Autopsy a burden for grieving families

By Emmy Fitri

JAKARTA (JP): Thirty-year-old Cuntirah, a vegetable farmer from Kuningan in West Java rushed to Jakarta after being told that her husband, Saripin, 40, an ice seller, had been stabbed by a fellow street trader at the Tanah Abang market in Central Jakarta.

She borrowed Rp 1 million from her relatives, who sold their jewelry to raise the money, and finally arrived at Sumber Waras Hospital in West Jakarta on Sept. 19.

Cuntirah gave the money -- all the more precious to this poor farmer -- to the cashier, hoping that the doctors could save her husband's life. Saripin died a few hours later.

But Cuntirah was not allowed to take her husband's body because police wanted it examined at Cipto Mangunkusumo General Hospital.

Police need a postmortem examination, and the evidence it provides, to bring suspects to justice later.

Before Cuntirah had finished thinking about how to repay her debt, a Cipto Mangunkusumo staffer handed her a bill for Rp 450,000 (US$118.50) for the procedure, administrative fees and the cost of transporting the body by ambulance from Sumber Waras Hospital.

In a charitable gesture, Saripin's fellow traders collected enough money to ensure their colleague's widow could pay the fees and take the body home for burial.

If Cuntirah had failed to pay the bill, but still wanted police to bring the suspect to court, Saripin's body would be "examined" by forensic doctors but relatives would be unable to reclaim it.

The body would be listed as an unidentified corpse and buried at the city-owned Semper Cemetery in North Jakarta or Pondok Rangon Cemetery in East Jakarta, noted forensic doctor Mun'im Idries of Cipto Mangunkusumo said recently.

Police approval

A body can be claimed before it undergoes a postmortem examination only with the written approval of a police chief. In return, the victim's relatives forfeit the right to seek legal redress against the attacker, he said.

For example, relatives of an old man who was found dead in his South Jakarta home last year could remove his body from the morgue only after they acquired the signature of the local police precinct chief.

By law, police must have a postmortem report for everyone who may have suffered a violent or inexplicable death.

Mun'im, who has been a forensic doctor for 25 years, said not all deceased people were examined.

"Only victims of crime need to be examined," he said. "Whether it is a crime or not is up to the police to detect and decide if it needs further investigate.

"So an autopsy is required by police and approved by the family of the victim."

Members of the public can also request an autopsy -- if they believe their relative's death was unusual and have reported it to the police -- but this was "rare".

"I hardly ever find a family who will voluntarily submit the body of their beloved to a forensic doctor for examination," he said.

Autopsies sometimes generate both confusion and fear among relatives.

For the well-off, it is not the cost but the idea of the gruesome procedure that is the main reason for them to refuse.

Many believe that a postmortem examination is the best way for doctors and medical students to get body organs for experiments.

"I don't know anything about autopsies," Cuntirah said. "I only hear that my husband's body will be cut up and some of his internal organs will be pulled out by the doctors."

Forensic expert Mun'im said the public's confusion was understandable.

"I know that a majority of people draw these conclusions because of a scarcity of information.

"It's totally wrong if people think that parts of the body will be removed during an autopsy."

Although the body may look deflated after the operation, he said this was due to the release of gases and not missing organs.

Mun'im also denied claims that medical students were also allowed to "playing around" with the dead bodies at Cipto Mangunkusumo's morgue.

Learning

Medical students were sometimes allowed into the morgue to learn how to detect the cause of death and issue postmortem reports.

They were also allowed to watch the operation and invited to conducted the operation, with senior doctors there to assist them, he said.

An autopsy also involves various tests being carried out on the body, including toxicology, serology, blood and semen tests and, if necessary, DNA profiling.

It seems even more tragic that a family must pay extra money at a time when they are grieving a loved one.

"Police wouldn't give me the death certificate when I refused to pay for the autopsy and sign the autopsy documents," a housewife said.

Cipto Mangunkusumo, the only hospital in Greater Jakarta authorized to issue postmortem reports, has set an autopsy tariff of Rp 50,000 per body during working hours and Rp 200,000 outside working hours.

The autopsy tariff for the body of an expatriate costs US$100 during working hours and $300 at other times.

"Poor families, however, are advised to come here during working hours or, if they cannot afford it, present the victim to us as an unidentified body," Mardiyono, the head of the morgue, said.

Article 136 of the Criminal Code Procedures says that the state is responsible for all expense of an investigation, including the autopsy.

Mun'im said: "But it's not clear because it doesn't specify who the state is, the police or the state hospital.

"And doctors are professionals, they have to be paid for their work.

"I know in some areas, like Tangerang, Bekasi and Karawang, police will pay for the autopsy but here in the big city, police would run out of money if they had to pay for all of the autopsies," he said.