The hospital autopsy: the importance in keeping autopsy an option

Rachel Scarl,Tanner Hardy,Vidya Arole,Bryce Parkinson,Patricia Allenby

doi:10.4322/acr.2021.333

Abstract

ABSTRACTAutopsy has been one of the most powerful diagnostic tools in medicine for over a century. Despite its importance in establishing cause of death and elucidating pathophysiology of disease, rates of hospital autopsies continue to decline. In this study we aim to determine if physicians believe autopsies are essential to patient care through discussion of autopsy with families. At the same time, we analyzed whether families are more willing to consent to autopsy if physicians are involved in autopsy discussion at the time of death, and what may be the reasons for not wanting an autopsy. Our results showed a doubling in autopsy consent when autopsy was discussed by the physician. Additionally, the biggest reason for families not consenting to autopsy was because they believed they already knew what caused death. The emergence of Coronavirus 2019 (COVID-19) has re-established the value of autopsy, as seen by increased autopsy rates in the past year. This study demonstrates that physician conversation with families on autopsy leads to an increased chance of autopsy consent.

Highlights

Performing autopsies allows the one doing the procedure to become proficient in anatomy and becomes a valuable tool to teach other students
If autopsies are not readily available to the pathology resident, the skills needed for postmortem examination decline, further making autopsy a less valuable tool
This study was conducted at The Ohio State University Wexner Medical Center (OSUWMC) and all data was collected via a SharePoint entry system within the electronic medical record system available at OSUWMC from June 2019 to July 2020

Summary

Introduction

Dissections of the human body occurred mostly for religious and cultural reasons. Postmortem examinations became the cornerstone for understanding disease within the medical community.[1]. To this day, clinicians, students, and families can continue to benefit from what is discovered during the medical autopsy. On the medical practitioner side, autopsies can disclose whether a correct diagnosis was rendered, how the disease progressed and possibly discover new aspects of a disease not previously described. All of these aspects become important to provide quality assurance of care and continue to educate physicians on how diseases may be managed or cured.[2]. If autopsies are not readily available to the pathology resident, the skills needed for postmortem examination decline, further making autopsy a less valuable tool

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