The debate on the efficacy of histology has been repeated in forensic practice often with reference to the time and cost, as it has for other procedures, including radiology, toxicology and biochemistry, and even for the autopsy itself; non-invasive postmortem imaging procedures are becoming popular worldwide. The practical decisions for performing these procedures depend on the tasks of forensic pathologists in their individual social and legal systems. In such a framework we should not hesitate to do what we can on request to contribute to social risk management, legally and ethically, and should update and suggest or inform what we can do based on authorized academic activities, which includes precise histology [1, 2]. From the aspect of risk management, the possibilities of misdiagnosis owing to a lack of histology or other laboratory investigations, even if infrequent, should not be ignored [3]. In addition, routine histology following routine tissue sampling and preservation is essential for quality assurance, as well as for peer review or reassessment. To meet these requirements, the whole forensic system, including the institution, staff and running costs, should be assessed and developed. Under these conditions, firstly, the incidence of misdiagnosis, of over 0.1%, is of medical concern from the aspect of risk management [3, 4]; the legal or social impact may differ for each case and is therefore unpredictable. Even the incidence at each institute cannot be assessed without routine work, which can reduce the costs per case. This should be considered in the management of the whole laboratory system, including histology, from the aspect of cost performance. Secondly, the first aim of forensic autopsy involves the interests of deceased people and public benefits; however, a family’s understanding of the forensic autopsy system involving sample collection for laboratory investigations is an essential requirement to perform an autopsy, which should also be confirmed officially to avoid any personal conflict of interest. This is a legal rather than an ethical issue in forensic practice. In this context, adequate information about the cause and process of death can reduce and improve the psychological stress responses of the bereaved; thus, a well-coordinated forensic autopsy service involving accurate determination and appropriate interpretation of the cause and process of death is of primary importance. Some families may not agree with an autopsy, but even seeing the deceased after forensic autopsy might reduce the risk of posttraumatic stress disorder in the bereaved who have experienced trauma-involved events [5]. Autopsy, including histology, is the final opportunity and the ultimate measure for a detailed investigation of a death, and this should be adequately explained to the bereaved. Lastly, it may be impossible to have complete histology in institutions performing thousands of autopsies per year. To select the cases that require further investigation, there should be discussion from the viewpoint of screening, to avoid possible medical and social/legal negligence, and guidelines should be established at individual institutions and by responsible professional societies to avoid the ‘easy decisions’ of individual pathologists. Histology could be excluded when scientific reasons can be clearly shown to answer any complaints, criticisms or opposing opinions, but should be considered in other cases, so far as it is allowed socially (legally, ethically and financially), depending on the situations of individual institutions. However, histology is recommended especially in cases involving possible infection, malignancy, alcohol/drug H. Maeda (&) Department of Legal Medicine, Osaka City University Medical School, Asahi-machi 1-4-3, Abeno, Osaka 545-8585, Japan e-mail: legalmed@med.osaka-cu.ac.jp