BACKGROUND: Cause of death is the most fundamental health statistic, and autopsies assure an accurate cause of death is determined. Many people have religious beliefs (e.g. American Indian traditions, Orthodox Judaism, and Christian Catholic) that prohibit or discourage autopsies. In February 2015, this tension was highlighted after the death of an individual with traditional American Indian beliefs. The family did not want an autopsy, but the medical examiner believed an autopsy was necessary. By July 2015, Minnesota enacted a statute that allowed for a decedent’s representative to object to an autopsy based on religious beliefs. In January 2016, a check box was added to the death certificate to indicate whether a religious objection to an autopsy had been requested. The check box was added to better track religious objections and monitor the impact of the statute.
METHODS: Death certificates with a religious objection to autopsy were analyzed and summarized by demographic information and cause and manner of death. Deaths with a religious objection to autopsy were compared with deaths where an autopsy was completed to determine the potential impact of the religious objection statute.
RESULTS: In 2016, there were 36 religious objections to autopsies recorded on death certificates, and a total of 3,135 autopsies completed. Men accounted for 25 (69%) of the objections compared with 2,197 (70%) of total autopsies. The median age of individuals with an objection was 67 years, compared with a median age of 53 years for those with an autopsy complete. Despite the objection, autopsies were completed for ten (28%) of the decedents. The cause and manner of deaths were similar for both groups. However, a greater percentage of non-white decedents indicated a religious objection to autopsy. For example, American Indian decedents accounted for 19% of the objections compared with 3% of autopsies completed.
CONCLUSIONS: Religious objections to autopsies are most likely to occur among white and American Indian decedents. Although religious objections to autopsies have occurred, medical examiners and coroners have been able to obtain information regarding the manner, cause, and circumstances of the death. To date, this statute has had minimal impact on health statistics. Medical examiners and coroners understand the importance of the law and believe they can work with the law and families to accommodate their requests, while also fulfilling their responsibilities. Seven other states have similar laws; a survey is being administered to assess the impact of such laws.