By Tsubasa Ogawa and Etsuo Hayakawa

Gunma University did not have much good to say about the nation's judicial autopsy system. "If things continue how they are, the system will collapse in 10 years," the university said in its response to a survey by The Yomiuri Shimbun.

The recent poll sought opinions from university forensic laboratories, and revealed the autopsy system faces a critical situation. Police and local governments rely heavily on universities, which perform autopsies as a "contribution to society," but doctors at these institutions are overworked, and complain of mental and physical stress.

Government organizations concerned have already moved to reform the nation's system of determining the cause of suspicious deaths, but the problems to be solved are daunting. Defects of the system were illustrated by several recent criminal cases, especially the fatal beating of a junior sumo wrestler in Aichi Prefecture in 2007. In the past year, public attention has been drawn by suspicious deaths in Saitama and Tottori prefectures.

The Tokyo metropolitan government was forced to reacknowledge the importance of discovering the cause of suspicious or abnormal deaths in 2006 after it was found that deaths due to carbon monoxide poisoning caused by defective gas water heaters manufactured by Paloma Industries Ltd. had been mistakenly declared "death from illness."

In the Tama district of western Tokyo, the rate of autopsies performed in abnormal deaths was about one-fifth that of Tokyo's 23 wards until 2006. The gap occurred because the Tokyo Medical Examiner's Office, with its full-time staff, serves the 23 wards, but the Tama district is forced to rely on universities for autopsies.

In response to this, the metropolitan government requested universities in the district increase their involvement in the system. As a result, the number of autopsies in the district jumped from 281 in 2006 to 840 in 2008.

Problems in the hinterlands

Tokyo, home to a large number of universities and doctors who perform autopsies, is lucky compared with other areas of the country.

In November last year, Hirosaki University in Hirosaki, Aomori Prefecture, stopped accepting requests for forensic autopsies because the professor who had been shouldering the burden alone for many years became ill.

"Doing the work by myself is an immense psychological and physical burden. I no longer have confidence in the accuracy of the autopsies I perform," the professor was quoted as saying.

The Aomori prefectural police are now forced to take bodies to Iwate Medical University in Morioka or Akita University in Akita when an autopsy is necessary. Hirosaki University plans to hire an additional doctor to perform autopsies, but so far has been unsuccessful.

"Contributing to the local community is important, but aren't [forensic autopsies] supposed to be the job of the administration?" said Kei Sato, dean of the Hirosaki University Graduate School of Medicine.

Other universities also face serious problems.

"I should do my best for society, but I'm no superman," Prof. Koji Dewa of Iwate Medical University's Legal Medicine Department said with a sigh.

The university is the lone institution in Iwate Prefecture that performs forensic autopsies. Last year two doctors dealt with 187 cases. By the end of June, the university had already handled 104 cases, with nearly 40 percent of them being sent from Aomori Prefecture. This spring, a doctor who performed autopsies left the university for studies overseas, leaving Dewa to handle all the autopsies.

"On top of it all, the staff in charge of organ tissue examinations and other tests can't handle any more cases," he added.

In Saga and Hiroshima prefectures, there have been periods since 2007 when there has been no doctor to perform autopsies in the prefecture.

About 130 doctors perform autopsies in the country. Among the 50 universities that said they performed forensic autopsies last year, 28 universities had only one autopsy doctor. The other 22 universities were similarly struggling, but were able to manage the workload as they had two or three doctors doing autopsies.

Doctors, jobs both scarce

One forensic autopsy can take two to three months to finish, including drug tests, organ tissue exams and paperwork. Some experts say this robs universities of time that could be dedicated to education and study, their original purposes.

While many universities feel they are facing a crisis in dealing with autopsies, national universities are now being asked to become profitable, as they have been given corporate status.

Police and prefectural governments that rely on universities to perform forensic autopsies pay the institutions for this service.

"But [autopsies] aren't part of our original mission. We were founded to educate and conduct research," an Okayama University official said. "The central or local government should pay the costs of personnel and necessary equipment."

This opinion was echoed by other universities surveyed. All institutions agreed that increased public funding is needed.

Forty-nine of the 60 universities polled said they have no plans to increase staff. In fact, two universities plan personnel cuts. Many universities said the government should increase the number of doctors that can perform autopsies. Some universities pointed out that while the central and local governments have relied heavily on universities, not much has been done to improve the situation.

Forensic doctors have extremely few job prospects, with no way to practice as a private autopsy doctor. At the University of the Ryukyus, Okinawa Prefecture, there are two graduate students in its legal medicine lab. However, the three posts for forensic medicine experts--professor, associate professor and instructor--are already filled.

Yoshiya Sato, dean of the medical department at the university, said: "Enthusiastic and qualified students are extremely valuable to Okinawa Prefecture since we can't ask other prefectures for help. But there's nothing we can do."

To improve the situation, a Nagoya University official suggested, "If the central government established an institution specializing in performing forensic autopsies and postmortem organ examinations, jobs for forensic doctors would be created and we could nurture personnel better than we do now."