Second post-mortem examinations in England and Wales were a rarity until the late 1940's. Since then, there have been three factors contributing to the increased frequency of such examinations. The first was the advent of legal aid, codified in the Legal Aid Act (1974), which has in most cases paid for the second examination. The second reason for the increase in second examinations goes hand in hand with an increasing hesitancy of the public to accept unquestioningly their medical practitioner's opinion or advice. This hesitancy has spread to lawyers who are now more aware of the possibility of challenging medical evidence. A third reason relates more specifically to second examinations in cases of homicides. Summarizing, then, there are important pragmatic and philosophical reasons for retaining and even expanding the practice of second post-mortem examinations. They can act as safeguards and contribute to the sense that justice is being done. Furthermore, this is for a very small cost. More generally, they offer an opportunity for the specialty to display, to the medical profession generally, a commitment to the maintenance of high standards.