医疗事故处理办法相关法规

《医疗事故处理办法》第十条规定“凡发生医疗事故或事件、临床诊断不能明确死亡原因的，在有条件的地方必须进行尸检。尸检应在死后48小时以内，由卫生行政部门指定医院病理解剖技术人员进行，有条件的应当请当地法医参加。医疗单位或者病员家属拒绝进行尸检，或者拖延尸检时间超过48小时、影响对死因的判定的，由拒绝或拖延的一方负责”。2002年9月1日起实施的《医疗事故处理条例》第十八条规定“患者死亡，医患双方当事人不能确定死因或者对死因有异议的，应当在患者死亡后48小时内进行尸检;具备尸体冻存条件的，可以延长至7日。尸检应当经死者近亲属同意并签字。

拒绝或者拖延尸检，超过规定时间，影响对死因判定的，由拒绝或者拖延的一方承担责任”。由此可以看出，在医患双方对患者死亡原因有异议的，应当进行尸检，哪一方拒绝尸检，影响到对死因的判断的，将承担相应的法律责任，不能仅仅依据举证责任由医疗机构承担的司法解释的规定判决医疗机构承担责任。

《医疗事故处理条例》2002年4月4日中华人民共和国国务院第351号令发布

第十八条患者死亡，医患双方当事人不能确定死因或对死因有异议的，应当在患者死亡后48小时内进行尸检；具备尸体冻存条件的，可以延长至7日。尸检应当经死者近亲属同意并签字。尸检应当由按照国家有关规定取得相应资格的机构和病理解剖专业技术人员进行。承担尸检任务的机构和病理解剖专业技术人员有进行尸检的义务。医疗事故争议双方当事人可以请法医病理学人员参加尸检，也可以委派代表观察尸检过程。拒绝或者拖延尸检，超过规定时间，影响对死因判定的，由拒绝或者拖延的一方承担责任。

尸检建议书

为了明确患者的死亡原因，根据国务院《医疗事故处理条例》第十八条及其附件《医疗事故争议中尸检机构及专业技术人员资格认定暂行规定》、《北京市卫生局关于尸体解剖检验的暂行规定》的有关规，院方建议在患者死亡后48小时内，具备尸体冻存条件的，在7日内，由北京市具有尸检资格的机构和病理解剖专业技术人员对其尸体进行解剖检验。

Laws of autopsy in the United States

1. Who determines whether an autopsy is performed?

A medical examiner can order an autopsy without the consent of the next-of-kin. Deaths that are investigated by the medical examiner or coroner include all suspicious deaths, and, depending upon the jurisdiction, may include deaths of persons not being treated by a physician for a known medical condition, deaths of those who have been under medical care for less than 24 hours, or deaths that occurred during operations or other medical procedures.

In all other cases, consent must be obtained from the next-of-kin before an autopsy is performed, even at academic institutions or hospitals. The next-of-kin also has the right to limit the scope of the autopsy (for example, excluding the brain from evaluation or limiting the procedure to examination of the abdomen).

2.WIKIPEDIA

A forensic autopsy is used to determine the cause and manner of death. Forensic science involves the application of the sciences to answer questions of interest to the legal system. In United States law, deaths are classified under one of five manners:

Natural

Accident

Homicide

Suicide

Undetermined

In some jurisdictions, the Undetermined category may include deaths in absentia, such as deaths at sea and missing persons declared dead in a court of law; in others, such deaths are classified under "Other". Medical examiners also attempt to determine the time of death, the exact cause of death, and what, if anything, preceded the death, such as a struggle. A forensic autopsy may include obtaining biological specimens from the deceased for toxicological testing, including stomach contents. Toxicology tests may reveal the presence of one or more chemical "poisons" (all chemicals, in sufficient quantities, can be classified as a poison) and their quantity. Because post-mortem deterioration of the body, together with the gravitational pooling of bodily fluids, will necessarily alter the bodily environment, toxicology tests may overestimate, rather than underestimate, the quantity of the suspected chemical.[9]

Most states require the state medical examiner to complete an autopsy report, and many mandate that the autopsy be videotaped.

Deaths that must be reported to and investigated by the medical examiner's or coroner's office can vary by state and may include those that have occurred:

Suddenly or unexpectedly, including the sudden death of a child or adult, or the death of a person who was not under the care of a doctor at the time of death.

As a result of any type of injury, including a fall, motor vehicle accident (MVA), drug overdose, or poisoning.

Under suspicious circumstances, such as a suicide or murder.

Under other circumstances defined by law.