HONORS / ACTIVITIES

Young Researcher’s Award of the Japanese Society of Legal Medicine

MEMBERSHIPS

The Japanese Society of Legal Medicine

EDUCATION

1993, Doctor of Medicine, The University of Tokyo, Tokyo, Japan

1994-1995

Graduate Student

Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo.

RESIDENCY

Resident, Physician 1993- 1994

Toshima Metropolitan Hospital

Tokyo, Japan

Career

2013-

Professor

Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo (Concurrent post)

2003-
Professor

Department of Legal Medicine, Graduate School of Medicine, Chiba University

2001-2003

Research Associate
Pulmonary and Critical Care, Department of Medicine, The University of Chicago

2000-

Associate Professor

Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo

1999-2000

Lecturer

Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo

1995-1999

Associate

Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo

Postmortem Imaging in Japan

This lecture will introduce the history of death investigation and postmortem imaging in Japan.

Japan was dominated by samurai until the latter half of the 19th century and was strongly influenced by Chinese politics and culture. Medical science and death investigation were also influenced by China. If the cause of death was not clear, the cause of death or criminality, was determined from external findings and the context of the dead body, rather than a scientific determination of the cause of death by autopsy. The defeat of China by England in the Opium Wars forced Japan to adopt European technology to protect Japan from foreign aggression. Japan abandoned samurai domination to establish a European-style country. In both medicine and a death investigation system they followed Europe, and started to determine the cause of death by autopsy.

However, the autopsy rate in Japan did not improve because the government did not allocate enough budget to determine the cause of death by autopsy. Continuing the 800-year-old Chinese method of cadaveric examination to determine criminality and performing an autopsy only when a crime was suspected, helped to keep Japan’s autopsy rate low and was still maintained in modern Japan. In this way, Japan’s death investigation system was a unique system in which old Chinese methods and the new European methods were mixed. Since the autopsy rate was low, there was a relatively high possibility of overlooking a crime. As a result, many forensic scientists called for an improvement in the Japanese death investigation system. The incorporation of national universities in 2004 was an opportunity to change the death investigation system. Until then, due to a shortcoming in the law, the police had to ask a national university to perform forensic autopsies free of charge. Incorporation made it legally possible to charge the police for the cost. However, due to the precedential principle of officials, dissection was continued free of charge even after the national universities were incorporated. A mobile CT scanner changed that. By introducing mobile CT in postmortem examinations on a trial basis, it was possible to show the differences in the cause of death diagnosed from an external examination of a corpse and the cause of death determined by CT. It became widely known, also to the public, that there was a problem with Japan’s death investigation system. The Japanese government was forced to respond. After 2006, universities could earn an income when performing an autopsy, and two new laws on the death investigation system were formulated and enacted. As a result, the financial situation of universities’ department of forensic medicine improved, and more than 30 of the 80 departments now have CTs. As a result, a hybrid type of forensic scientist emerged, such as a radiologist/forensic pathologist, such as Drs. Hyodo, Makino, and Yoshida. CT and MRI in the field of forensic medicine are now used to assess not only a corpse but also injuries of living people.

Thus, with the development of forensic imaging, another movement has taken place in Japan. This is a movement called autopsy imaging (Ai). The word Ai was conceived by a novelist and doctor, and was popularized in novels and TV dramas. The medical community advocated that clinicians should also perform Ai as a method of avoiding police intervention in the medical field, so Ai became popular for postmortem imaging performed by clinicians. Because Ai was considered a way to eliminate police and forensic medicine investigation, the postmortem imaging tests performed by clinicians did not link up with investigations conducted by forensic pathologists. Although there are many instances where autopsy findings and the interpretation of imaging differed and imaging overlooked criminality, there is no feedback to the interpretation doctor. Thus, Ai performed by clinicians can promote a situation where crime may still be overlooked.