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What is a Death Certificate?
A death certificate is an official, government-issued document that declares the date and time, location, and cause of death, as well as other personal information about the person who died. Causes of Death Determining Cause of Death Firstly was the deceased found at a location where he or she would not normally have been? Where they in a state of undress or have visible injuries not normally present in a natural death? If injuries were present were they the result of a knife or gun attack? Estimating The Time of Death Categorising Time of Death Time of death is categorised in three ways:Physiological time of death: The point at which the deceased's body - including vital organs - ceased to function. Estimated time of death: A best guess based on available information. Legal time of death: The time at which the body was discovered or physically pronounced dead by another individual. This is the time that is shown - by law - on a death certificate. Methods Used One method of estimating the time of death is to measure body temperature. The normal equation for this is:37.5oC - 1.5 oC This formula equates to the body temperature (37.5oC), which loses 1.5 oC per hour until the temperature of the body is that of the environment around it; known as the ambient temperature. This ambient temperature - depending on how low it is - may take minutes or hours to be reached and this is a good indicator as to how long a body has been in situ. Additionally it is worth noting that a body's temperature will drop much more slowly if the body has been exposed to extreme cold; such as being left outdoors, submerged in water or icy conditions. The most common way of taking the temperature of the deceased is to use a rectal thermometer or to take a temperature reading from the liver, which can achieve a more realistic core body temperature. Rigor Mortis also acts as a good measuring stick for estimating the time of death. This natural process which occurs in all of us when we die and is the natural contracting and relaxation of the body's muscles caused by changes in the body's chemical balances. Rigor normally occurs in the smaller muscles such as those in the face and neck and will work its way down through the body as the muscles become larger. The process normally begins roughly two hours after death and can last for anything from twenty to thirty hours. It is a common misconception that rigor does not leave the body; it will after these time frames have elapsed. Rigor is one of the most used ways of estimating death as it occurs in the body during the first thirty-six to forty-eight hours. Forensic Entomology (the study of insects) is another way in which the time of death can be estimated. By studying the insects found at the crime scene the pathologist is able to establish a more accurate time scale depending on which insects are found on the body and what stages they are at in their life cycle. To find out more read our article on Forensic Entomology. External Examination An external examination of a corpse is essential at two stages in the forensic science process. The first time an external examination is carried out is upon discovery of a corpse. At this point the body should be checked for visible signs of injury and those injuries that are most likely to have caused subsequent death. At this stage both the Pathologist and Scenes of Crime Officer (SOCO) are present as well as authorised police personnel and the body is checked over in what is known as a preliminary examination. Whilst the Scenes of Crime Officer (SOCO) is taking photographs of the corpse and surrounding area - and in particular photographing wounds and injuries pointed out to him or her by the pathologist - the pathologist will examine these wounds and measure them. Clothing will also be examined for any signs of excreted bodily fluids and/or fibres. Once the body has been removed from the scene of crime and taken for pathological examination there is another external examination to be carried out before an autopsy can be completed. This examination is conducted to determine height and weight and also to facilitate the photographing of the corpse in its post mortem state. This is also done to ensure that no additional post mortem injuries have been sustained. The clothes of the deceased are thoroughly checked for fibres, hairs, bodily fluids and blood stains; as well as for tears and rips that might correspond to knife or gun attacks. The body is then checked for signs of rigor mortis (stiffening of the muscles post mortem) and lividity (settling of the blood post mortem); both of these conditions can be measured and used as a means of determining time of death. In addition to this these conditions can also be used to help determine whether or not a body has been moved post mortem prior to its discovery. Sometimes x-rays are taken at the external examination stage if there are visible head injuries. What Happens During The Examination? During this external examination fingernails are clipped or scraped clean so that