Saukko P
Department of Forensic Medicine, University of Turku, Finland.
Nihon Hoigaku Zasshi. 1995 Dec;49(6):458-65.
The Nordic region consists of Denmark, with the autonomous territories of the Faeroes and Greenland, Finland, with the autonomous Aland Islands, Iceland, Norway, and Sweden. However, this review deals only with the situation in Norway, Denmark, Sweden and Finland. In these four countries only a physician can confirm that a person is dead and practically any physician can certify a death due to natural causes if he knows the cause of death. A clinical autopsy can be performed to confirm the diagnosis with the permission of the relatives. The regulations concerning the reporting and investigation of sudden unexpected and non-natural deaths are very similar in all Nordic countries. In general those deaths, which are criminal, suspicious, accidental, suicidal, sudden and unexpected, unexplained or in any way not due to natural causes, cannot be certified by a doctor and must be reported to the police for medico-legal investigation. Forensic Medicine exists as a medical specialty at present only in Finland and Sweden. The total autopsy rates vary from country to country, with the lowest autopsy rate in Norway-10.6% of all deaths, followed by Denmark-16%, Sweden-22% and Finland-31.1%. Despite the apparent similarities in legislation regarding those deaths which should be referred for medicolegal examination, the practices differ so much in the different countries that it is, in fact, not possible to make many valid comparisons. The number of Group XVI-cases (symptoms and ill-defined causes of death) of the International Classification of Diseases (ICD) in the mortality statistics of each Nordic country seems to be inversely correlated to the autopsy rate. This gives some indication of the efficacy of the certification of death in a given country. Finland, having the highest autopsy rate, has the lowest number of ill-defined causes of death. The declining autopsy rate in all Nordic countries seems to be in line with the international trend. If this tendency continues, it will, without doubt, have a negative impact on the reliability of mortality statistics in general and, in the individual case, increase the possibility of incorrect classification of the mode of death. In the worst instance this might result in failure to detect homicide.
北欧地区包括丹麦及其自治领地法罗群岛和格陵兰、芬兰及其自治领地奥兰群岛、冰岛、挪威和瑞典。然而，本综述仅涉及挪威、丹麦、瑞典和芬兰的情况。在这四个国家，只有医生才能确认一个人死亡，并且实际上任何医生只要知道死因，就可以开具自然死亡证明。经亲属同意，可以进行临床尸检以确诊。北欧各国关于突然意外和非自然死亡的报告及调查规定非常相似。一般来说，那些属于刑事、可疑、意外、自杀、突然意外、无法解释或以任何方式并非自然原因导致的死亡，医生不能开具证明，必须报告给警方进行法医学调查。目前，法医学仅在芬兰和瑞典作为一个医学专业存在。各国的总尸检率各不相同，挪威的尸检率最低，为所有死亡人数的10.6%，其次是丹麦的16%、瑞典的22%和芬兰的31.1%。尽管在关于应提交法医学检查的死亡情况的立法方面表面上相似，但不同国家的做法差异很大，实际上无法进行许多有效的比较。每个北欧国家死亡率统计中，国际疾病分类（ICD）第十六组病例（症状和死因不明）的数量似乎与尸检率呈负相关。这在一定程度上表明了某个国家死亡证明的有效性。芬兰的尸检率最高，死因不明的数量最少。所有北欧国家尸检率的下降似乎与国际趋势一致。如果这种趋势持续下去，无疑将总体上对死亡率统计的可靠性产生负面影响，并且在个别情况下，增加死亡方式错误分类的可能性。在最糟糕的情况下，这可能导致未能发现他杀。
