Virtual autopsies...peace in Jerusalem

Ultra-Orthodox seek to replace autopsies with non-invasive imaging techniques

By Yair Ettinger

Ultra-Orthodox figures are calling on the police and the legal establishment to investigate unnatural deaths through non-invasive imaging rather than autopsies, which the ultra-Orthodox oppose - a position that has played a key role in clashes with the state for 40 years. The move comes as the largely ultra-Orthodox Zaka rescue and recovery organization is set to begin a campaign to portray autopsies as undermining human dignity.

The Zaka campaign, which is due to begin in the next few days and will include a petition, targets not only the Jewish population, but also Muslims, who typically oppose autopsies.

In the last few months, Zaka leaders, with the assistance of ultra-Orthodox MKs, have asked the Justice, Health and Public Security ministries to replace autopsies with MRI and CT scans. Armed with scientific research and legal precedents from Britain and Switzerland, along with an opinion by Israeli experts, Zaka argues that a virtual autopsy is faster and more accurate in determining the cause of death than the traditional kind.

"An invasive operation is something that there's no need for today," said Zaka head Yehuda Meshi Zahav. "The state must - and today, also can - take the families' feelings into account. Not only the ultra-Orthodox and the religious, but also secular people oppose autopsies for their loved ones. It adds a terrible sorrow to their grief."

The technology that makes virtual autopsies possible is not new. But it is only recently, after requests from Zaka, that the chief pathologist of the Institute of Forensic Medicine at Abu Kabir, Prof. Yehuda Hiss, revealed that he supports using MRIs and CTs at the institute. Indeed, Hiss is planning to spend a year in Britain and Switzerland to learn how to conduct virtual autopsies. Nonetheless, he said that while the use of imaging machines could minimize invasive procedures, it will not be able to completely replace them.

For instance, a report Hiss wrote on the issue indicates that the machines cannot replace a physical examination in a search for poison or tissue morbidity. Zaka, however, is demanding that an MRI machine be introduced into the forensic institute for immediate use, rather than waiting until Hiss returns from abroad. He plans to leave in the next few months.

Police statistics indicate that in the first five months of 2005, 334 autopsies were conducted in Israel. Of those, about 80 percent were conducted with the families' approval, and 20 percent were carried out by court order, despite the families' opposition.

The police are likely to support the use of imaging procedures in the investigation of some deaths, especially if it would prevent the occurrence of embarrassing incidents like the one in Ashdod three weeks ago, when the body of a baby girl from an ultra-Orthodox family was stolen from a cemetery under police officers' noses and buried before the autopsy could take place. Police investigators encounter similar cases on a regular basis. On Monday, for instance, a woman died suddenly in Elad and the ultra-Orthodox community leaders worked with Zaka to convince police officers not to conduct an autopsy - possibly averting another round of clashes. If the police had the option of determining the cause of death through the use of an MRI, Zaka says, the dilemma could be avoided.

That's why Zaka is working to purchase an MRI machine, whether through state or private funding, Meshi Zahav said. He said ultra-Orthodox in Israel and abroad have expressed interest in buying the machine. MK Ya'akov Litzman (United Torah Judaism) said he planned to discuss the issue with State Prosecutor Eran Shendar and Justice Minister Haim Ramon.

The Justice Ministry said Litzman's request was being transferred to professionals in the field, "after which we will consider our position."

The latest clashes over autopsies centered around the baby girl whose body was stolen from the Ashdod cemetery and outbreaks of violence in ultra-Orthodox neighborhoods in January, after the autopsy of a Kiryat Ata woman who was murdered. The conflict reached its height in the 1960s and '70s, when ultra-Orthodox groups organized mass protests, threatened the lives of pathologists and stole bodies from medical centers. The situation settled down after 1981, when an amendment to the Anatomy and Pathology Law was passed, minimizing pathologists' right to conduct autopsies.

Whereas before they would frequently conduct autopsies for research purposes, pathologists today must have reasonable cause to suspect foul play or to require an autopsy to determine the cause of death. If the family opposes an autopsy, the police can ask permission from the courts, which must hear the family's arguments.