Adrian Hernandez
Noel Brownlee
Blacksburg, Virginia

The forensic autopsy of U.S. President John F. Kennedy (JFK) was full of mistakes that gave rise to subsequent controversies. Kennedy was assassinated on November 22, 1963, during an official visit to Dallas, Texas. He was in the right seat of an open car accompanied by Mrs. Kennedy, Texas Governor John B. Connally, and Mrs. Connally. Three shots were heard, and the president fell forward, bleeding from his head. Governor Connally was also seriously injured. The car was driven to Parkland Hospital in Dallas, and lifesaving procedures were performed. President Kennedy’s head wound and a second wound in the low anterior neck were noted. A tracheostomy was performed, along with IV infusions of blood and saline. President Kennedy soon went into cardiac arrest and was pronounced dead at 1:00 PM.

The president’s body was transported to Bethesda Naval Hospital for forensic examination.¹ The pathologists who performed the autopsy were James J. Humes, J. Thornton Boswell, and Pierre Finck. The autopsy revealed one bullet entry wound near the occipital bone and one exit wound on the right parietal bone, covered in brain matter. A second entry wound was identified in the upper right posterior thorax, but the pathologists could not find the exit wound.¹ The attending physicians at Parkland Hospital then revealed that the exit wound for the second bullet was used to insert the tracheostomy tube in the low anterior cervical region. However, the bullet responsible for the wound could not be found anywhere in the president’s body. The president’s brain was removed from the body and fixed in formalin for further examination.

The Warren Commission was established to investigate the assassination. Its report was made public and concluded that Kennedy was assassinated by Lee Harvey Oswald, the sole gunman. The Warren report also determined that a total of three shots had been fired. The first bullet missed, the second shot caused the president’s neck wound, and the third fatal shot hit JFK in the head.

Controversies arose about the autopsy conducted at Bethesda Naval Hospital. Humes and Boswell were not board certified in forensic pathology, and in fact had never performed an autopsy. Finck was board certified and had forensic experience, but all three pathologists were under time constraints and subject to the concerns of the family. Moreover, the autopsy room was crowded with Secret Service and FBI agents who would have been able to control the autopsy for political purposes.² A forensic autopsy in today’s setting should have no casual observers and a recorded register of people legally entitled to be present.³

Another discrepancy was that the investigation was limited to the head and chest; the neck organs were not removed or examined.² The gunshot wound on the president’s upper right posterior thorax was not dissected, and as a result the bullet path was not able to be entirely traced. The presidents’ clothes were not examined in the autopsy room, which prevented further ballistic determination of bullet speed and caliber.⁴

The examination of the president’s brain has also been questioned, as no measurements were included in the original autopsy report. An average human brain weighs around 1500g; however, it was reported that the president’s brain weighed 1500g even after the loss of brain tissue from violent trauma. This inconsistency is one major argument of researchers who claim that the autopsy’s findings were altered and inaccurate. JFK’s brain was stored in the National Archives but went missing in 1966; its current whereabouts is unknown. In forensic pathology, it is crucial to store and protect samples correctly to prevent tampering.⁵ The mishandling of JFK’s preserved brain did not allow for future examination when the integrity of the autopsy was questioned, which led the public to believe the brain was destroyed as a political cover-up. Another ethical issue arose when JFK’s body was removed from Dallas before a local autopsy could be performed, raising the suspicion that the autopsy was done only by government officials.

These missteps highlighted serious shortcomings in the field of forensic pathology, which led to systemic improvements to prevent similar mistakes in the future. Even though forensic pathology was recognized by the American Board in Pathology during this time, JFK’s autopsy helped push the establishment of forensic pathology as a formal subspecialty. The Board subsequently required all autopsies to be performed by board-certified forensic pathologists. The Armed Forces Medical Examiner System (AFMES) was established in 1988 as a dedicated system to investigate high-profile cases involving the military.⁶ It created standard protocols to handle evidence, collect specimens, and collaborate with trauma physicians. In 1999, Recommendation Number R (99) 3 was published, which set rules for any autopsy performed in the United States.⁷ Such rules include that both a macroscopic and a microscopic examination of all organs must be performed. Postmortem imaging has also been an important tool to verify autopsy integrity, since dissection, histological interpretation, and description are all subject to human error and bias.⁸

The autopsy of President John F. Kennedy remains controversial to this day, leading to ongoing questions and conspiracy theories. However, the mistakes that were made led to significant reforms in the field of forensic pathology that have greatly aided the ability to accurately determine a person’s cause of death.

References         

1. U.S. Government. JFK autopsy report: Appendix 9 to the Warren Commission Report. 1963. Accessed July 25, 2025. https://www.archives.gov/files/research/jfk/warren-commission-report/appendix-09.pdf
2. Weedn VW. Origins of the Armed Forces Medical Examiner System. Acad Forensic Pathol. 2020;10(1):16-34. doi:10.1177/1925362120937916
3. Menezes RG, Monteiro FN. Forensic autopsy. StatPearls. Published September 11, 2019. Accessed July 25, 2025. https://www.ncbi.nlm.nih.gov/books/NBK539901/
4. Carr DJ, Kieser J, Mabbott A, et al. Damage to apparel layers and underlying tissue due to hand-gun bullets. Int J Legal Med. 2013;128(1):83-93. doi:10.1007/s00414-013-0856-1
5. Salerian AJ. The postmortem examination of President Kennedy is invalid: The evidence. Med Hypotheses. 2008;71(4):597-599. doi:10.1016/j.mehy.2008.06.025
6. Scendoni R, Fedeli P, Cannovo N, Cingolani M. The “Magnificent Seven Errors” in forensic autopsy practice: The Italian context. Acad Forensic Pathol. 2021;11(4):208-214. doi:10.1177/19253621211056191
7. Mazuchowski EL, Gordon CJ, Finelli LN, Harcke HT. Beyond the forensic pathology investigation: Improving warfighter survivability. Acad Forensic Pathol. 2017;7(4):591-603. doi:10.23907/2017.050 8.
8. Gormez M, Samdanci E. The history and current status of forensic pathology. Med Sci. 2019;8(2):480. doi:10.5455/medscience.2019.08.9046