Which states restrict release of autopsy findings and what exemptions exist for public interest?

1. Legislative map: many states explicitly restrict autopsy records

A multi‑state review found 26 states with statutes that directly address disclosure of autopsy reports, reflecting an explicit legislative trend to categorize at least some autopsy materials as off‑limits or available only to specified parties such as family, prosecutors, or public health officials ^[1]. Several states treat autopsy reports as medical records or otherwise exempt them from open‑records laws; for example, South Carolina’s Supreme Court held autopsy reports are medical records and not public records, prompting legislative restrictions on autopsy photographs ^{[4] [5]}.

2. How “confidential” is defined: state examples

States vary in the mechanics: New Hampshire presumes autopsy reports confidential absent next‑of‑kin permission, while Connecticut limits release to those with a “legitimate interest” but expressly allows broader public access if the decedent died in state custody ^[2]. Washington statute makes autopsy reports confidential but lists precise exceptions — family representatives, attending clinicians, prosecutors, law enforcement, public health officials and certain agency designees — and bars public discussion of findings during active criminal investigations ^[3]. New York generally requires a court order and a showing of a “substantial” interest for access to autopsy reports ^[1].

3. Public‑interest carveouts and judicial balancing tests

A subset of states builds public‑interest balancing into law or practice: South Dakota and Pennsylvania expressly permit disclosure when a law enforcement agency or court determines the public interest outweighs nondisclosure ^[1]. Courts in other jurisdictions have applied balancing tests in litigation, sometimes upholding nondisclosure to avoid “substantial injury to the public interest” (illustrated in Colorado case law), or ordering release when transparency outweighed privacy or investigatory harms ^[5]. Legislatures and governors have also debated widening or narrowing access — for instance, Colorado’s legislature considered restrictions that drew high‑profile vetoes and judicial scrutiny ^{[4] [5]}.

4. Common rationales for restriction and counterarguments

States and courts justify secrecy on privacy of the deceased and family, investigatory integrity, and medical‑privacy concerns; legal scholarship documents these rationales and notes that many open‑records exemptions for law‑enforcement investigatory files can be applied to autopsy materials ^{[6] [1]}. Journalists, public‑health advocates and some courts argue the opposite: autopsy findings are essential for oversight, public safety and accountability, especially in suspicious or custodial deaths, producing recurring conflicts between transparency and privacy ^{[4] [5]}.

5. Procedural realities and federal limits

HIPAA does not broadly authorize public disclosure of autopsy reports and generally limits medical‑record sharing to authorized representatives, while state public‑records acts create the operative rules about who may obtain autopsy materials and under what exceptions ^{[7] [8]}. Because statutes, case law and agency policies differ, precise access depends on the state’s statute or judicial precedents and on whether a coroner/medical examiner classifies the matter as investigatory, medical, or public‑interest release ^{[1] [5]}. Where reporting is silent, this account does not assert state practice beyond the cited materials.