any material underneath may be examined for traces of skin or blood possibly that of an attacker. Pubic hair is combed for traces of skin and the area around the sexual organs - particularly in sexually related murders - is swabbed. Injuries such as cuts and bruises are marked out and in cases of stabbings or shootings the entrance wounds are measured in order to gauge closeness of the victim to the perpetrator and also to try and establish what kind of knife or gun was used in the attack. Throughout the process the pathologist will make audio notes as to his or her discoveries and his assistant will take photographs and make written notes on a detailed sketch of the body so that a detailed autopsy report can be produced once the autopsy proper has been carried out. At all times throughout the process notes are taken so that there can be nothing left to chance from a medical point of view. Identifying the Victim When it comes to identifying the deceased forensic science and forensic medicine are both crucial weapons in any law enforcement agency's armoury. Difficulty in Identification Identifying the victim can sometimes not be as simple as looking at their face and matching them to a description given by a worried relative or loved one. Sometimes there are extraneous forces at work, which make identifying the victim a long and laborious task. The main reasons for difficulty in identifying the victim are: Massive head trauma Submergence in water for long periods of time Decapitation Disfigurement All of these are of course grisly in their own right and the task of identifying a victim can be made much trickier if any of these issues arise. Ways of Identifying a Body Normally dental work, blood tests and fingerprinting would go some way in making a positive identification of a corpse but there are other things to take into consideration. Firstly are any of these methods applicable in this particular instance? Some people are fortunate enough never to have required any great amount of dental work. Others may not have ever had to have blood work carried out during hospital visits and therefore no records exist and in some extreme cases wounds inflicted to the corpse post mortem may make fingerprinting impossible. This is also very difficult if the victim has been involved in a fire or explosion. Of course one of the first things a forensic scientist will look for in their quest to identify the deceased is what they are wearing. Does the deceased's clothing match the description given to the police? If so this is a good place to start and items of clothing or footwear can - as much as the task is unpleasant and upsetting - be shown to the family of the deceased. Certain items of clothing and footwear are unique to individuals and can be identified easily. Items of jewellery are also used in an attempt to identify the victim as many items of jewellery can be personalised with engravings. The forensic science officer will also collate the individual's personal effects and look for forms of identity such as a driving licence, banker's card or anything that may hold a name and address. This is of course not to say that this method of identification is foolproof; it is not unheard of for misidentifications due to the victim of a crime wearing similar clothing to that of a missing person. But it is a good indicator from which DNA can be taken from the parents or siblings of the missing person for comparison. Mitochondrial DNA - a strain of DNA that is present through the bloodlines of many families down many generations - can be used to identify the victim but this is normally only used when no other forms of identification; such as dental work, blood work and fingerprints are not available. It is important to note that cases of misidentification are rare and that every effort is made on behalf of the authorities and the forensics team to make sure identification is as quick as possible and without adding any further anxiety to the family of the victim. Performing an Autopsy An autopsy is performed when there are suspicious circumstances surrounding someone's death; or when no signs of natural causes can be located. Stages of an Autopsy An autopsy takes the form of six stages: Y-Incision Removal of Organs Stomach Contents Sample Collection Head and Brain examination Conclusion The Y-Incision is the procedure used by the pathologist to open up the breastplate of the deceased and gain access to the body's major organs; heart, lungs, liver, stomach, spleen etc. This incision is so called because it resembles the shape of the letter Y and is cut from either shoulder to the lower end of the sternum and then downwards in a straight line over the abdomen to the pubis. After the Y-Incision has been made all of the organs are removed and weighed. This is done because certain types of illness can cause a reduction or increase in the weight of organs such as the heart and/or the lungs. Most times when removed these organs are removed in one unit but sometimes - depending on trauma to the body - are removed in a specific sequence. Blood samples are taken, samples for DNA