Independent autopsies have become a common tool for families who question official determinations regarding how a loved one died, according to a report published July 29. These reviews often emerge from a deep distrust of official systems, particularly in cases involving Black victims killed by law enforcement where families question if investigations were sufficiently thorough.
The process of seeking a second autopsy can be complicated by a fragmented national system. In the United States, there is no single death investigation model; 20 states and Washington, D.C., use centralized medical examiner systems, while nine states rely on local coroners. Other areas use a mix of state and local officials, often at the county level.
Forensic experts note that the first autopsy is typically the most valuable because it provides the most complete opportunity to document evidence before it is altered. A 2025 report from the National Academies of Sciences, Engineering, and Medicine found that the nation's medicolegal death investigation system lacks uniform standards, oversight, and the resources needed for consistent determinations.
Families may face several hurdles, including high costs and the difficulty of obtaining reviews. In some instances, an independent review may not be able to provide a definitive answer if internal organs were removed during the initial examination. For example, an independent review of 18-year-old Nolan Xavier Wells' death in Mississippi resulted in an undetermined cause of death because the pathologist could not examine the airway or lungs.
The lack of transparency and communication can further strain trust between authorities and grieving families. Iva Rody, the chief operating officer at the National Center for Victims of Crime, stated that the current system structure can prevent officials from communicating well and being truly transparent.
Additionally, law enforcement agencies often limit the information shared during an ongoing investigation to protect the integrity of the case and witnesses. This can lead to delays that leave families feeling excluded from a process that directly affects them.
Experts suggest that building public confidence in death investigations requires independence, scientific oversight, and better communication. Brandon Garrett, a Duke University law professor, noted that the concerns raised by families reflect broader issues in forensic science, such as labs being closely tied to law enforcement and a lack of research to support certain medical judgments.
