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Introduction: In some road traffic crashes with fatal outcome, the police investigations lead to charges against and prosecution of a person. The police can request a medico-legal autopsy as well as a toxicological examination, but the extent to which this is done, and the role here of in the legal setting is unknown., Material and Methods: Information concerning traffic crashes with fatal outcome in the period 2000-2004 in Aarhus Police District was retrieved and compared. The information included comprised crash specific and legal information, as well as medical data concerning autopsy, examination for alcohol, drugs and/or medicine., Results: In all, 81 traffic crashes had a fatal outcome for 92 persons, of whom 17 (18%) were autopsied, 55 (60%) were tested for alcohol, and five (5%) were examined for drugs/medicine. Twenty-six were charged with negligent homicide, of which 18 were convicted. Autopsy was performed in four of these cases, 19 were tested for alcohol and one was tested for drugs/medicine., Conclusion: This study shows that the police requests few medico-legal autopsies following road traffic fatalities, and that testing for alcohol as well as drugs/medicine is not conducted routinely. As a consequence, important information may not come to the knowledge of the police in cases of negligent homicide. We recommend that postmortem examination be conducted routinely in traffic-related homicide cases to secure the best possible conditions for a legal evaluation.

Introduction: Computerized tomography (CT) is finding increased use in forensic medicine. In this article we present our experience with CT in medico legal deaths., Materials and Methods: This is a retrospective investigation of 150 deceased individuals who were CT-scanned and autopsied. The CT-scanning was performed and interpreted by a specialist in forensic medicine. The CT-scanning and the autopsy were performed independently by two different physicians., Results: In 9% of the cases, important findings by the CT-scanning were overlooked at the autopsy, and in 51% important findings by the autopsy were not found by the CT-scanning. The cause of death could be established by CT-scanning in 30%, by autopsy in 72% and by toxicology in 21% of the cases. CT-scanning was most useful in cases of traumatic death., Conclusion: CT is rarely a substitute for autopsy, but may contribute with important new information in many cases such as identifications (including mass-disasters), gunshot wounds and traffic accidents. CT provides documentation in digital form that is easily stored and copied, permits review by others and provides pictures that may be more suitable for presentation in court than autopsy photos. CT may be helpful in medico legal external examinations (inquests) in the process of selecting cases for autopsy.

Introduction: Since the new law on autopsies was passed in 1990, the frequency of autopsy has fallen. We have carried out an analysis to illustrate the conditions/proportions for various age groups before and after the law came into force., Method: All the figures for deaths and autopsies during the period of 1977-1996 were reviewed. This includes the figures from the Danish Board of National Health and from the Department of Pathology at Rigshospitalet, Copenhagen. The frequency of autopsy was calculated for all groups, both before and after the amendment, and the results are discussed., Results: The figures showed not only a significant decrease in the frequency of autopsy in almost all groups, but also a considerable decrease in the groups of the elderly as compared to the younger groups., Discussion: The frequency of autopsy decreased during the period of 1977-1996. The most significant fall was seen around 1990, both in the general figures registered in connection with the cause of death and in the figures from the Department of Pathology at Rigshospitalet, Copenhagen. We also found that the decrease in the frequency of autopsies was greater in the groups of the elderly, when different age groups were examined. The percentage of autopsies performed on younger people has increased since the 1990 amendment.

The question whether being found dead is a problem related to living in a big city was examined by using death certificates from a 3-month period in 1994. The rates of persons found dead were higher for both sexes in the City of Copenhagen than in the rural County of Storstrøm. The age distribution showed that the rate increased with advancing age. The vast majority were found dead in their own home, although the rate was higher in Copenhagen than in Storstrøm. Whereas the manner of death was natural for the majority of cases in both areas, more deaths with an uncertain manner of death were recorded in Copenhagen than in Storstrøm (32% vs 9%). In general, suicide or accident was more often reported in those found dead in the County of Storstrøm than in those in Copenhagen. The cause of death was unknown in 46% of deaths in Copenhagen where 16% had died from external causes, proportions that were 58% and 21%, respectively, in Storstrøm. The rate of legal autopsies was higher in subjects with an uncertain manner of death than in the rest, and was also associated with an age below 40 years. We conclude that being found dead is related to living in a big city, although the reason(s) for this remains unidentified.

The frequency of hospital autopsies declined after a new autopsy law was introduced in 1990. The purpose of the study was to evaluate the frequency of autopsy over a six month period in Copenhagen county. We compared the causes of death recorded on death certificates with autopsy findings. One thousand seven hundred and four hospital deaths were followed by 534 (31%) autopsies. Neither age of the decreased nor length of the admission seemed to influence the autopsy frequency. In 20% of the autopsies we found valuable new informations compared to the causes of death recorded on the death certificates.

The purpose of this study was to illustrate the attitude towards informed consent in connection with performing an autopsy and sending out discharge notes amongst a group of patients, doctors and nurses. A questionnaire was given to four different groups consisting of 75 patients, 20 nursing staff, 20 hospital doctors and 20 family doctors. The attitudes amongst the two groups of doctors were generally close to the attitudes amongst patients. The majority of doctors and patients in contrary to the nursing staff found it unnecessary to obtain informed consent before sending out discharge notes. More than half of all of the groups thought that patients should take part in the decision of performing autopsy, but still the family should be asked as well.

The frequency of refusal for autopsy by relatives of the deceased was investigated in Arhus Municipal Hospital before and after revision of the Danish legislation concerning these matters. The frequency of refusals increased from 28.9% to 49.8%. Energetic efforts by clinicians and pathologists are required to reverse this trend.