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External Examination

In Austria, every deceased person must undergo an external examination by an authorised doctor (coroner, medical examiner).

According to the Austrian Death and Funeral Act (Leichen- und Bestattungsgesetz) and the Austrian Midwifery Act, newborns (live births), miscarriages, stillbirths and body parts must be examined externally.

  • Live births: A foetus in which the heart has already beaten, the umbilical cord is pulsating, natural lung respiration has begun, or clear movements of voluntary muscles are recognisable.
  • Stillbirths: None of the above signs of life were present, but the birth weight was at least 500 grams.
  • Miscarriages: None of the above vital signs were present and the birth weight was less than 500 grams.

The purpose of an external examination is to pronounce death and to determine the manner and cause of death. The external examination shall also determine whether the circumstances surrounding the manner or cause of death require a post-mortem examination.

Deaths in a public hospital (definition according to the applicable state law) must be examined by the attending and authorised pathologist according to the applicable provision law (in Vienna: Section 4 of the Vienna Death and Funeral Act). This specialist pathologist must be given access to the entire medical history of the deceased person by the attending physicians. If a cause of death can be deduced from the medical history, the pathologist may release the deceased for burial after issuing a death certificate.

If a clinically relevant question arises from the medical history or is raised by the attending physicians, the clinical pathologist is authorised to perform a clinical post-mortem examination.

If it is not possible to determine the cause of death from the available medical history, the clinical pathologist is authorised to carry out a clinical post-mortem examination, even against the wishes of the relatives / next of kin, in accordance with Section 25 of the Federal Hospitals Act. The clinical pathologist must prepare a report on the post-mortem examination and can then release the body for burial once the death certificate has been issued.

If, during the examination of the case histroy or the clinical post-mortem examination, the suspicion arises that a third party may have been involved in the death of the person being examined (e.g. condition after road traffic accident and several months in hospital or improper medical attention), the clinical pathologist is obliged, under Section 54 of the Austrian Act on the Medical Profession to immediately discontinue any post-mortem procedures that may have been initiated and to inform the police (e.g. at Vienna General Hospital (AKH) using the form ‘Request for a Forensic Examination’).

In the case of death outside a public hospital, e.g. in a private hospital, nursing home, apartment, public place (street, public transport, etc.), an external examination must be carried out by a medical examiner from the competent health authority (in Vienna: MA 15).

The coroner must be given a certificate of medical treatment or a letter of referral from a hospital by the relatives in order to determine the cause of death.
If the medical records indicate illnesses that could have led to death by natural causes at any time, the coroner will release the body for burial after issuing a death certificate and a corpse accompaniment document (Leichenbegleitschein).
If there are no medical records, or if the records do not indicate illnesses that could explain sudden death from natural causes, the coroner must request a post-mortem examination from the competent authority, for example under the Vienna Death and Funeral Act.

If the relatives of the deceased suspect that the death was caused by medical malpractice, they can lodge a complaint with the police, which almost always results in the body and medical history being seized by the public prosecutor’s office and a forensic doctor being appointed to carry out an autopsy and write a report under Section 128 of the Code of Criminal Procedure (forensic autopsy).

If the attending physicians suspect that the cause of death was due to medical negligence, they are obliged to notify the police (e.g. at Vienna General Hospital (AKH), using the ‘Request for a forensic examination’ form) in accordance with Section 54 of the Austrian Act on the Medical Profession.

In the event of death caused by a third party, suicide, drug abuse of people who died in a public place or in custody, as well as the corpses of infants and toddlers, and if body parts and bones are found, the body or body parts must be subject to a police commissioning by a police lawyer, a public health officer and a civilian law enforcement officer. Depending on whether third-party involvement is suspected, a post-mortem ordered by the court or by the health authorities is to be carried out to establish the cause of death and the circumstances surrounding death. The corpse cannot be released by the police commission. The corpse is released by the medical examiner commissioned by the competent authorities (in Vienna: MA 15, Health Department) or by the forensic medical expert.

Summary of external examination

  • Pronouncing death
  • Determining nature and cause of death → Collection medical documents (medical treatment certificate, letters of referral, medical history)
  • Issuing the necessary documents
    • Death certificate → Released for burial
    • Document accompanying a corpse (Leichenbegleitschein) → needed to transport a corpse
  • Reporting death to the competent health authorities → indeterminate cause of death
  • Reporting death to the police → Suspicion of third-party involvement

Furthermore, the medical examiner is obliged to report notifiable diseases (Epidemic, Tuberculosis or AIDS law) and deaths associated with drug abuse.