After the death of Otto Warmbier, who arrived seriously brain damaged, sensory deprived, and "tortured" from North Korea, his parents opted out of an autopsy without objection from the coroner. Hmm...

As a layperson uninvolved, forgoing the autopsy seems like a missed opportunity that could have solved this "undetermined" case. Take my millennial thoughts as you will, but give credence to the morbid minds of coroners and medical examiners who influence these tough choices.

The general idea that breaking out a scalpel now wouldn't show any more than a simple CT scan would, was conveyed by Hamilton County Coroner, Dr. Lakshmi Sammarco. Instead, a "virtual autopsy" of Otto's body was completed. Basically, it's an external examination plus x-rays.

"So we're able to take a look at his skeleton...[and] his organs...without altering the actual evidence," Dr. Lakshmi Sammarco stated about the noninvasive alternative. She also acknowledged its limitations.

Since virtual autopsies rely on visuals, it's difficult to judge the root cause of death based on superficial findings.

To better understand these procedures, I reached out to local district medical examiners and was lucky enough to get some responses.

Dr. Stephen Nelson, Florida's district 10 medical examiner, explains how the scope of autopsies can result in more case leads.

"Yes, in certain instances the internal examination can detect injury that isn’t seen externally, such as strangulation injuries that may not be apparent externally but injuries are seen internally during the dissection," longtime pathologist Dr. Stephen Nelson responds.

In the same vein, Lindsey Bayer, director of operations at district 5 medical examiner's office, also finds autopsies beneficial in discovering signs of foul play. In our communication, she cites "waterboarding and sleep deprivation" as two examples.

With the virtual autopsy efforts, Otto's medical team did not figure out what caused the lack of oxygen to his brain. This still leaves the question of torture unanswered.

For the record, Ohio uses the coroner system of elected officials while Florida uses the medical examiner system of appointed field practitioners. Both individuals investigate cause/manners of death. In Ohio, the coroner can mandate an autopsy, however, families can oppose for religious reasons, and proceed through a judicial process.

"If the family has strong objections then the pathologist would discuss the potential benefits or lack thereof of having an autopsy performed," Lindsey Bayer affirms. "Most likely our office may have performed an autopsy, and in order to prevent one, the family would have needed a court order, which we would give them time to get."

In their CNN interview, the Warmbier parents rejected the autopsy out of an intrinsic duty to their son. The answers are buried forever, and that's it. Whatever peace of mind or understanding the family gave up, is also at the expense of the medical community, U.S. foreign policy, and the greater good.

When pressed for answers in a what-would-you-do scenario, Dr. Stephen Nelson and Lindsey Bayer both leaned toward performing the autopsy.

"Why not simply take the time to do the autopsy, rather than spend countless hours trying to explain and rationalize why you didn't," Dr. Stephen Nelson adds. "It doesn't seem like a good use of time to try to avoid doing your job."

Rest in peace Otto Warmbier.

Big thanks to Dr. Stephen Nelson and Lindsey Bayer for their insightful responses and willingness to help an aspiring journalist. You are Florida's finest.