In an unprecedented move, the Sri Lankan Ministry of Justice and Integration has issued a directive mandating post-mortem examinations for all deaths of children under the age of five, regardless of the circumstances.
The Ministry’s circular, sent to all Coroners, states that this policy aims to better understand the causes behind child mortality and reduce future deaths. It points to past successes in lowering maternal mortality rates through similar investigations as justification for the new measure.
Until now, Sri Lanka had followed the global standard, where autopsies in child deaths were performed only under suspicious circumstances, accidents, or at the request of authorities — and always with parental consent. Once a medical report confirmed a cause of death, no further examination was typically deemed necessary. Experts have also pointed out that a single autopsy can cost around Rs. 15,000, raising concerns about the efficient use of public resources.
The new order has sparked immediate controversy, raising complex legal, social, and psychological questions. Critics argue that mandatory autopsies could cause immense trauma to grieving families and infringe on their rights. Legal experts also warn that this could open the door to constitutional challenges.
Globally, the standard approach remains far more restrained. The UK’s Sudden and Unexpected Deaths of Infants and Children (SUDIC) guidelines recommend autopsies only when there is doubt about the cause of death. Countries like the United States, Australia, Sweden, and Norway follow similar practices, limiting autopsies to cases where foul play, accidents, or medical uncertainty are suspected.
No other country in the world mandates autopsies for all deaths of children under five, making Sri Lanka’s move highly unusual on the international stage.
This is not the first time Sri Lanka’s government has courted controversy by deviating from international norms. During the COVID-19 pandemic, the country faced widespread criticism for ordering the forced cremations of virus victims, despite global health guidelines allowing for burials.
As the new directive comes into effect, families, medical professionals, and legal bodies are calling for urgent reconsideration, warning that while the goal of reducing child deaths is noble, the approach could lead to unintended and profound consequences.
