Cause of Death Unknown: How to Investigate Unexplained Deaths

When someone dies, the cause of death is usually clear and obvious. However, in some cases, the cause of death may be unknown, uncertain or suspicious. These are called unexplained deaths, and they require a thorough investigation to determine the true cause and manner of death.

Unexplained deaths can occur due to natural causes, such as heart disease or stroke, or unnatural causes, such as homicide, suicide, accident or poisoning. Sometimes, the cause of death may be influenced by multiple factors, such as underlying medical conditions, environmental exposure, drugs or alcohol, or trauma. In these cases, it may be difficult to establish the exact cause of death and the intent of the deceased or others involved.

In this article, we will explore how unexplained deaths are investigated, what are the challenges and limitations of such investigations, and what are the legal and ethical implications of determining the cause of death.

What is an Unexplained Death?

According to the World Health Organization (WHO), an unexplained death is “a death for which there is no obvious cause or explanation based on available information”¹ This means that there is no clear medical diagnosis or evidence that can explain why the person died.

An unexplained death may be classified as natural or unnatural depending on the circumstances and findings of the investigation. A natural death is one that results from a disease or an internal malfunction of the body. An unnatural death is one that results from an external cause, such as injury, violence, poisoning or infection.

Some examples of unexplained deaths are:

• Sudden infant death syndrome (SIDS), which is the sudden and unexpected death of an apparently healthy baby under one year of age²
• Sudden cardiac death (SCD), which is the sudden and unexpected death of an adult due to a heart problem that was not previously diagnosed or known³
• Sudden unexplained death in epilepsy (SUDEP), which is the sudden and unexpected death of a person with epilepsy without any apparent cause⁴
• Undetermined homicide, which is a death that is suspected to be a homicide but there is not enough evidence to prove it beyond a reasonable doubt⁵
• Undetermined suicide, which is a death that is suspected to be a suicide but there is not enough evidence to confirm it⁶
• Undetermined accident, which is a death that is suspected to be an accident but there is not enough evidence to rule out other possibilities⁷

How are Unexplained Deaths Investigated?

The investigation of unexplained deaths involves a multidisciplinary team of professionals, such as police officers, forensic pathologists, coroners or medical examiners, toxicologists, geneticists and other specialists. The main objectives of the investigation are:

• To identify the deceased person and notify their next of kin.
• To collect and preserve any physical evidence related to the death scene and the body.
• To perform an autopsy or a post-mortem examination on the body to determine the cause and manner of death.
• To conduct any additional tests or analyses on the body tissues, fluids or organs to detect any abnormalities or substances that may have contributed to the death.
• To review any medical records, personal history, witness statements or other information that may provide clues about the death.
• To prepare a report that summarizes the findings and conclusions of the investigation.
• To communicate the results of the investigation to the relevant authorities and parties.

What are the Challenges and Limitations of Unexplained Death Investigations?

Unexplained death investigations are complex and challenging for several reasons. Some of these are:

• The lack of clear signs or symptoms that can indicate the cause of death.
• The difficulty in establishing the time and place of death.
• The possibility of multiple causes or factors that may have contributed to the death.
• The potential influence of human error, bias or fraud in collecting, handling or interpreting evidence.
• The variability in standards and protocols for conducting investigations across different jurisdictions and countries.
• The ethical and legal issues involved in obtaining consent, respecting privacy and confidentiality, and disclosing information.

What are the Legal and Ethical Implications of Determining the Cause of Death?

Determining the cause of death has important legal and ethical implications for various stakeholders, such as:

• The deceased person’s family and friends, who may seek closure, justice or compensation for their loss.
• The public health authorities, who may use the data to monitor trends, prevent outbreaks or improve policies and programs.
• The criminal justice system, who may use the evidence to prosecute suspects or exonerate innocent people.
• The insurance companies, who may use the information to determine eligibility for benefits or claims.
• The research community, who may use the samples or data to advance scientific knowledge or innovation.

Therefore, it is essential that unexplained death investigations are conducted with accuracy, integrity and respect for human dignity and rights.