Probleme bei der ärztlichen Leichenschau: Sicht der niedergelassenen Ärzte, der Klinikärzte, der Notärzte und der Polizei

Background: In Germany all doctors are committed by law to testify death and to perform an external inspection of the body. Afterwards they have to fill out a death certificate which mainly contains relevant judicial questions and have to be answered by medical doctors. This creates a number of problems. Resident doctors: The main problem is the conflict of interests between acting as the family doctor on the one hand and as the neutral medical expert on the other. Often the relatives or even the police put pressure on the doctor to certify a natural cause of death. Also the fee for examining the body is considered as being inadequately low. Clinicians: Doctors in hospitals wish to have clarity concerning what manner of death they have to certify when a patient died during or shortly after a medical intervention. They also like to have a better feedback concerning the results of an autopsy. Emergency physicians: Because of their close relationship to police officers emergency physicians often feel great pressure of expectation to certify a natural death irrespective of the lack of information concerning the medical history of the deceased. Police: Police officers often experience that doctors do not perform a good and sufficient external examination of a dead body and in hospitals they often have to face doctors who are not willing to communicate in an adequate way. Conclusion: The system of testifying death in Germany is in need of reform. The medical education of students and the continuing training of doctors concerning testifying death have to be intensified. Furthermore the autopsy rate in Germany has to be significantly increased to identify the real cause and manner of death.