "natural death", e specially by internists. Conclusions: Signs of an unnatural cause of death will only be detected by chance if the body is only briefly examined and not undressed completely. I f such signs are absent the manner of death should be classified as "uncert ain" in unclarified or doubtful cases, even against attempted influencing b y third persons. In order to avoid conflicts of interests it would be desir able if only specialized medical practitioners would perform the external e xamination of corpses.