The attitudes of relatives to autopsy: a misconception

Tsitsikas, Dimitris A.; Brothwell, Morag; Aleong, Jo-Anne Chin; Lister, Andrew

doi:10.1136/jcp.2010.086645

Cited by 42 publications

(45 citation statements)

References 15 publications

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“…8 Moreover, if handled in a sensitive and appropriate manner, there can be tangible benefits for relatives of the deceased, many reporting a sense of 'closure' in knowing for certain the cause of death, and a sense of the deceased helping others even in death. 9 The reasons for the long-standing decline, in face of the apparent benefits, are much debated. Whilst previously it had been thought that the opinion of relatives was behind the decline, a recent study 9 suggests it may be the result of fear of the post-mortem examination in the medical community.…”

Section: Competing Interestsmentioning

confidence: 99%

“…9 The reasons for the long-standing decline, in face of the apparent benefits, are much debated. Whilst previously it had been thought that the opinion of relatives was behind the decline, a recent study 9 suggests it may be the result of fear of the post-mortem examination in the medical community. Reasons for this include medico-legal concerns and assumptions that relatives would not want the deceased's body further disturbed.…”

Section: Competing Interestsmentioning

confidence: 99%

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Dead in the water – are we killing the hospital autopsy with poor consent practices?

Henry

Nicholas

2012

J R Soc Med

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It is now a recognized fact that the practice of conducting a consent (or hospital) post-mortem examination is in decline. There have been many reasons put forth to explain this demise, but the quality of the consenting process is frequently cited as having a high impact. This article focuses on consent practices for post-mortem examinations in England and Wales, and considers if our consent techniques are adversely affecting post-mortem examination uptake. We examine the regulatory compliance of trusts with their statutory obligations by analyzing the Human Tissue Authority's compliance and inspection reports. We further analyze 21 publicly available NHS Trust policies on post-mortem examination consent procedures, and consider whether these are fit for the purpose of meeting the dual needs of clinicians and the bereaved. Despite more Human Tissue Authority inspections, there is a disproportionate rise in enforcement actions, with up to 48% of sampled Trusts exhibiting shortcomings in their legal duties. Additionally, only 52.4% of sampled trusts follow the Human Tissue Authority best-practice model, with 23.8% having no documented procedures. Despite the well founded evidence base for best-practice models, consent practices for post-mortem examinations remains poor and is likely to have a gross adverse effect on the rate of post-mortem examinations. We recommend that NHS Trusts rigorously review their protocols and introduce a team-approach between clinicians and trained bereavement staff in core-consent teams, as the Human Tissue Authority suggests, whilst at the same time placing a strong emphasis on education for junior and senior colleagues alike.

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Section: Competing Interestsmentioning

confidence: 99%

Section: Competing Interestsmentioning

confidence: 99%

Dead in the water – are we killing the hospital autopsy with poor consent practices?

Henry

Nicholas

2012

J R Soc Med

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“…2 The medical staff can clarify about misperceptions and myths to the family members, in an articulate and sensitive manner. 3,4 Medical personnel must know what a lay person is exposed to? What they think about?…”

Section: Introductionmentioning

confidence: 99%

Myths and misconceptions about medico-legal autopsies among the people of Tamilnadu, India

Pawar

Suryawanshi

Kumar

2015

Journal of Forensic and Legal Medicine

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“…It has been shown repeatedly that increasing the number of requests to families can significantly improve autopsy rates,11 12 suggesting that currently there is a failure to realise the potential for higher hospital autopsy rates. Moreover, it has been shown that some National Health Service (NHS) trusts have been failing to comply with their statutory duties with respect to this issue 13…”

Section: Introductionmentioning

confidence: 99%

Mind the gap: are NHS trusts falling short of recommended standards for consent to autopsy?

2013

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The decline of the hospital autopsy is a well-known phenomenon that shows no sign of ending. Debate continues for the reasons behind this, but inadequate consent practices are thought to play a role. The furore resulting from organ retention scandals at Bristol Royal Infirmary and The Royal Liverpool Children's Hospital led to widespread soul searching in the medical profession, and a fundamental change in how we treat the dead body. In response, the 2004 Human Tissue Act was created, and consent is now centrally placed to permit all activities dealing with the cadaver, including autopsy. This article reflects on consent practices for hospital autopsy in England and Wales. Relevant policies from 26 National Health Service trusts were examined against the recommended standards set by the Human Tissue Authority. We found numerous failures of multiple trusts to follow these standards. Several trust policies failed to outline basic information to guide staff in conducting the consent process, such as the training requirements of the consent taker, and the desired approach to take consent. Many trusts failed to outline vital recommendations of the Human tissue Authority, such as the requirement of the consent taker to be experienced, trained in dealing with the bereaved and well informed on autopsy practice, as well as the requirement to have witnessed an autopsy. We recommend trusts reassess their practices in order meet the established standards with an emphasis on educating staff and developing a team-based approach to consent taking.

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The attitudes of relatives to autopsy: a misconception

Abstract: The attitude of the general public is positive overall, and translates into high autopsy rates when the value of the examination is presented honestly and the details of the procedure are adequately explained.

Cited by 42 publications

References 15 publications

Dead in the water – are we killing the hospital autopsy with poor consent practices?

Dead in the water – are we killing the hospital autopsy with poor consent practices?

Myths and misconceptions about medico-legal autopsies among the people of Tamilnadu, India

Mind the gap: are NHS trusts falling short of recommended standards for consent to autopsy?

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