Ask the experts?
Does everyone get an autopsy when they die? If not, who determines whether someone should get one?
No, in fact, most people do not get an autopsy when they die. In cases of suspicious deaths, the medical examiner or coroner can order an autopsy to be performed, even without the consent of the next of kin. In all other cases (not of a medicolegal nature) the next-of-kin must give consent before an autopsy can be performed.
Sometimes family members decide that they want an autopsy performed to learn about possible genetic conditions or illnesses that may run in their family. An autopsy can also help provide closure to grieving families if there is uncertainty as to the cause of death. Sometimes the treating physician will request that the family give permission for an autopsy in order to assess the effectiveness of treatment or to confirm a clinical diagnosis.
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"Selected Characteristics of Death Requiring Investigation by State"
Centers for Disease Control