Diagnóstico del origen y la causa de la muerte después de la autopsia médico-legal (Parte II)

one of the most difficult tasks in forensic pathology is deciding the origin and the cause of death after the autopsy when those issues are unclear or debatable. a technically perfect autopsy is a necessary but not a sufficient condition to adequately fulfil this decision. the present paper clearly defines the concepts of cause and mechanism of death, natural and violent death. we review many aspects related to the diagnosis of the origin and cause of death, especially the current approach of the value of autopsy in the diagnosis, the interaction between trauma and disease, the doctrine of causation, the use of icd- 10, the so-called manner of death, the psychological autopsy, the negative autopsy and the origin of death from therapeutic complication, and so on., all of which are illustrated with relevant examples. we also discuss the limited role of the forensic pathologist in spain in determining the so-called manner of death. the conclusions include(s) a list of recommendations for the best performance of this work, including the abandonment of the so-called unacceptable causes of death -as cardiac arrest, cardiopulmonary arrest or brain death, and so on- and whenever possible the adoption of the classification of icd-10 and the standard paragraph in which the cause of death is informed (part i and ii), as proposed by the who international certificate of death. these conclusions intend to be a brief guide to provide a fair judicial outcome and enhance the forensic pathologist's credibility.