Virtual Autopsy

LECTURES :
dr. Arif Rahman Saddad, SpF,S.H,Msi Med,DHM
dr. Stephanus Rumancay
Members :
Fika Amalia
Gerald Mandra Dwi Putra
Hendri Wijaya
Juny Kurnia Nuzantry
Maureen
Stephanie Yohanna Tania

Background

Problems

What is the meaning of virtual autops

y?

What are the advantages and disadvan

tages of virtual autopsy?

How is the law of virtual autopsy in In

donesia?

What are the religious views about

autopsy?

Purpose
General Purpose

To give knowledge
about virtual autopsy
for medical worker
especially doctor

Specific Purpose
1. Religious view on autopsy
2. Definition of autopsy
3. Advantages & disadvantages autops
y
4. Medicolegal autopsy

BENEFIT
To expand knowledge ab
out Virtual Autopsy
To develop writing skills

For Writer

For Reader:
As a reading material and reference for r
esearch purposes.
To introduce and increase our knowledg
e about Virtual Autopsy.
To give more information about Virtual
Autopsy so that its clinical application ca
n be expanded.
To increase readers interest in utilizing f
urther use of technology in Forensic me
dicine

AUTOPSY

Definiton
Inspection and disse
ction of death body t
o determine the caus
e of death

History of Autopsy
Babylonia Era (3500 SM)

Ancient Greek (131-200 SM)

Faculty of Law University of Bo

logna (the end of 1200)

Paus Sixtus IV (end of 1400)

1500

Animals autopsy For mythical interest

Animals and humans autopsy To study anatomic structur
e

Helping to solve the law problem

Allow human body surgery before, human body surgery w
as a criminal

Systematic Examination

History of Autopsy
Microscopic examination
Rudolph virchow (1821-1902)
Relationship of pathologic findings with clinical manif
estation

Morgagni (60 years)

Developement of autopsy
Vesalius (1514-1564)
Pare (1510-1590)
Lancisi (1654-1720)
Boerheave (1668-1771)

01

02

03

Classification of Autopsy

Anatomical
autopsy

Clinical
autopsy

Forensic
autopsy

Autopsy according to the Law

CLINIC
UU RI No. 36 tahun 2009 tentang Kesehatan Pasal 119
PP No. 18 tahun 1981 tentang Bedah Mayat Klinis.

ANATOMY
UU RI No. 36 tahun 2009 tentang Kesehatan Pasal 120
PP No. 18 tahun 1981 bertujuan untuk Pendidikan Calon Dokter

LEGAL MEDICINE

UU RI No. 36 Tahun 2009 tentang Kesehatan Pasal 122

KUHAP Pasal 133, 134
KUHP pasal 222
Instruksi Kapolri nomor INS/E/20/IX/1975.

Views of Religions on autopsy

Muslim

Islam require its believers to r

espect human remains and not
to harm the body but under ce
rtain circumstances autopsy is
allowed.

Mencegah kemafsadatan lebih didahulukan (di-utamaka

n) dari pada menarik kemaslahatan.
Kondisi darurat membolehkan hal hal
yang (sebelumnya) dilarang

Sesungguhnya Allah menyuruh kamu menyampaikan aman

at kepada yang berhak menerimanya, dan (menyuruh kamu)
apabila menetapkan hukum di antara manusia supaya kamu
menetapkan dengan adil. (QS. An-Nisa : 58).

Fatwa MUI (Majelis Ulama Indonesia)

1. The rights of every human remains must be fulfilled and respected.
2. Autopsy is allowed by authorities if there is an urgent need.
3. Autopsy has to fulfill the following:
a) Based on the purpose that is legally approved by the Law of Syari, assig
ned by the authorities and done by the specialist
b) Autopsy is the only way to achieve point (a)
c) Human remains rights that is autopsied have to be fulfilled such as: bat
hed, kafan, prayed and buried.
d) Permission in advance has to be taken from the object of autopsy when
he/she was alive through wills, permission from heir, and/or Governme
nt according to law.

View of Religion of autopsy

Protesta
nt
There is no law that forbids autopsy
but human remains have to be
treated respectfully.

It is believed that there is no

connection between the soul and the
body.

View of Religion of autopsy

Catholic
Autopsy for the purpose of
scientific researches is morally
accepted.
The use of human parts is
acceptable and can be very
meritorious.

View of Religion of autopsy

Hinduism
Autopsy disrupt the soul that is still in
the body.
In Veda Age, dissection and mutilation of
human body is considered detrimental
to the fulfillment of life.
In summary, Hinduism forbids autopsy
but it is allowed under certain
circumstances.

View of Religion of autopsy

Buddhism
Buddhists generally believe that
autopsies are a form of
compassion that help preserve life.
Even though it is believed that it is
not proper to desecrate the body,
autopsy rely on the intent and the
purpose of doing it.

