[Reliability of the diagnoses of external post-mortem examinations in non-natural deaths before and after the German reunification].

In Germany, the unsatisfactory quality of external post-mortem examinations and the low autopsy rate of only 5 % of all deaths are often criticized. Based on the autopsy protocols of 8,593 cases of non-natural death of the Leipzig Institute of Legal Medicine (1985 to 1989--practice in the former German Democratic Republic; 1990 to 1994 - time around the fall of the Berlin wall, and 2000 to 2004--practice in the Federal Republic of Germany) the diagnosis indicated in the death certificate was compared with that of the autopsy report. Beside a drastic decrease in the number of autopsies performed, it was found that in 72% of the cases the clinical and the autoptical cause of death corresponded completely, whereas in 9.2% there was only partial and in 15.4% no correspondence at all. The lack of correspondence increased from 13.8% (1985-1989) to 18.0% (2000-2004). The low rate of correspondence in the causes of domestic deaths was particularly alarming. There were obvious differences in quality among different groups of specialists in determining the cause of death.