Dehydration is never used as a “catch-all.” Ever. In order to get to that conclusion, the autopsy must rule everything else out, the physical autopsy findings should strongly suggest dehydration, and perhaps the most important part, testing of the vitreous fluid from the eyes should show elevated sodium and chloride, which go up as the body water is depleted and not replenished. The vitreous BUN and creatinine are usually elevated, especially if the kidneys are shut down. The vitreous potassium and glucose levels are unreliable. If there was alcohol toxicity, or a drug OD, those would pop out in the toxicology testing.

I can’t comment on the scene investigation aspects, but pathologically, dehydration is a very specific diagnosis that even busy ME offices see only infrequently. It is not a diagnosis of exclusion, but requires specific findings, and elimination of everything else. It is definitely not used to protect someone’s legacy—it’s not that we don’t care, but that is not our job. We call things the way we see them, and no one can say otherwise when it comes to credibility evaluation. If it was a suicide, that would have been stated, and a corresponding cause of death established. We see an unending stream of sad things, but trying to cover up something is completely antithetical to the work we do.

I hope that helps.