Virtual
Autopsy
Noninvasiveautopsyperformed
onahumanbody.
Alsocalleda"Virtopsy,
Avirtualautopsyusesvarious
techniquesincluding3Dsurface
scanning,catscansandMRIs

1898
Post mortem radiography used first ti
me

1980

VIRTOPSY
1977
Wullenweber et al reported the use of Ctscan t
o describe the radiographic pattern of gun sho
t wound to the head.

Flodmark et al conducted a comparative stud

y to compare the result of conventional auto
psy and

CTscan in perinatal asphyxia case

s.

2000
Prof. Richard Dirnhofer started a research
on autopsy virtual in Zurich Univeristy, Swi
ss

1990
Post mortem radiography 3D used first t
ime

Autopsy Virtuals technique

Multi-slice com
puted tomogra
phy (MSCT)

Magnetic reson
ance imaging
(MRI)

3D Virtual
Autopsy Ta
ble

Multi-slice computed
tomography (MSCT)
Before CT scan ( one line detector ara
y)
(+) 3D to compare the condtion of t
he vehicle after the accident with the vi
ctim, find the cause of death.
Head trauma & gun shoot

Magnetic resonance
imaging (MRI)
To visualize human internal organs so that it can be exami
ned in detail.

3D Virtual Autopsy Table

Swedish researchers have developed an interactive touchscreen
3D autopsy table that allows pathologists to examine virtual repr
esentations of real bodies in minute detail and from numerous vi
ewing angles.
Using data provided by scans of an actual body, the table allows
the user to remove layers such as skin and muscle, add or remov
e tissue and circulatory systems, zoom in and out and cut throug
h sections with a virtual knife.

Click icon to add picture

Usu dico maiorum mnesarchum ea, salutandi cotidieque adversarium per id. In summo dicam soleat v
ix, id nec dictas detracto. Solum laudem corrumpit ius in.
Has falli iisque blandit ad, ut insolens antiopam vim.

3D Virtual Autopsy Table

The victim's body is placed on

an examination table under a
CT scanner and/or MRI machin
e and processed using softwar
e developed by the researcher
s, takes only 20 seconds and di
splays the bones, gases and an
y foreign objects in the body.

Virtual Autopsy acurate

Head & necks trauma
Infarct Myocard
Drawning
Sudden death Infant & Childre
n

Head & necks trauma

MSCT dan MRI Herniated (+) in head trauma
Confirmation with convensional autopsy same result.
Intramedullary bleeding: same result with hystopatholgy

Head & necks

concusion

Sudden death in Infant and Children

PMCT (MRI dan MSCT) result same with conventional autopsy

Sudden death in Infant and Children

PMCT (MRI dan MSCT) result same with conventional autopsy

Myocardial Infarction
Switzerland MRI + hystopathologys examination
Result:

Bad : Peracute infarct myocard

Good : Subacute, acute and chronic

Drowning
Result : MRI dan M
SCT similar with co
nventional autops
y.

Trauma
Result : MRI dan M
SCT similar with co
nventional autops
y.

Advantages of Virtopsy
1.

Virtual autopsy i
snt invasive

3.

The human remain

doesnt stay in long
time at hospital.

5.
Do not need radiatio
n dose for postmorte
m check

2.

Enable examiner t
o examine human
remains in many s
ide of views

4.

Virtual autopsy effectiv

e in study about wound
especially shot wound.

The disadvantages
1

High cost

Virtual autopsy allow bias in diagnosis.

3
4
5

Virtual autopsy is unable to detect death caused by pois

on.
Unable to give data for postmortem wound / antemortem w
ound.
Unable to give status data of infection

Differences virtopsy & Conventional

Virtual autopsy

Conventional
autopsy

High cost

Low cost

Unable to detect death causes

by poison
Unlimited side of views

Able to detect death

causes by poison.
Limited side of views

Human remains in good

condition
Family prefer to comply

Human remain not in good

condition
Family commonly refuse

Source: https://indonesiana.tempo.co/read/43041/2015
/06/18/thamrindaffan/hanya-polri-yang-memiliki-ct-sc
an-post-mortem

Conclusion
1. Autopsy inspection and dissection of a
body after death, as for determination of
the cause of death.
2. To support law enforcement, research
purposes, development of science,
scientific studies especially in medical
fields.
3. Virtual autopsy is believed to be the
solution to anticipate controversial ideas
in countries such as Indonesia, where
religious beliefs is tightly upheld.
4. Still new in Indonesia, has several
disadvantages compared to conventional
technique.

Suggestion
Further research is highly
encouraged in order to support the
disadvantages of virtual autopsy
and to develop more advanced
technology in its practice.
It is suggested to increase the
usage of virtual autopsy by, for an
example, doing routine screening
before doing conventional autopsy
and comparing the results.