Experts Explain | How virtual autopsies can aid both medico-legal processes and grieving families

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India witnesses one of the highest numbers of road traffic fatalities in the world. Every year, a large number of people also lose their lives in railway accidents, industrial disasters, natural calamities, criminal acts, and other traumatic events. In many regions, the number of deaths resulting from accidents and injuries rivals or exceeds deaths from natural causes among younger age groups.In such cases, the death of an individual initiates two parallel processes. The first is the legal and forensic requirement to determine the cause and manner of death and collect evidence. The second is the humanitarian obligation to return the deceased to the family at the earliest so that funeral rites can be conducted with dignity.Unfortunately, these two objectives often come into conflict because conventional medico-legal autopsies are time-consuming, manpower-intensive, and frequently lead to delays in releasing the body. In this context, a virtual autopsy or virtopsy can help forensic investigations while reducing the burden on bereaved families.What is a virtual autopsy?A virtual autopsy is a non-invasive or minimally invasive method of examining a deceased person using modern imaging technologies, such as Computed Tomography (CT) and Magnetic Resonance Imaging (MRI), without the need for extensive dissection.The process typically includes:Whole-body CT scanningMRI examination where requiredThree-dimensional reconstruction of injuriesDigital preservation of findingsVirtual documentation of fractures, internal bleeding, foreign bodies, and weapon trajectoriesDigital archiving for future reviewWhy might virtual autopsies be suitable for India?India faces several unique challenges, such as overcrowded mortuaries, limited availability of forensic experts, procedural delays and the threat of decomposition of bodies owing to those delays. A virtual autopsy can significantly reduce examination time and facilitate faster release of bodies.Opinion | In dowry death cases, a hidden hurdle: India’s forensic autopsy systemUnlike conventional autopsy findings that are recorded in written notes and photographs, virtual autopsy creates a permanent digital record that can be revisited repeatedly without disturbing the body. Further, a single CT-based virtopsy can be reviewed remotely by experts based anywhere in the country, allowing specialist consultation without transporting the body.Story continues below this adMany families are also distressed by invasive dissection procedures. A virtual autopsy preserves bodily integrity while still providing valuable medico-legal information, making it more acceptable in certain cultural and religious contexts.How exactly do virtual autopsies work?In the case of road accident fatalities, virtual autopsies can rapidly detect fatal injuries. Whole-body CT scans can identify brain haemorrhage, internal bleeding and fractures within minutes.Three-dimensional imaging allows investigators to reconstruct accident dynamics, such as the nature of the collision and direction of impact. This information becomes crucial in accident reconstruction and insurance claims. Three-dimensional digital reconstruction can generate facial approximations to aid public identification campaigns. It also allows judges, prosecutors, and investigators to understand injuries clearly during court procedures.Criminal investigations into hit-and-run accidents, vehicular homicide and drunken driving can be aided by objective imaging evidence.Story continues below this adAdditionally, India records thousands of unidentified bodies annually. Virtual autopsies can help preserve permanent records, with digital scans capturing facial structures, skeletal features and dental structures, which can later assist identification. CT scan data can also be compared with hospital records and previous medical imaging to establish identity.By reducing waiting time for families and releasing bodies in a timely manner, virtual autopsies prove better for relatives of the deceased. It aligns with the values of humanitarian forensics, which advocates that every deceased individual deserves respect and scientific documentation.For Indian states, establishing Virtopsy Centres in major medical colleges, creating a national digital grid of post-mortem repositories, developing SOPs and training specialists for such work can go a long way in incorporating virtopsies into criminal justice processes. AIIMS Delhi has a Centre for Advanced Research and Excellence in Virtual Autopsy.Virtual autopsy represents the convergence of science, justice, and humanity. Its greatest contribution lies not merely in detecting injuries or preserving evidence but in restoring dignity to the dead and compassion to the investigative process. In the coming decades, virtual autopsies should be seen as more than technological innovations. They can become humane and scientifically robust tools that place the interests of both justice and grieving families at the centre of death investigation.Story continues below this adDr Keshav Kumar, IPS (Retd), PhD, is an Advisor (Forensics) to the Government of Assam, and Nikita Opal is an advocate. Dr Kumar established the Centre for Humanitarian Forensics at the National Forensic Sciences University in Gandhinagar with the help of International Committee of the Red Cross Geneva.