Inquest

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This article or paragraph presents the situation in Germany . Help us to describe the situation in other countries.

Autopsy (1890) Enrique Simonet
Autopsy room at the Charité Berlin

The inquest (. Austrian coroner , mortem examinations ; in Switzerland common name for unusual deaths: Legal inspection ) is to examine the corpse of a man for the determination of death and to determine the causes and circumstances surrounding a death . It is done by a doctor .

Terms

The inquest falls into the area covered by law and medicine . It is recognized as a branch of forensic medicine .

In Germany , the regular post-mortem examination is regulated by the (funeral) laws of the federal states and is not handled uniformly across the country. In Switzerland it is regulated by the cantons.

In addition, there are guidelines of the German Society for Forensic Medicine (DGRM) No. 054/002, which describe the implementation of the medical investigation lege artis.

An internal examination is called a cadaver opening, autopsy , autopsy, necropsy or dissection.

A second examination of the corpse (cremation examination, official medical examination ) must take place before a cremation (cremation, cremation, cremation, cremation). It is carried out in the crematorium by a doctor from the health department , a commissioned forensic medicine institution or a certified pathological institute and is the prerequisite for approval for cremation.

Within the framework of the various criminal procedure laws , there is a uniform state basis in each case. It is between morgue in Germany, the coroner in Austria and Legal inspection in Switzerland, and the autopsy in Germany and the autopsy to distinguish in Austria and Switzerland.

Independent official procedures to determine the cause of death , as carried out in the Anglo-American area by a coroner , do not exist in German-speaking countries. Similar procedures only apply to the investigation of rail, sea and air accidents .

Tasks (Germany)

The external inspection of the corpse should be carried out at the place of discovery (which does not necessarily have to be a place of death). Make sure there is sufficient lighting and the corpse must be stripped. As a rule, it must be carried out immediately after notification. A repetition can be omitted, according to most state laws. The exception is currently Hamburg, in the event of death outside a hospital or facility. If there is any indication of an unnatural death, the investigation must be stopped and the police must be alerted.

In practice, the determination of death is made by providing evidence of at least one sure sign of death. These include death spots , rigor mortis , putrefaction, or “injuries that are incompatible with life”, such as severing the head. It can also be carried out through unsuccessful resuscitation of approx. 30 minutes with an approx. 30-minute baseline ECG despite adequate resuscitation measures and by excluding the reversible causes of cardiovascular arrest (e.g. alcohol or hypothermia). This must be differentiated from brain death , which is characterized by (partly) preserved organ functions, but a permanently extinguished function of the brain.

Most of the funeral inspection regulations of the federal states also provide that all body regions must be included.

A death certificate will be issued after the investigation has been carried out. This consists of a non-confidential part, which is forwarded to the registry office, and information about the person, their identification, information on the IfSG, etc. a. contains, and a confidential part in which the cause of death and the causal chain leading to death should be included.

The information on the cause of death is based on the pattern of the WHO "International Form of Medical Certification of Cause of Death":

  • Information on the immediate cause of death (Section Ia)
  • Details of the illnesses which directly led to the cause of death mentioned in Ia (Section Ib)
  • Indication of the underlying causal condition (Section Ic)
  • Co-causative diseases (Section Il)

A distinction must be made between the cause of death, which relates to a medical-scientific connection with the occurrence of death, and the type of death , the circumstances, etc. a. describes from a criminalistic point of view (natural, not natural or unexplained). In some federal states, the type of death can be noted unexplained on the death certificate . This is when there is no medical diagnosis that can medically explain natural death, but at the same time there are no signs of unnatural death.

If nothing speaks against the assumption that the place of discovery is the place of death, the time of death can be determined relatively precisely by measuring the temperature of the environment and the body core temperature .

If, when the corpse is found, there is a suspicion that it could be an unnatural death or the type of death is unknown, the police or the public prosecutor's office must be informed immediately. If the cause is unclear, a careful examination of the corpse should still be carried out. In order to reliably determine the exact cause of death or the underlying causal course , the internal investigation is carried out.

The clarification of the cause of death is greatly facilitated by prior knowledge of the state of health and the circumstances of the death, but can only be carried out without any doubt through an internal investigation. Even then, cases can remain unresolved. This may be due to the fact that no specific cause of death can be reconstructed (e.g. in the case of incompletely preserved or largely decomposed corpses) or in the case of sudden infant death syndrome , which is a diagnosis of exclusion .

A second post-mortem inspection (also called crematorium coronation inspection) is planned in almost all federal states (except Bavaria) for cases of cremation or burial at sea, as potential evidence is irreversibly destroyed here. This must be done by a second doctor, who clarifies the results of his examination with those of the first post-mortem examination. If they have doubts about the findings and if they consider the anamnesis to be insufficient to certify a natural death, they can request a cremation section. If this is rejected by the relatives, the body may only be buried in the earth. In the event of indications of a non-natural death, as in the case of the first investigation, the law enforcement authorities are immediately notified.

