Resident physician opinions on autopsy importance and procurement

Hull, Mindy J.; Nazarian, Rosalynn M.; Wheeler, Amy; Black-Schaffer, W. Stephen; Mark, Eugene J.

doi:10.1016/j.humpath.2006.08.011

Cited by 82 publications

(59 citation statements)

References 20 publications

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“…The literature reviewed, while largely calling for more autopsies, is remarkably lacking in providing any standards by which autopsy rates Studies of medical students and residents have generally found that trainees acknowledge the value of autopsies, but also are reluctant to make inquiries. Attitude surveys have found that trainees find the task unpleasant, are concerned with upsetting families, and believe they have been inadequately prepared to conduct inquiries and answer family questions [19,20]. Sherwood and colleagues in a survey of practicing physicians found that few had any formal instruction in how to inquire about an autopsy [21].…”

Section: Discussionmentioning

confidence: 99%

Autopsy Rates in the Department of Veterans Affairs Comparisons by Treating Specialty and Venue

Hsin¹

2013

J Palliative Care Med

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Section: Discussionmentioning

confidence: 99%

Autopsy Rates in the Department of Veterans Affairs Comparisons by Treating Specialty and Venue

Hsin¹

2013

J Palliative Care Med

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“…The determination of the correct cause of death is a prerequisite for reliable mortality statistics, and an essential tool in this process is autopsy. However, the number of autopsies performed for hospital in-patients has been decreasing in recent decades, 24,25 and the number of autopsies performed for patients who die out-of-hospital has been reported to be 26-39%. 17,19 In a large number of cases, the COD is an estimation and true CODs may be missed.…”

Section: Discussionmentioning

confidence: 99%

Out‐of‐hospital cardiac arrest: studies on aetiology, treatment and outcome

Virkkunen¹

2009

Acta Anaesthesiol Scand

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“…Approaching a family for autopsy consent after a loved one has died (regardless of the cause of death) is nearly always difficult. In addition to concerns about suffering (suggested in the case above by the response Ms. Foster's family gave Dr. Zinker), lack of information about why an autopsy might be needed and the steps of the procedure itself have been identified as leading reasons for autopsy refusal [14]. In our case, Dr. Zinker should clarify why he is suggesting the procedure, communicating to the family that he wants to determine whether something he did during Ms. Foster's surgery could have contributed to her death.…”

Section: An Approach To Consent For Autopsymentioning

confidence: 99%

Is Consent to Autopsy Necessary? Cartesian Dualism in Medicine and Its Limitations

Lane¹,

Vercler²

2016

AMA Journal of Ethics

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When a hospitalization ends in death, a request for an autopsy can lead to an emotionally charged encounter between a physician and the deceased patient's family. A case is presented in which a cardiac surgeon, believing he might have made a mistake, requests an autopsy, but members of the deceased patient's family believe that she would not have wanted an autopsy performed. A central question discussed in this commentary is whether and when consent for autopsy is necessary. We discuss two theoretical frameworks that support differing views on this question. Beyond engaging this philosophical discussion, we also highlight a practical approach to discussing an autopsy with a grieving family by using the case presented. CaseDr. Zinker, a cardiac surgeon, is surprised by the rapid and unexpected death of his patient, Ms. Foster, whose postsurgery recovery had appeared complication-free. Prior to her death, she complained of shortness of breath and was found to have a pleural effusion, an abnormal volume of fluid around one of her lungs. The pleural effusion was drained, but she developed unstable blood pressure, which required increasing administration of vasopressors. Despite these supports, Ms. Foster died. Dr. Zinker wants to order an autopsy to determine the exact cause of Ms. Foster's death. Specifically, he wants to discover whether something he did during the surgery contributed to her unexpected death.Dr. Zinker meets with Ms. Foster's husband, Jim, and adult daughter, Alta, to obtain consent for an autopsy. He explains to them what's involved in an autopsy and how long it might take. The normal protocol for autopsy includes examining both the head and the body, but Dr. Zinker explains that the family may limit autopsy to the body if so desired. He also explains that the autopsy should take a few hours and that preliminary results would be available shortly after the procedure was complete. He tells the family that final results might not be available for several weeks because academic autopsies often involve microscopic evaluation of tissues, which requires additional histologic processing. Jim and Alta are reluctant to consent to the autopsy of Ms. Foster, stating, "She's already

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Resident physician opinions on autopsy importance and procurement

Cited by 82 publications

References 20 publications

Autopsy Rates in the Department of Veterans Affairs Comparisons by Treating Specialty and Venue

Autopsy Rates in the Department of Veterans Affairs Comparisons by Treating Specialty and Venue

Out‐of‐hospital cardiac arrest: studies on aetiology, treatment and outcome

Is Consent to Autopsy Necessary? Cartesian Dualism in Medicine and Its Limitations

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