Autopsies used to be very common. At one point in the 1940s the autopsy rate at hospitals was around 50%. That means one out of two people who passed away would have an autopsy. Many of those autopsies were done because hospitals needed a 20% or higher autopsy rate for accreditation. Back then autopsies were largely done in an effort to advance medicine and measure the quality of medical care. Today, the autopsy rate has fallen to just 7.4% of deaths according to the CDC, and about half of those are performed for forensic purposes due to unintentional injuries, suicide or homicide.
Every state has their own guidelines and regulations surrounding autopsies. The state law will dictate when autopsies need to be done as well as who can do them. In the Lone Star State, autopsy regulations are spelled out in the Texas Code of Criminal Procedure, Article 49. If you live in Texas, here are a few things to know about who is involved in autopsy procedures.
Who Can Authorize an Autopsy in Texas?
Before an autopsy can be performed in Texas it has to be authorized. So the first question is, who can authorize an autopsy? In other words, who can give consent for an autopsy to be performed?
Some pathology services are required by the Texas Code of Criminal Procedure, Chapter 49.25 to be performed by county medical examiners if the death was sudden, unexpected, violent, suspicious or unnatural. They must also investigate whenever someone dies in jail/prison, within 24 hours of being admitted to a hospital, a treating physician can’t certify the cause of death or the person is six years old or younger.
When a case is referred to the medical examiner’s office they will review the case to determine if it’s within their jurisdiction before proceeding. Services must also be provided if local authorities submit a written request.
Under Texas law the following people can also authorize a postmortem examination or autopsy (also known as an inquest into a death) in the following prioritized order:
- Spouse of the deceased.
- Caretaker of the deceased.
- Administrator or executor of the deceased’s estate
- The deceased’s adult children.
- Parent(s) of the deceased.
- Adult sibling of the deceased.
Any of these people can also file an objection with the medical examiner, county judge, physician or justice of the peace to stop an autopsy that isn’t required by law.
If there is no one related to the deceased that can provide consent for the autopsy, then the acting physician may be able to still get authorization from a county judge, medical examiner or justice of the peace.
It should be noted that a request for an autopsy does not mean one will be performed. In 2024 the Travis County Medical Examiner’s Office reported that just 1,779 of the 7,855 deaths that were reported were physically examined by the office.
Who is Authorized to Perform an Autopsy in Texas?
Once the authorization for an autopsy is given the procedure can be performed. In Texas, autopsies are performed by the county medical examiner who is a trained pathologist. It’s the medical examiner’s job to determine the manner and cause of a death when:
- The death is unnatural
- The death is unexpected deaths
- A medical doctor can’t certify the cause of death
- The death is a homicide
- The death occurred by suicide
- An accident caused the death
- The cause of death is undetermined
All county medical examiners must follow the Texas Code of Criminal Procedure guidelines for performing autopsies. The guidelines can be found in Article 49.25 subchapter B.
Private Forensic Pathologists
Autopsies that aren’t required by law can be performed by private forensic pathologists that are licensed by the state. They can also provide secondary autopsies after an autopsy by a medical examiner as well as specialized services. Texas Autopsy Services and Hill Country Forensics are two examples of facilities that can provide autopsy services. However, unlike the medical examiner’s office, families have to pay a fee for a private autopsy.Â
What is the Role of Death Investigators?
In Texas counties with an Office of Death Investigation, death investigators assist the county medical professional that’s performing an inquest for forensic purposes. The death investigators aren’t helping perform the autopsy, but they do assist in the inquest by investigating the place, manner and time of the death. They will also seal off the location of the death for the investigation. Once they are done they will write up a report of the findings.
The medical examiner can also get approval to name deputy examiners to help out with an inquest.If you have questions about post mortem procedures or authorizing a cremation in Texas you can give our knowledgeable experts a call, text or email any time of day.
