Autopsies in Japan are performed on only 1.6% of all deaths, the lowest rate among developed countries. Cause of death is almost always determined by simple visual inspection, as it was 100 years ago. Japanese forensic medicine needs to catch up to avoid murders being overlooked.
In 2011, the National Police Agency announced that 43 murders had been missed since 1998, with many found to have been disguised as suicides or natural deaths.
The agency is now trying to carry out more autopsies, but examinations are often cursory because of budget restrictions. To tackle the problem, rigorous autopsies need to be performed routinely.
In 2012, two laws relating to death investigations were passed, and the government established the Committee for the Promotion of Cause of Death Investigation, which published interim reports in May 2013. No governmental agency will take responsibility for the budget, however, so little progress has been made.
Exposing the possible involvement of crime in unnatural deaths continues to be as hard as it ever was in Japan.
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Ikegaya, H. Update forensics for deaths in Japan. Nature 507, 306 (2014). https://doi.org/10.1038/507306e