Some Native-Americans have issues with autopsies for deceased tribal members.  Although death rituals and burial practices vary from tribe to tribe, I have heard this concern raised a lot in my work as a lawyer, and in my previous work as a coroner.  A new case from Pierce County has addressed the rights of family members to stop autopsies on cultural grounds.   The case involved an orthodox Jewish man, but the same legal principals could be applied to Native Americans or other cultural groups who oppose autopsies on cultural grounds.

Factual background of Pierce County case

Here is a little background on the Pierce County case:  Dr. Brian Grobois, of New York, took a trip to Washington State, and attempted a day hike in Mount Rainier National Park on December 11^th, 2011.  He died of hypothermia.  When his body was located, he was then transported to the office of Dr. Thomas Clark, the Pierce County Medical Examiner.  Dr. Grobois’ family explained that they didn’t want an invasive autopsy performed because the family is of the Orthodox Jewish faith.   When it appeared that the medical examiner was still going to proceed, the deceased’s wife hired a lawyer to seek to prohibit an autopsy.

Legal procedures involved

The lawyer Dr. Grobois’s widow filed a lawsuit seeking an injunction.  The lawyer attached a declaration by a local Washington Rabbi who explained the religious and cultural reasons why an autopsy should not be done.  The suit was filed on December 14^th at around 1 p.m., and an ex parte order was signed about 90 minutes later.  The court order prohibited the autopsy until a hearing could be held the next day at 3 p.m.  The judge who signed the order was Commissioner Mark Gelman.   The case was continued until the next day, and the attorney for the medical examiner wrote a lengthy legal memorandum citing the powers of coroners and medical examiners.  On December 16^th, Judge Brian Tollefson ruled against the medical examiner, and ordered the body to be returned.  No appeal was filed.

How this case might apply to Native Americans.

I ordered a copy of the court file in this case, and took a close look at it.  The plaintiff’s lawyer had a rabbi draft a declaration regarding religious practices.  The rabbi sited Deuteronomy 21:23 and 12:23, but not a lot of sources or citations to other religious texts were needed to stop the autopsy in this case.  It seems to me that other cultural groups (including Native Americans) could bring a similar case in a court in Washington State.  A plaintiff would want to track down cultural leaders to explain the issues with autopsies in as much detail as possible.  To prevent an autopsy, the plaintiff needs to make it clear that they are acting out of cultural beliefs, not just an individual views or preferences on the subject of autopsies.

The balancing test

Although it is not really clear from the record in Grobois v. Pierce County, a superior court in Washington will do a balancing test when faced with a request for an injunction.  In other words, the judge will balance why the pathologist feels he needs an autopsy versus why the family is opposed to it.  Was there suspicion of foul play?  Is the cause of death apparent without an autopsy?  Is the family member opposing the autopsy a suspect?

Death investigations in Washington.

Here is how the death investigation system works in Washington State.  If a person dies unexpectedly outside the care of a physician, the county coroner (or medical examiner) has jurisdiction to investigate the cause of death.   In metropolitan counties like Spokane, King and Pierce County, the county commissioners appoint a “medical examiner” to perform this function.  The medical examiner is a board certified forensic pathologist.  However, in mid-size counties like Stevens County, Yakima County, Grant County, etc., an elected coroner conducts death investigations.  These coronors might by retired nurses, retired police detectives etc, but they are not usually doctors.  In counties with populations under 40 thousand people, the job of coroner falls on the elected prosecutor.  In these counties (such as Ferry, Okanogan, Lincoln, etc) the elected prosecutor might attend a class or two, but more extensive formal training is not too common.  In these counties, the coroner investigates the death, but sends the bodies down to forensic pathologist for the actual autopsy.  For example, the Ferry County and Okanogan coroner contract with Dr. Gina Fino of Wenatchee  In Stevens and Lincoln counties, the bodies are sent to Dr. Sally Aiken or Dr. John Howard of Spokane.  There is a reason that it is important to know how the system works in different areas.  A party seeking an injunction needs to know who to serve, and needs to act fast.

The nature of an autopsy

While we often think of an autopsy as the cutting open of a body, the term “autopsy” simply means to examine the body.  However, in cases of unattended or suspicious deaths, usually the autopsy means a full examination.  In such an examination the brain is removed and dissected, and the internal organs are removed and weighed.  Samples are taken and viewed microscopically, and often sent for tests.  The parts are them put back together and the torso is sewn back up.  I had the opportunity to observe such an autopsy at Holly Family Hospital once in Spokane.  It is not pleasant to watch, of course, but the body is treated with respect and care.  Sometimes a forensic pathologist is able to tell the cause of death and sometimes not.   Sometimes an autopsy yields surprising results.  On occasion, a person who takes his or her own life will be found to have had a brain tumor that was causing the depression.  This is the type of thing that families like to know.  Many of the unattended deaths in this country are due to strokes or heart attacks.  It is possible to do a limited autopsy to address the cultural concerns or traditions of groups such a Native Americans or Orthodox Jews.  For example, Judge Tollefson did allow the Pierce County Medical Examiner to do an x-ray of Mr. Grobois.   I can recall that years ago the Spokane County Coronor would authorize such limited autopsies for Native Americans.

To obtain an injunction a person needs to find an attorney that can work fast.  When I have head to seek an injunction in the past, it usually means working all day and night to prepare the legal paperwork, and sometimes contacting a judge after hours.