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Rapid Responses: Rapid Responses published:
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Islam and Autopsy
- Mouied Alashari (23 November 1998)
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Magnetic Resonance Imaging may be alternative to necropsy
- Jas Brookes (3 December 1998)
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Magnetic resonance imaging may be alternative to necropsy
- Laszlo Szabo (13 January 1999)
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Re: Islam and Autopsy
- Sohail Ahmed Dar, nil (18 March 2006)
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Mouied Alashari, Assistant Professor of Pathology Children's Hospital of Buffalo, New York, US
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Blaming Islam for refusing autopsy permission is inappropriate and incorrect. Many people of the Islamic faith may refuse permission for autopsy due to social or cultural reasons and they may reflect it on the religion. In reality, Islam emphasizes and encourages scientific investigations to reach the truth in all aspects of life and it considers that is the best way to understand God and His wisdom in the creation, (On the earth are signs for those of assured faith, as also in your ownselves: will yet not they see) Quran; Section26, Sura 51, Verse 20,21. |
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Jas Brookes
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Sir The first public presentation of work specifically assessing the use of magnetic resonance imaging as an alternative to necropsy was made by Brookes in 1995 (1). The first peer-reviewed publication of this work appeared in the Lancet in 1996 (2). Further developmental work continues at UCLH, London (3, 4). Magnetic Resonance Necropsy (MRN) is now offered for perinatal postmortem examination as an established service in the imaging department of UCLH, London. At a time when non-coroner necropsy rates have fallen to less than 10% for adults and approximately 50% for perinates (the most prognostically significant age group for necropsy) MRI offers an acceptable alternative (5). Imaging diagnosis has become the established norm for the living (for example abdominal CT scanning has almost entirely replaced diagnostic laparotomy). Surely it can no longer be denied to the dead, the majority of whose relatives find surgical necropsy unacceptable. By increasing the uptake rate of postmortem examination in this way, we may once again be in a position to derive postmortem information of epidemiological significance relevant to todays population. We applaude the efforts of Dr Bisset (et al?) in North Manchester General Hospital in rallying to the call and look forward to the formal publication of his results. Yours sincerely JAS Brookes M Hall-Craggs WR Lees REFERENCES 1). THE NON-INVASIVE PERINATAL NECROPSY; A new role for MRI. Brookes JAS, Lees WR. Nov 95. Abstract in Radiological Society of North America Chicago Scientific Program Nov 1995 197(P):174. 2) NON-INVASIVE PERINATAL NECROPSY BY MRI. Brookes JAS, Hall-Craggs MA, Sams VR Lees WR. The Lancet 1996;348:1139-1141 3) 3D MR IMAGING OF THE POST-MORTEM FETAL HEART. Deng J, Brookes JAS, Gardener JE, Rodeck CH, Lees WR. Fetal Diagn and Ther 1996;11:417-421. 4) ESTIMATION OF FETAL DEVELOPMENTAL AGE WITH 3D MRI OF THE FETAL BRAIN Brookes JAS, Deng J, MacArthur A, Lees WR. BIR, Birmingham, UK May 1997. 5) Editorial: POSTMORTEM PERINATAL EXAMINATION: THE ROLE OF MRI. Brookes JS, Hall-Craggs MA. Ultrasound Obstet Gynaecol. 1997; 9 :145-147. Dr JAS Brookes MB BS MRCP FRCR Consultant radiologist Department of Medical Imaging UCLH, The Middlesex Hospital Mortimer St London W1N 8AA tel 0171 380 9015 Fax 0171 380 9068 |
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Laszlo Szabo
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Editor - There is nothing new under the sun. From the earliest day following the discovery of X - rays in 1895 there has been considerable interest in the value of Radiology in the investigation of mummified Egyptian remains. Until recent years most recorded specimens were radiographed and in 1978 the first computer tomography was performed of a whole mummy. Surprisingly several diseases were revealed by these methods (1,2). Concerning Dr Rob Bisset letter, it seems to be good idea to perform Magnetic Resonance Imaging in case of unexplained death to whom necropsy was not allowed. But allow us some questions concerning this opportunity: 1. Why MRI as the gold standard postmortem changes can easily fail in the correct findings. 