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June 16, 1999

Autopsy Rates and Diagnosis

Author Affiliations

Margaret A.WinkerMD, Deputy EditorIndividualAuthorPhil B.FontanarosaMD, Interim CoeditorIndividualAuthor

JAMA. 1999;281(23):2181. doi:10-1001/pubs.JAMA-ISSN-0098-7484-281-23-jac90005

To the Editor: As a practicing pathologist, I agree with many of Dr Lundberg's1 conclusions, but he gives only passing mention to the issue I believe warrants the most attention—the problem of professional liability. I doubt that any of his suggestions for improving autopsy rates will succeed under current liability conditions. A discordance between clinical and autopsy findings certainly represents an opportunity for learning and improving patient care. However, it also represents an opportunity for trial lawyers to file more and more pointless lawsuits, second-guessing clinical judgments with retrospective information that could not possibly have been obtained antemortem. The only way autopsy rates will increase is in conjunction with liability reform, such as the proposed "loser pays" laws that Congress has failed to enact.

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