Pre-requisites

Certain preliminary conditions should be fulfilled before carrying out any autopsy procedures. These include:

Authorization and Consent
Any medico-legal autopsy should be carried out following a request made by a legal authority, to the satisfaction of the medical doctor. In Nepal, police leads all death investigations.If the authorization is not clear, it is best to clarify it with investigating officers.

Consent from family is not required to carry out  a medico-legal autopsy. However, as a humanitarian consideration, it is best to inform the family members before the commencement of procedure. It is also recommended to have family member(s) identify the body during the handing over, to avoid exchange of bodies or any other mistakes. 

Personnel permitted to witness autopsy
The family members must be informed of place and time of autopsy but their attendance in autopsy room should be refused. However, a registered doctor representing the family or accused as well as related attorneys and police officers should be permitted to witness the autopsy. This should be documented in the notes as well as the final report. Mortuary in-charge should immediately stop the autopsy if there is unwarranted interference, especially if forcefully attempted.

A second autopsy may be requested, provided the investigating officer authorizes it. This usually takes place at a later date, but the doctor conducting the first autopsy should be permitted to attend the second autopsy. 

Trainees, interns and medical students who wish to observe autopsy for academic purposes should be allowed only upon the wish of the medical officer examining the case. In cases of hospital death, presence of the treating doctor is allowed and encouraged, provided it is not a case of alleged medical negligence against him/her, since it is expected that he/she has the best knowledge of the medical history.

However, in all cases, the number of attendees witnessing the autopsy should be minimized, as there might be risk of overcrowding, mismanagement, loss of confidentiality and contamination. The hazards of autopsy should be explained to any one attending mortuary for the first time and biosafety measures ensured.

No casual observers must be allowed, not even unrelated police personnel or lawyers. Media should not have access to autopsy room and no one except the designated personnel should be allowed to take photographs and videos. Names of all individuals present during an autopsy must be mentioned in the postmortem report.