Demise of medical autopsy

Abstract

The term “autopsy” is derived from a Greek word “autopsia” meaning act of seeing with one’s own eyes. An autopsy involves dissection and examination of a dead body to determine the cause of death and learn about disease processes. In the early 20 th century, autopsy is considered to play a fundamental role in medical education guided by the Osterian philosophy. [1] The medical autopsy continue to have a multifactorial role in the delivery of modern medical education. It is the most reliable method to evaluate the validity of clinical diagnoses. [2] Over the years especially during the latter part of the 20 th century, a decline in the rate of autopsies performed occurred world-wide. [3-6] The demise of the educational role of medical autopsy has followed its decline in-hospital practice. [7] Decline in the autopsy rates has occurred world-wide over the past 40 years especially in New Zealand, the United Kingdom [8] and the United States. [9] Usefulness of medical autopsy may be divided into various categories. 1. Educational role: Hill and Anderson highlighted the core areas of knowledge learnt effectively by the medical students that includes clinicopathological correlation, pathophysiology, anatomy and observational skills. [10] Autopsy also increases the awareness of patients with multiple conditions and the level of uncertainty in medical science. Moreover, autopsy brings about the opportunity to discuss ethical and legal aspects of death and death certification. [11] Many undergraduate and postgraduate students find autopsy to be very useful although some find it distasteful. [11,12] 2. Clinical role: Various studies highlighted discrepancies between clinical diagnosis and autopsy findings. [13,14] The autopsy thus plays a vital clinical role in auditing medical care despite the advancement in diagnostic techniques. [7] 3. P athologist’s perspective: Many pathologists describe autopsy as the ultimate medical consultation [13] and the ultimate audit. [14]