A funeral examination in Germany was remunerated between 14.57 and 51.00 euros until December 31, 2019 (current GOÄ ). On April 12, 2019, the Federal Ministry of Health presented a draft bill that provides for the fee items and thus the fee for the determination of death to be more differentiated. This is intended to compensate for the time required to carry out the investigation carefully. Since January 1, 2020, a preliminary funeral examination according to the new No. 100 GOÄ has been remunerated at 110.51 euros, the final funeral examination according to the new No. 101 GOÄ at 165.77 euros.

Criticism (Germany)

Doctors and criminal prosecutors often criticize the fact that the post-mortem examination in Germany is not regulated on a nationwide basis. There are shortcomings in medical training. Closing forensic medicine institutes also increases the risk that more deaths will be recognized incorrectly than natural. The criminological estimates suspect of mid-2010s a number of unreported cases is between 1: 1.5 and 1: 8. The conservative estimate (1: 1.5) states that for every two deaths recognized as unnatural there are three incorrectly recognized deaths as natural.

In 2008, a working group of the Conference of Justice Ministers sought a separation of the determination of death and the determination of the cause of death. The corresponding law failed due to the approval of the federal states.

According to a study by forensic doctors at the University of Rostock , which ran from August 2012 to May 2015, an all-round correct death certificate is the big exception. Of 10,000 death certificates examined, only 223 were absolutely error-free. These included 3,116 serious and 35,736 minor errors. In total, 27 percent of all documents had at least one fatal error.

history

The judicial (that is, carried out by the judge ) post-mortem examination has been handed down from the 13th century. In 1299 Pope Boniface VIII issued the bull De sepulturis on the practice of internal examinations. The Sachsenspiegel forbade the body to be buried without inspection by the judge. At times, the funeral examinations deteriorated due to the turmoil of wars: For example, the funeral examination was carried out by “any” people. Since the middle of the 20th century, the examination of the corpse has only been allowed to be carried out by doctors. In Austria it was introduced on March 30, 1770 by coroners who were examined by the medical faculty.

The regulation of the funeral inspection in the Federal Republic of Germany is the subject of the state legislations. However, superordinate law such as autopsies regulated by federal law must be observed by those carrying out the work. In order to enable the first contact person, usually the funeral attendant, to be protected from communicable diseases, the coroner points out any communicable diseases - even if they are suspected. The responsible local authority, the health department , then instigates an epidemic section ( Section 25 (4 ) Infection Protection Act ).

See also

literature

Web links

Wiktionary: Corpse examination  - explanations of meanings, word origins, synonyms, translations

Individual evidence

  1. ↑ Germany: § § 87 −91 StPO and nos. 33−38 RiStBV ; Austria: § 128 StPO ; Switzerland: Art. 253 StPO (PDF; 856 kB)
  2. ↑ AWMF Guidelines Register - Guidelines of the German Society for Forensic Medicine (DGRM) - No. 054/002, - ( Memento from March 4, 2016 in the Internet Archive )
  3. ↑ RB Dettmeyer, MA Verhoff: Legal Medicine . Springer-Medizin-Verlag, Heidelberg 2011, p. 26 ff.
  4. ↑ a b c Christine Ruhland: Appearances are deceptive . In: Welt am Sonntag . No. 8 , February 23, 2014, ZDB -ID 1123516-0 , p. 56 ( online ).
  5. ↑ RB Dettmeyer, MA Verhoff: Legal Medicine . Springer-Medizin-Verlag, Heidelberg 2011, p. 26 ff.
  6. ↑ RB Dettmeyer, MA Verhoff: Legal Medicine . Springer-Medizin-Verlag, Heidelberg 2011, p. 25 ff.
  7. ↑ RB Dettmeyer, MA Verhoff: Legal Medicine . Springer-Medizin-Verlag, Heidelberg 2011, p. 31
  8. ↑ New regulation of the remuneration of the medical investigation from January 1, 2020, Deutsches Ärzteblatt of November 15, 2019, pages A 2124-25 and A 2155
  9. ↑ Gerd W. Zimmermann: Finally 166 euros for the inquest! But new requirements force calculations. In: Medical Tribune. May 10, 2019, accessed July 15, 2019 .
  10. ↑ Wolfgang Thiel, Most death certificates have errors ( Memento from September 2, 2017 in the Internet Archive ), University of Rostock, press release from September 1, 2017. Accessed September 1, 2017.
  11. ↑ Martin Grassberger: 200 years of the Vienna Chair for Forensic Medicine . ( Memento from December 19, 2005 in the Internet Archive ) Department of Forensic Medicine, Medical University of Vienna , 2005.