2. It would be nice to know postmortem ”optimal” time to perform it. As after some time period there is no means to perform the examination. 3.Why not perform CT in some cases. It could be more informative and cheaper than the MRI. Finaly, we agree with Dr Rob Bisset’s idea but we can not agree to the next statement : "Despite these drawbacks radiological investigations may be as valuable in death as they are in life. " Bela Lombay, Professor Laszlo Szabo, Professor Borsod County Teaching Hosp. Dept. of Diagnostic Imaging Miskolc, POBox 188, 3501 Hungary 1. Harwood – Nash DC Computed tomography of ancient Egyptian mummies. J. Comp. Ass. Tomogr. 1979, 3: 768 2. Isherworod I., Jarvis H., Fawcitt RA Radiology of the Manchester mummies. In : David AR ed. The Manchester 1979. Mumminy Project. Manchester Museum 25 – 64 |
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Sohail Ahmed Dar, Accident and Emergency Manchester, nil
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Dear sirs, I wish to respond to the subject of performing autopsies in deceased Muslims. Although a relatively old subject, I did read in a recent edition an article encouraging a more positive attitude towards conventional post mortems amongst the Muslim population. Most arguments articulated in support of this stance were approached from the perspective of bringng substantial benefits to faith groups who are otherwise opposed to such measures. The notion that Islam encourages scientific study and advances in technology has also been used as basis for argumentation. I would like to add a different twist to this debate. Exactly what benefits are brought by performing conventional post mortems? The suggestion that correctly identifying the cause of death helps in our understanding of disease processes and the health of the nation is not as clear cut as it initially appears. We need to remember that identifying a cause of death simply povides us information on that and that alone. Understanding health trends in this society requires much more than a cause of death. We know for example a patient with Leukaemia, who is on Chemotherapy may in fact die in a road traffic accident. His chronic illness therefore has no role in his death, and hence an autopsy will provide little or no information about such chronic illness, simply because post mortems are not performed for that purpose. Coming back to the case of Islam and Science. It is indeed true that Islam encourages and obliges the study of science in order to make advancements in technology, and the history of Islam is testimony to that. However, using this general rule to legitimise every course of scientific study is an over simplification and does little to promote a genuine discussion. The issue requires a much deeper study of the divine Islamic texts to ascertain the correct perspective of Islam on post mortems. We will find therefore that the Islamic Sharia itself defines exactly what is or is not absolutely necessary. We will find that the Sharia actually does not suggest that identifying a cause of death as being an absolute must. So the role of autopsies in this context needs to be raised, especially if we consider the actual Islamic rule on bringing harm to a deceased body and its mutilation as being totally prohibited. This does not however suggest that Islam is an obstacle to scientific progress. Quite the opposite. In such a situation, what is then required is for other creative ideas to be developed and alternative scientific procedures to be studies. To suggest that autopsies must be done, since its the tradition or the most effective means of identifying a cause of death is the wrong premise for doctors and scientists to build their decisions and judgements on. We are constantly studying disease processes, developing existing procedures through research, so why stick to a convention established, in origin, centuries ago? There are currently many studies undertaken by the US military utilising radiolgical studies to establish causes of death in US service men. In addition to this there is much other work currently taking place that suggests that radiological examinations are a credible alternative to conventional post mortems. I would conclude by suggesting that as doctors we need to be empathic towards the needs of the deceaseds' families as we would be during the patients' lives, and hence look to bridging the gaps which clearly exist between peoples' faiths and the needs of modern medicine rather than simply insisting that people of different faiths dump their beliefs and accept, under compulsion or need, the conventional and old fashioned rituals of modern medicine Competing interests: None declared |
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