It was with interest that we read the study on the use of routine histology in trauma-related deaths such as suspension-, fire-, immersion-, and traffic-related [1]. The authors concluded that in the assessment of causes and manners of death, histology did not contribute to the assessment in a meaningful way, since the cause of death was changed only in a small proportion of cases, 0.5%-4% [1].
The main objective of a forensic autopsy is to uncover hidden homicides, as far as we know such cases are rare. In 2021, there were 113 deaths due to lethal violence in Sweden according to the Swedish Council for Crime Prevention [2]. Still, in Sweden, we performed 5727 forensic autopsies in the year 2021 [3] making the homicide yield 2.0% (113/5727). However, we could estimate that in 50 cases per year, the forensic autopsy is of importance to discover or to correctly assess the cause and manner of death in those homicides, bringing the yield down to 0.9% (50/5727). This percentage is like those obtained in the study [1]. But, despite this, the forensic autopsy is not in question because the rule of law in our modern society depends on the citizens' trust that each questionable death is thoroughly investigated by the authorities. We recognize that our example is not totally fair since we compare the use of the forensic autopsy in unnatural deaths to the use of histology in selected trauma deaths, but we argue that the comparison highlights the implied cost-benefit analysis...