KOCHI: “Doctor, is it possible to avoid performing a postmortem on my child?” This heart-wrenching question was recently posed to a forensic surgeon in Kerala by a grieving family whose eight-year-old boy had tragically drowned in a swimming pool during an outing. For many such families, the emotional trauma of losing a loved one is severely compounded by the thought of a surgical blade cutting into the deceased’s body, the sight of stitches post-examination, or religious and cultural beliefs surrounding death and dignity.
To address these profound concerns, forensic experts in the state have proposed an advanced non-invasive alternative called ‘virtual autopsy’ (VA) or ‘virtopsy’. A detailed project report (DPR) aimed at establishing the first public-sector virtual autopsy centre is currently awaiting approval from the Kerala state government.
According to Dr A K Unmesh, Head of the Forensic Medicine Department at Kottayam Medical College Hospital (MCH) and a police surgeon who drafted the report, this state-of-the-art technique makes it entirely possible to determine the cause of death without performing a traditional dissection. While virtual autopsy may not be suitable for every single case, it has the potential to significantly minimize the necessity of conventional open-body autopsies.
The project report emphasizes that every human being is entitled to dignity both during life and after death. Traditional autopsies, which necessitate large incisions and extensive internal dissection, often inflict immense mental agony on grieving relatives, adding to their existing emotional trauma. Virtual autopsy has emerged as a highly compassionate alternative, supporting both forensic experts and grieving families by cutting down the need for such invasive procedures.
Although medico-legal autopsies remain legally mandatory worldwide for suspicious or unnatural deaths, conventional techniques alter the physical appearance of the deceased due to long incisions. Studies indicate a strong societal preference for non-invasive options to avoid this distress. Dr Unmesh highlighted that if implemented, this facility would not only serve as Kerala’s first virtual autopsy centre but would also be the first of its kind among government medical colleges across South India. “Virtual autopsy aligns perfectly with legal standards while simultaneously promoting human dignity, scientific accuracy, and emotional comfort for the families,” he stated.
Under Indian law, a postmortem examination is compulsory in cases of unnatural death. Investigating officers release a body without a postmortem only in exceptionally rare instances based on strong circumstantial evidence and preliminary findings.
The report notes that conventional autopsies are inherently invasive and sometimes controversial. Virtual autopsy has already been successfully introduced at select premier centres across India, including Delhi, Rishikesh, Shillong, and Bengaluru. The current proposal aims to bridge and strengthen the collaboration between forensic medicine, radiology, the judiciary, and law-enforcement agencies. It strongly recommends launching a pilot project at Kottayam MCH, leveraging its status as a tertiary-level government referral hospital with an established forensic department.
While a section of the medical community has raised concerns regarding the absolute accuracy of virtual procedures, Dr Unmesh clarified that it is not intended to completely replace conventional postmortems in complicated cases.
“Available statistics indicate that in nearly 60% of cases in Kerala, the exact cause of death and other vital forensic findings can be determined solely through virtual autopsy, without any invasive procedures,” he explained.
He further added that a substantial number of road traffic accident fatalities, certain categories of natural deaths occurring under unusual circumstances, and accidental deaths backed by reliable eyewitness accounts fit perfectly into the category where surgical dissection can be completely avoided.
The proposal highlights major challenges in the current system, such as cultural objections to invasive methods, case backlogs due to a shortage of forensic manpower, difficulties in presenting graphic findings in court, and the degradation of physical evidence over time. Implementing virtual autopsy in Kerala would enhance medico-legal services, boost judicial transparency, offer permanent digital evidence for legal reviews, and ease family distress. The core equipment proposed for the centre includes a 16/32-slice CT scanner for whole-body imaging, a 1.5T/3T MRI scanner for soft tissue evaluation, 3D image reconstruction workstations, specialized forensic radiology software (such as Amira, Mimics, and OsiriX MD), and a Picture Archiving and Communication System (PACS) with secure cloud backup.
ലഘു വിവരണം
മൃതദേഹം കീറിമുറിക്കാതെ സിടി, എംആർഐ സ്കാനിംഗിലൂടെ മരണകാരണം കണ്ടെത്തുന്ന ‘വെർച്വൽ ഓട്ടോപ്സി’ സംവിധാനം കേരളത്തിൽ നടപ്പിലാക്കാൻ ഫോറൻസിക് വിദഗ്ധർ സർക്കാരിന് പദ്ധതി സമർപ്പിച്ചു. കോട്ടയം മെഡിക്കൽ കോളേജിൽ ദക്ഷിണേന്ത്യയിലെ ആദ്യ സർക്കാർ വെർച്വൽ ഓട്ടോപ്സി കേന്ദ്രം സ്ഥാപിക്കാനാണ് ശുപാർശ. റോഡ് അപകടങ്ങൾ ഉൾപ്പെടെ 60 ശതമാനത്തോളം കേസുകളിൽ മൃതദേഹത്തോട് ആദരവ് പുലർത്തിക്കൊണ്ട് ഈ നോൺ-ഇൻവേസിവ് രീതിയിലൂടെ പരിശോധന നടത്താൻ സാധിക്കുമെന്നും ഇത് ബന്ധുക്കളുടെ മാനസിക വിഷമം കുറയ്ക്കുമെന്നും പദ്ധതി രേഖ വ്യക്തമാക്കുന്നു.
(With inputs from TNIE)
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