The laws regarding the circumstances under which the medical examiner must conduct an inquest (inquiry into the cause of death) or under which a person may request an autopsy vary from state to state, and are usually located in a state’s statutes. The following information is generally applicable to inquests and private autopsies.

Inquest

If a person dies in a county with a medical examiner, the medical examiner (or authorized deputy) must conduct an inquest under the following circumstances: (1) when a person dies within 24 hours after being admitted to a hospital or institution, or dies in prison or jail; (2) when a person is killed, or dies from an unnatural cause of death (unless executed by the state for a crime), or dies without one or more good witnesses; (3) when the body or a body part of a person is found, and the cause or circumstances of death are unknown; (4) when the circumstances of the death of any person lead to suspicion the person died by unlawful means; (5) when any person commits suicide, or the circumstances of the person's death lead to suspicion the person committed suicide; (6) when a person dies without having been attended by a duly licensed and practicing physician, and the local health officer or registrar required to report the cause of death does not know the cause of death; (7) when the person is a child who is younger than six years of age and the death is reported to child welfare services; and (8) when a person dies who has been attended immediately preceding his death by a duly licensed and practicing physician or physicians, and such physician or physicians are not certain as to the cause of death and are unable to certify with certainty the cause of death.

Private Autopsy

Consent for a postmortem examination or autopsy often may be given by any member of the following classes of persons who is reasonably available, in the order of priority listed: (1) the spouse of the decedent; (2) the person acting as guardian of the person of the decedent at the time of death or the executor or administrator of the decedent's estate; (3) the adult children of the decedent; (4) the parents of the decedent; and (5) the adult siblings of the decedent.

In Massachusetts, the Office of the Chief Medical Examiner (OCME) is responsible for conducting inquests into deaths under specific circumstances. An inquest is mandatory when a death is unattended by a physician, occurs under suspicious or unusual circumstances, is sudden and unexpected, is the result of violence or trauma, or occurs in custody or incarceration. This includes cases of suicide, deaths without a known cause, or when a death occurs within 24 hours of hospital admission without a clear medical cause. Additionally, if a child under the age of six dies and the case is reported to child welfare services, an inquest is required. Regarding private autopsies, Massachusetts law allows for a postmortem examination to be authorized by the next of kin or other authorized individuals, in a priority order starting with the spouse, followed by a guardian, executor, adult children, parents, and then adult siblings of the deceased. Consent must be obtained from the highest priority individual available to give such consent.