Is postmortem biochemistry really useful? Why is it not widely used in forensic pathology?
Medico legal autopsy has a basic objective to reconstruct as accurately as possible the circumstances of death to solve a judicial problem, is a process of collection of evidences from the cadaver and interpretation of the data to solve a series of questions raised in the judicial process. These questions are not only the cause of death, the survival time, the data of death, the role of previous pathology in the death's process, etc. Considering that there are more difficult problems to be solved and higher requirements for quality it is necessary that new diagnostic tools are introduced into forensic pathology. In Forensic Pathology the scientific and technological evolution has been subsidiary to other disciplines: immunology, inmunopathology, molecular biology, clinical pathology, etc. The little influence that postmortem biochemical methods have had in forensic pathology is a fact not an opinion. The reasons can be very diverse and they go from a lack of trust in the scientific literature on these topics, to an ignorance of the many possibilities which are offered by biochemical complementary tests in the cadaver for the solutions of some questions. One of the problematic issues in postmortem biochemistry is the interpretation of the obtained results; in the absence of databases with sufficient numbers of cases to establish the ranges of normality, therefore it is a real difficulty to use these types of results. On the other hand there are very few works where a correspondence between the histopathologycal findings and the biochemical values has been established; this fact is decisive for understanding the difficulties of introduction of these biochemical techniques. The main problem is forgetting that a complementary test needs a set of basic data for its interpretation and it's integration into the global findings. It is not easy for the pathologist to include in their work routine tests that require not only a change of attitude but a change in the sampling methods to obtain the materials and necessary fluids for these determinations. The weight of histopathology is decisive and it is more practical. Obviously pathologist prefers take the closer methodology to own field.
Luna
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Department of Forensic and Legal Medicine, University of Murcia, Espinardo, Medical School, 30100 Murcia, Spain. aurluna@um.es