testing (as and when necessary but not necessary in all autopsies), and toxicological tests are carried out on the heart for signs of poisoning if no physical injuries have manifested themselves. After this the abdomen is examined and tissue samples taken for analysis and the contents of the stomach are examined. Examining the contents of the stomach can determine when the victim last had a meal and also what that meal consisted of. This is vitally important if determining time of death is a major factor. As with anything we eat the body takes time to digest it, removing valuable nutrients and energy producing elements and this takes time moving through the digestive tract. Meals that are partially digested, completely digested or not digested at all can all lead to time frames being adopted for the time of death. Samples of bile from the gall bladder, ocular (eye) fluid, liver tissue and urine are also taken for toxicology testing as some poisons may not show in one part of the body but will show in others. Once these procedures have been completed the pathologist will then turn his or her attention to the head area. The first thing they will do is look for signs of head injury, which should have been visible during both external examinations. Sometimes however head trauma cannot be visible simply by sight alone. The pathologist makes a triangular incision across the top of the scalp to reveal the brain and first of all examines it inside the head. Then once this has been completed satisfactorily the brain is removed for a more thorough inspection and also for tissue samples to be taken. After all of these procedures have been carried out the organs are then placed back into the body and the body is carefully sewn up again. Once these procedures have been completed it is then the pathologist's job to report his or her findings to the police who will then be charged with the task of what to do next. It is important to note that although these procedures are carried out more often than not in the case of natural death; if carried out as the result of a violent death or murder then the body is not released to the family for burial until all investigations have been completed and inquests carried out. The Rate of Decay in a Corpse The rate of decay within the human body after death is normally split into two distinct categories. These are: Autolysis: A process of self-digestion where the body's enzymes contained within cells begin to go into a post death meltdown. The process can be speeded up by extreme heat and likewise slowed down by extreme cold. Putrefaction: Bacteria that escape from the body's intestinal tract after the deceased has died are released into the body and begin the process of literally melting the body down. If you are of a nervous disposition you may choose not to read on. What is Putrefaction? Putrefaction follows a predetermined timetable in nature and after the first 36 hours the neck, the abdomen, the shoulders and the head begin to turn a discoloured green. This is then followed by bloating – an accumulation of gas that is produced by bacteria toiling away within the deceased. This bloating is most visible around the face where the eyes and the tongue protrude as the gas inside pushes them forward. As the body continues to putrefy, the skin blisters, hair falls out and the fingernails of the deceased began to sink back into the fingers. These skin blisters are also filled with large amounts of liquid just as in a blister you might get from running or walking too far. The body's skin tone then becomes what is known as 'marbled'; an intricate pattern of blood vessels in the face, abdomen, chest and other extremities becomes visible. This is the result of the body's red blood vessels breaking down, which in turn release Haemoglobin. As the process reaches its conclusion, the body will now be almost black-green and the fluids – known as purge fluid – will drain from the corpse. This happens normally from the mouth and nose but can also occur from other orifices. The body's tissues then begin to break open and will release gas and other fluids in the same way as a fruit that has been left too long in the sun. It is also important to note that the internal organs of the deceased will begin to decay in a particular order; beginning with the intestines, which as well as holding bacteria also hold various levels of acidic fluid which – when unable to circulate – begin to eat through their surrounding tissues. As the intestinal organs decay so too do the liver, kidneys, lungs and brain. The contents of the stomach may also slow down the rate of decay if there is undigested food in and around that area. The last organs to give way to decay are the prostate and/or the uterus. Again, this may sound all very unpleasant but it is a natural calendar of events for the body to go through and one which the pathologist and Scenes of Crime Officer (SOCO) will find useful in their quest to Determine the Time of Death. Be aware also that hot temperatures will speed up this process, while cooler temperatures will slow it down. Also, a person who has died