The Role of Forensic Officers in performing Autopsies

Setting the record straight – The role of Forensic Officers in performing autopsies

Over the last few weeks there have been several inaccurate and at times confusing media reports with regards to the role of a Forensic Pathology Officer. It has mainly centred on the claim that Forensic Pathology Officers perform autopsies by themselves and without any supervision by a qualified Forensic Pathologist or Medical doctor.

Forensic Pathology Officers are assistants who contribute to the medico-legal investigation, but it should be stressed that a fully qualified Pathologist at all times is responsible for the overall and direct control of the autopsy process, with direct supervision and instructions to assistants, from beginning to end. 

In clearing the confusion, the Department wishes to recognise all Forensic Pathology Service personnel for the critical and important service that they render and reassure families and the criminal justice stakeholders that the service is rendered according to strict protocols. In line with our Departmental values, the remains of the deceased are treated with dignity and respect. All unnatural deaths require a medicolegal investigation of death which includes a post-mortem examination. We acknowledge that the high case load of unnatural deaths in the Western Cape put strain on our forensic pathology service. However, the claim by a Forensic Pathology Officer at Tygerberg mortuary that they perform autopsies without training and without the required supervision is unfounded and false.

It is important to understand the difference between various procedures during the post-mortem examination process including autopsies, eviscerations, dissections and the roles of both the Forensic Pathologist and the Forensic Pathology Officer in the entire process. While both work within the same environment it is inaccurate to refer to Forensic Pathology Officers and those who function as assistants to have been “conducting autopsies”. 

According to statement by Prof Gert Saayman on 22 June (Professor and Head of Clinical Department, Forensic Pathology Service at University of Pretoria and chairperson of the National Forensic Pathology Services Committee) the practice of using forensic officers has been in practice for a long time - “both internationally and locally, doctors/pathologists have conducted autopsies with the help of assistants who are not medically qualified”.

Forensic Pathologists are qualified, specialist medical doctors in the field of pathology which deals primarily with the pathology of non-natural causes of death. This may also include Registrars who are also highly trained and registered Doctors who are in the process of specializing in Forensic Pathology. Their role in conducting an autopsy is to analyse the full medical history and circumstance of death, taking into account the relevant occupational health perspectives and risks, the need for specialized dissection procedures according to the nature of the pathology which is expected and ensuring that the correct evidentiary and diagnostic specimens are collected for further microscopic, toxicological and other examinations. Above all, the pathologist must inspect and examine organs and tissues. Having due regard for a myriad of pathological conditions and injury manifestations they must record and interpret these findings, ultimately integrating all findings ranging from medical history, macroscopic autopsy manifestations, specialist laboratory and toxicology findings, microscopic examinations and more, before arriving at a diagnosis or cause of death in  preparing a technical medical report which will serve the judicial process.  

A Forensic Pathology Officer is not medically qualified and does not perform autopsies. They act as assistants to the Pathologist in preparing the body, positioning and presenting it for the pathologist, to assist with specified dissection procedures, to remove organs and to clean body cavities and return tissues to the body. The only processes not performed under direct supervision is limited to the reconstituting of the body, by sewing up thereof, washing the body and making it available to undertakers. These processes however do not form part of the autopsy process as the Medico legal examination has already been concluded by the supervising Pathologist.

The Health Professions Council of South Africa (HPCSA) is currently developing the Scope of Profession that would regulate the FPO cadre. As there is currently no scope of profession or scope of practice for the FPO, the tasks being performed is performed under the Medical Professional’s supervision or direction who is the authorized person to perform the autopsy and post mortem examination process.

Historically the Forensic Pathology Service resorted under the jurisdiction of SAPS. The Department of Health Western Cape is supporting and collaborating with the Cape Peninsula University of Technology to develop a Diploma in Forensic Pathology Support to provide Forensic Pathology Officers access to a tertiary level qualification.

Irresponsible, inaccurate and ill-informed statements and media reports will undoubtedly discourage other medical professionals to enter this critical field of service and will furthermore demotivate existing specialists and the many dedicated Forensic Pathology Officers throughout the province who provide valuable support to the Forensic Pathologists. In the interest of ensuring understanding and co-operation in this important field of the healthcare service, the Department will continue dialogues with all members of staff, to ensure this critical area is strengthened to ensure good service to our stakeholders and communities.

Dr Beth Engelbrecht
Head of Department
Western Cape Government: Health