Teaching the Anatomy of Death: A Dying Art?

Horsley, Philomena

doi:10.1007/s12376-010-0042-4

Cited by 4 publications

(3 citation statements)

References 47 publications

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“…[13][14][15][16] In contrast, clinical autopsies, which were once routine hospital procedures and mandatory requirements for medical students, have become almost non-existent in Western medical settings since the late 1980s. 17,18 This has left most current clinicians unfamiliar with, or inexperienced in, discussing autopsies with families.…”

Section: Introductionmentioning

confidence: 99%

The art and science of recruitment to a cancer rapid autopsy programme: A qualitative study exploring patient and clinician experiences

et al. 2020

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Background: CASCADE is a successful, Australia-first cancer rapid autopsy programme. Patients are recruited to the programme by their clinician once they understand that further treatment has only palliative intent. Despite its value, rapid autopsy is a rare research method owing partly to recruitment challenges. Aim: This research aimed to explore (1) how, in practice, clinicians select and recruit patients to the programme and (2) patient experiences of this process. Design: This was a qualitative study grounded in phenomenology. CASCADE team members (clinicians and researchers) and patients participated in semi-structured interviews. Data were analysed using an inductive, team-based approach to thematic analysis. Participants: Interviews were conducted with 31 participants (11 patients and 20 CASCADE team members). Results: Patient selection and recruitment to a rapid autopsy programme is both an art and science. In practice, patient selection is a subjective process that involves assessing a patient’s psychosocial suitability for the programme. Trust and rapport are necessary for informing this assessment and to create an environment conducive to discussing rapid autopsy. Clinicians have also crafted their own ways of delivering information about CASCADE, with both clinicians and patients acknowledging that, if not handled sensitively, recruitment could cause distress. Overall, patients were satisfied with the way in which they were recruited. Conclusion: Findings provide insight into how clinicians successfully select and recruit patients to a rapid autopsy programme and suggests that discussing such topics are acceptable to end-of-life patients. This research also raises thought-provoking questions about the ‘gatekeeping’ role of clinicians in recruitment.

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Section: Introductionmentioning

confidence: 99%

The art and science of recruitment to a cancer rapid autopsy programme: A qualitative study exploring patient and clinician experiences

et al. 2020

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“…Even to more experienced practitioners, the nakedness of post-mortem bodies has an arresting effect. Horsley (2010) studied doctors training to be pathologists, many of whom had recently completed their surgical rotation, yet this experience did not necessarily prepare them for the emotional impact of PMEs.…”

Section: Indignity and Assaults Upon Bodily Integritymentioning

confidence: 99%

The social life of the dead: The role of post-mortem examinations in medical student socialisation

Goodwin

Machin

Taylor

2016

Social Science & Medicine

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Dissection has held a privileged position in medical education although the professional values it inculcates have been subject to intense debate. Claims vary from it generating a dehumanising level of emotional detachment, to promotion of rational and dispassionate decision-making, even to being a positive vehicle for ethical education. Social scientists have positioned dissection as a critical experience in the emotional socialisation of medical students. However, curricular revision has provoked debate about the style and quantity of anatomy teaching thus threatening this 'rite of passage' of medical students. Consequently, some UK medical schools do not employ dissection at all. In its place, observation of post-mortem examinations - a long established, if underutilised, practice - has re-emerged in an attempt to recoup aspects of anatomical knowledge that are arguably lost when dissection is omitted. Bodies for post-mortem examinations and bodies for dissection, however, have striking differences, meaning that post-mortem examinations and dissection cannot be considered comparable opportunities to learn anatomy. In this article, we explore the distinctions between dissection and post-mortem examinations. In particular, we focus on the absence of a discourse of consent, concerns about bodily integrity, how the body's shifting ontology, between object and person, disrupts students' attempts to distance themselves, and how the observation of post-mortem examinations features in the emotional socialisation of medical students.

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“…In contrast, anatomical pathologists occupy a far lower rung on medicine’s status ladder: university pathology departments are being down-graded and young doctors are increasingly shunning the specialty (Horsley, 2010). On occasion, the caricature of anatomical pathologists as ‘failed doctors’ who ‘simply didn’t have what it took to communicate with real, live people’ has been publicly voiced by health experts ( The Age , 2006).…”

Section: Stains Stigma Status: Doctors Who Work With the Deadmentioning

confidence: 99%

‘How dead dead the dead are’: sensing the science of death

Horsley

2012

Qualitative Research

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This article focuses on two revelatory moments I experienced during hospital-based fieldwork. The first, involving a microscope, offered me a glimpse into the sensory intellectuality that attracts some doctors to the specialty of anatomical pathology. The second occurred as I gazed into an emptied human skull. This experience generated a gestalt-shift of insight into the capacity of pathologists to work with human remains. Both events opened a doorway to the sequestered science of death – the macroscopy and microscopy upon which anatomical pathology is built – and the enervating emotions that support the doctors who ‘mutilate’ the dead during autopsy.

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Teaching the Anatomy of Death: A Dying Art?

Cited by 4 publications

References 47 publications

The art and science of recruitment to a cancer rapid autopsy programme: A qualitative study exploring patient and clinician experiences

The art and science of recruitment to a cancer rapid autopsy programme: A qualitative study exploring patient and clinician experiences

The social life of the dead: The role of post-mortem examinations in medical student socialisation

‘How dead dead the dead are’: sensing the science of death

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