with a septic wound will suffer the effects of putrefaction faster, as the bacteria from sepsis spreads quickly and does damage on a larger and faster scale. What is a Pathologist? A pathologist is the senior doctor responsible for the performance of autopsies and for the determining as to how an individual died. This particular role within the forensic science sector is a demanding and sometimes harrowing job, which is not for those faint of heart. What a Pathologist Does Indeed a pathologist will often be called upon not just to perform autopsies but to offer expert advice to law enforcement agencies as well as supervise the running of the pathology laboratory and those individuals who are employed there. Pathologists are also responsible for the supervising of a crime scene and the evidence collection process that takes place there. This is all geared towards providing the relevant authorities with as much information as possible. A pathologist will often have to juggle more than one investigation at a time and supervise teams who are charged with collating information, samples, blood and tissues.During these investigations the pathologist will have to attend inquests and give expert advice to both juries and counsel alike; breaking down complex medical jargon and putting it across in such a way that it is accessible and understandable to all. The pathologist will also have to discuss the nature of autopsies performed, his or her findings, and ultimately offer their opinions as to the nature of how death occurred?These opinions are important and can offer much needed credence to the prosecution or defence. The Pathologist and The Crime Scene While the crime scene is the realm of the police the pathologist has the ultimate say in what happens with the body.The body - even though the crime scene has its own secrets to reveal - is the most important piece of evidence in any crime and the pathologist is the individual responsible for unlocking the corpse's secrets. Responsible for the overseeing of everything from the removal of the corpse to the ultimate returning the deceased to their family for burial, the pathologist has to ensure along the way that every aspect of the investigation - from a forensic medicine viewpoint - is handled in the manner in which it should be and that all means at his or her disposal are utilised to find the answers behind the death of an individual. It is also worth noting that a pathologist must have an acceptable and working knowledge of many areas of forensic science and medicine; some of them including: Pathology Crime scene evaluation Anatomy Microscopy Forensic Dentistry Anthropology It is not necessarily the case that all of these disciplines will be required during their time as a pathologist but it is certainly worth having a working knowledge of them as each crime scene - and indeed each crime - is different and can throw up many different scenarios. The ability to deal with the general public in extremely stressful circumstances is a must and it should be noted that emotions can run high. An individual who is interested in being a forensic pathologist can start their journey up the ladder by becoming a forensic pathology technician but it is important to note that climbing the career ladder to reach the position of forensic pathologist can take many years. When processes such as the following are reported, additional information about the etiology should be reported: Abscess Abdominal hemorrhage Acute myocardial infarction Adhesions Adult respiratory distress Altered mental status Anemia Anoxia Anoxic encephalopathy Arrhythmia Chronic bedridden state Ascites Aspiration Atrial fibrillation Bacteremia Bedridden Convulsions Biliary obstruction Bowel obstruction Brain injury Brain stem herniation (when not otherwise specified) Carcinogenesis Carcinomatosis Cardiac arrest Cardiac dysrhythmia syndrome Cardiomyopathy Cardiopulmonary arrest Cellulitis Cerebellar tonsillar herniation Cerebral edema Cerebrovascular accident Cirrhosis Coagulopathy Compression fracture Congestive heart failure Decubiti Dehydration Dementia Diarrhea Disseminated intravascular Dysrhythmia Increased intracranial pressure End-stage liver disease End-stage renal disease Epidural hematoma Exsanguination Failure to thrive Fracture Gangrene Gastrointestinal hemorrhage Heart failure Hemothorax Hepatic failure Hepatitis Hepatorenal syndrome Hyperglycemia Hyperkalemia Hyponatremia Hypotension Hypovolemic shock Intracranial hemorrhage Malnutrition Metabolic encephalopathy Multi-organ failure Multi-system organ failure Myocardial infarction Necrotizing soft-tissue infection Old age Subarachnoid hemorrhage Open (or closed) head injury Pancytopenia Paralysis Perforated gallbladder Peritonitis Pleural effusions Pneumonia Pulmonary arrest Pulmonary edema coagulopathy Immunosuppression Pulmonary embolism Pulmonary insufficiency Renal failure Respiratory arrest Seizures Sepsis Septic shock Shock Starvation Subdural hematoma Sudden death Thrombocytopenia Uncal herniation Urinary tract infection Ventricular fibrillation Ventricular tachycardia Volume depletion |