Need to Develop Strategies to Solve the Decline

Letter to the Editor

There has been a drastic decline in the number of autopsies being performed since the 1960s, and with this decline, a valuable informational and teaching tool is being lost. While there are definitely pros and cons for this procedure, from my perspective, the benefits of autopsies far outweigh the negatives.

Autopsies can provide the precise cause and manner of death [1] and give families much-needed closure. They can reveal additional medical problems (unrelated to the cause of death) [2] and delineate potential hereditary issues. They are excellent teaching tools providing firsthand observations of human anatomy and disease processes. They also allow healthcare staff to compare premortem and postmortem findings so they can determine if the care provided was appropriate and effective. They help to improve the scientific understanding of disease processes and foster new advances in their treatment. Autopsies also are useful for monitoring public health and for providing epidemiological data.

While some families may not want to see their loved one traumatized further, minimally invasive autopsies often can be utilized to diminish these concerns. Religious, legal, and financial issues may also be viewed as drawbacks, but these factors often can be successfully addressed on an individual level as they arise.

Autopsies have value for caregivers, families and society; we should take steps to see that they are increasingly performed [3]. Programs could be developed that educate healthcare providers and citizens regarding their benefits. Additional incentives also could be offered to medical providers to perform autopsies. If we can develop and implement new strategies and policies that promote more autopsies being performed, both healthcare and public health will improve.

As Sir William Osler, the distinguished physician, stated long ago“…the best teaching is that taught by the patient himself” [4] and patients can still teach us — even after death.

References

1. Burton EC. The Autopsy: A Professional Responsibility in Assuring Quality of Care. Am J Med Qual. 2002; 17: 56-60.
2. Shojania KG, Burton EC. The Vanishing Nonforensic Autopsy. N Engl J Med. 2008; 358: 873-875.
3. Skelley BH. When Families Ask About an Autopsy. Am J N. 2016; 116: 11.
4. Osler W. Aequanimitas, With Other Addresses to Medical Students, Nurses and Practitioners of Medicine. Philadelphia: P. Blakiston’s Son & Co. 1904.