Copyright 1999 American Medical Association.
All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.1999
To the Editor: Despite diminishing
numbers of autopsies, the need for this crucial procedure, "a
fundamental principle of all clinical research,"1 remains
irrefutable.2 One element of current autopsy practice is
undermining the goals of autopsy: limitations placed on autopsy consent
by next-of-kin. At our institution such consent limitations are placed
on approximately 1 in 5 autopsies.3 The most common consent
limitation (about 40% of all restricted cases) is placed on the
examination of the brain owing to the mistaken assumption that such an
examination would preclude an open-casket funeral. Of course, some
religious or spiritual beliefs may preclude examination of certain
organs. In all other cases, perhaps, the placement of consent
limitations makes the performance of an autopsy more acceptable to the
next-of-kin. However, it ought to be realized that consent limitations
inhibit pathological evaluation of effects of fatal disease and of
cause of death. At our hospital, pathological evaluation may be
significantly hampered in approximately 18% of cases that are
autopsied with consent limitations (eg, cases of stroke or suspected
encephalitis with the head as the limitation).
Saqi A, Hoda SA. Autopsy Rates and Diagnosis. JAMA. 1999;281(23):2181. doi:10-1001/pubs.JAMA-ISSN-0098-7484-281-23-jac90005
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