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. 2024 Mar;138(2):639-649.
doi: 10.1007/s00414-023-03114-x. Epub 2023 Nov 7.

Are autopsies on minors a taboo?: The experience of Milan in a 19-year retrospective study

Stefano Tambuzzi  1 , Graziano Crudele  2 , Lidia Maggioni  2 , Federica Collini  3 , Sara Tunesi  4 , Adriano Decarli  4 , Antonio Giampiero Russo  4 , Cristina Cattaneo  2
Affiliations

Are autopsies on minors a taboo?: The experience of Milan in a 19-year retrospective study

Stefano Tambuzzi et al. Int J Legal Med. 2024 Mar.

Abstract

Forensic autopsy is an important tool for the proper management of non-natural deaths in minors. However, it seems that autopsy in minors is a practice which may not be performed routinely. In this framework, we conducted a study analyzing autopsies of minors (under 18 years of age in Italy) performed at the Institute of Forensic Medicine in Milan in the period 2001-2019. For the period 2015-2019, we extrapolated all deaths due to non-natural causes in minors to investigate how many and which of these deaths were not subjected to forensic autopsy. Of the total, 344 minors (235 males and 109 females) underwent autopsies, with an overall downward trend of about 80% since 2004. Most autopsies occurred between the ages of 0 and 1 year, and the fewest between the ages of 5 and 9 years. The place of death was home in most cases, and accidental death was most common, followed by natural death, suicide, and homicide, with prevalence varying by age group. Blunt force trauma predominated among accidental death in all age groups, followed by asphyxia. Similar findings were observed for suicides, although there was a more differentiated pattern for suicides between the ages of 15 and 17 years. Among homicides, blunt force trauma, asphyxia, and gunshot wounds were fairly evenly distributed across all age groups. Between 2015 and 2019, a total of 86 minors died of a non-natural cause, and a forensic autopsy was performed in only 33 cases (38%). Our data shows that fewer and fewer autopsies are being performed over the last years, which indicates a dangerous lack of forensic investigation of children and adolescent deaths, with enormous implications for prevention of child abuse.

Keywords: Forensic autopsy; Minors; Non-natural deaths; Underage victims.

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Conflict of interest statement

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Fig. 1
Fig. 1
Number of minors autopsied at the Institute of Forensic Medicine in Milan from 2001 to 2019, with the breakdown into males and females for each year
Fig. 2
Fig. 2
Number of autopsies for each age of deceased minors
Fig. 3
Fig. 3
Total methods of injury for suicide, homicide and accidental event, broken down by gender of victims, with details of raw number and percentage value (%) of the total in each category
See this image and copyright information in PMC

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