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Is it right to request the use of scans rather than invasive procedures for postmortems?

    Question: When our father died, the authorities wanted a post-mortem. But my brother, who is more religious than I, insisted it should be done by scan rather than by an invasive procedure. I couldn't see the point but reluctantly I bowed to his wishes. Was I right?

    Rabbi Naftali Brawer

    Naftali Brawer is the CEO of the Spiritual Capital Foundation.

    Were you right to be reluctant? Or right to bow to your brother's wishes? I'm not entirely clear what you are asking but let me provide some background to the issue and then you can draw some conclusions about your specific case.

    The overarching Jewish value that stands in the way of an arbitrary autopsy is the conviction that a corpse, having once housed a sacred soul, be treated with utmost dignity. Performing something as invasive as an autopsy is understood to undermine the dignity of the corpse. There is also a related problem in that frequently autopsies delay the burial and any delay of the burial is seen as undignified, which is why Jewish law mandates burial as close as possible to the moment of death.

    This is not to say that autopsies are prohibited in all circumstances. There is a lively debate amongst the halachic authorities over which circumstances allow for an autopsy and which do not. It is generally agreed that in order to save a human life an autopsy is permitted. So, for example, if the data one hopes to glean from the procedure can help in the advancement of a cure for an illness this would be acceptable grounds to proceed. Likewise many, but not all, rabbis would permit an autopsy in the case of a murder victim in order to identify and prosecute the murderer. Removing a murderer from society can be seen as an extension of preserving human life.

    Despite the above exceptions, the rule is that autopsies are frowned on in Jewish law.

    As a young rabbi I recall numerous times when, for one reason or another, a coroner demanded an autopsy and I had to marshal all my powers of persuasion to try and convince the coroner otherwise. Sometimes I was successful, often I was not.

    In the autumn of 2014, the children of the deceased Serlotta Rotsztein challenged a senior London coroner by taking out an emergency High Court injunction and halted an impending autopsy. The upshot was that instead of an invasive autopsy a scan was carried out that satisfactorily determined the cause of death. Subsequent to this landmark case the High Court ruled that in future, autopsies must be replaced with scans if, for religious reasons, a family objects to the former. Observant Jews owe a debt of gratitude to the Rotsztein family for resolving a potential conflict between religious and secular law.

    Rabbi Jonathan Romain

    Jonathan Romain is rabbi at Maidenhead (Reform) Synagogue.

    There has long been opposition in some circles to postmortems because of the incisions made to the body. Some object because cutting is seen as disrespectful, going back to pagans making marks on corpses; others worry about the body no longer being whole and therefore incomplete at the time of the resurrection in the messianic era.

    From a Progressive point of view, these arguments do not bear any weight. While many imagine an afterlife, few believe in a physical resurrection. Postmortems are not pagan rites or deliberate desecrations, but legal requirements by the state when there is doubt over the exact cause of a person's demise. This ensures that their death is not treated lightly.

    It can also have wider benefit to society at large if the analysis reveals an error in medical procedure that can be rectified, a combination of drugs that can be avoided or acts of negligence.

    While relatives may wish to avoid a postmortem for other reasons - because of the unpleasant image of an invasive procedure or because it delays the funeral - a hierarchy of values means that its advantages should take precedence over those concerns.

    It is true that, ever since the mass killings of the rogue doctor, Harold Shipman, some deaths that might otherwise have been signed off beforehand are now being referred for a postmortem. But that is precisely because so many deaths were unnatural and could have been avoided had there been greater vigilance.

    The advent of CT scanning has offered an alternative procedure that avoids incisions, but there is no need for Jews to rush for that instead. First, because, as discussed above, there is no rational objection to ordinary postmortems. Second, CT scans are expensive, and it is a dubious morality to burden the NHS with extra costs when it is already under strain. Private CT scans are available, but also costly, and it would be equally wrong for families to feel pressurised into paying for them unnecessarily.

    Third, those CT scanners might be better used to diagnose patients who are unwell and who need analysis of their condition. The living must take precedence. In your particular case, it was good of you to accommodate your brother's wishes if it meant a lot to him, but CT scans should not become the automatic default position when there is no obligation for them.

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