The external examination system of determining the cause of death as operated in Dundee, Scotland is controversial. The addition of a blood or urine specimen for drugs and alcohol processed by hospital autoanalysers will reduce error in death certification. This is even more convenient to organise with a shorter turnaround time than imaging by computed tomography (CT) or magnetic resonance imaging (MRI). These measures may reduce the autopsy rate and ameliorate the distress of families of the deceased.