When someone dies, in the majority of cases he/she is found by someone. What criteria must a body meet to be declared dead? What happens to the body next? What is the coroner’s role in this? How is it determined whether it is a natural or unnatural death? And what happens in the case of an unnatural death?
Signs of death
Non-perceptible breathing and blood circulation are considered uncertain signs of death. Algor mortis (cooling) in the early stages, rigor mortis (rigor mortis), livores (corpse spots) and in the late stages putrefaction and decomposition are sure signs of death.
Declaration of death
The death certificate is drawn up by the attending physician. A non-attending physician may confirm death, but may not issue a death certificate. This statement consists of an A and a B part. The A part is the declaration of death for the civil registry. This states that it is a natural death. The B part is the statement for the CBS medical officer. This provides information about the deceased (gender, age, place of death, etc.)
Natural or unnatural death?
The treating physician must contact the coroner if he is not convinced of a natural death. After an external trauma, it is mandatory to consider it as non-natural, even if it only occurs after a long time. If the coroner believes that it is not possible to issue a declaration of natural death, he must report immediately to the public prosecutor. The coroner may be accompanied by a police officer.
In a number of cases, the officer will demand a criminal investigation or judicial autopsy. If there is no objection to burial or cremation from the perspective of criminal truth-finding, permission will be given for burial.
A doctor must answer the following questions at the autopsy:
- Is it a corpse?
- Who is the corpse?
- Since when is it a corpse?
- Why/what makes it a corpse?
During the autopsy, the entire body of the deceased is examined and on this basis a decision is made as to whether or not there is a conviction of natural death. The forensic doctor is called in if there is doubt about the cause of death. In addition, the forensic doctor is called in if no treating doctor is available or if the treating doctor is related by blood or marriage up to the third degree or by marriage to the deceased.
The coroner
If there is any doubt about a natural cause of death, the coroner can look at the following points:
- Rigor mortis: begins 1-2 hours after death and is complete after 6-12 hours. Disappeared again after 72 hours. Increased rigor mortis is seen with: severe pain, extreme physical exertion, convulsions, electrocution.
- Livores: starts after 30 minutes to half an hour and is complete after 6-12 hours. The location of the livores can indicate whether there is a so-called autochthonous burial position. Normal color is blue-red to purple-red. Livores can differ in color, including in case of CO intoxication (pink to cherry red), severe cooling (bright red) and acute asphyxia (dark blue-red).
Upon entry, attention must always be paid to factors such as the organization of the environment, the smell, biological traces (blood, semen), the behavior of others, the location of the corpse, etc. If there are clear indications of something abnormal, an investigation may never be carried out, except for any assistance. The doctor may not change the situation encountered, but immediately calls in the police and/or forensic physician. Any injury, no matter how small, for which no good explanation can be given should be regarded as suspicious.
Funeral procedure
Funeral services must take place no earlier than 36 hours and no later than the 5th day after death. The mayor can give permission for earlier or later burial. The funeral director can help any surviving relatives to arrange the funeral. He can guide them in the choices that need to be made for the funeral. The funeral director also arranges many administrative chores, so that the surviving relatives do not have to do this themselves.
Practice
It appears that not all doctors are equally careful in following the rules regarding reporting a death to the forensic medicine doctor. The most frequently mentioned reasons for this are: negative experiences with reporting in the past, the association of reporting with errors and/or crime and the declining lifeline that has already been initiated. In addition, it is often difficult to assess to what extent the violence factor played a role. After a cervical spine fracture, death is reported less often, the further in the past the fall occurred.