Postmortem examination is a persistent controversy. Ever changing groups of advocates and detractors constantly alter the role assigned to autopsy in the practice of medicine. Present trends indicate a decline in interest for the traditional roles of the autopsy and a lack of support for its potential as a quality control device. Recommendations are made to reverse this trend. Namely, that minimum standards of autopsy performance for all hospitals should be established and enforced. Hospital medical staffs should take the initiative in encouraging autopsies, and physicians' attitudes and participation in postmortem activities should be incorporated in guidelines regarding staff reappointment and promotion. Professional hospital personnel such as senior administrators, social workers, and nurses should be trained to participate in autopsy requests. Ideally, the physician should ask permission to perform an autopsy for every fatality, and this request for consent should be augmented by the assistance of trained hospital personnel, which help (editors' experience) is very effective in the majority of cases. Many people in these circumstances would rather trust a (motherly) nurse, than the (cool, scientific) doctor. (There are doctors who just never get consent for any autopsy). Physician recognition awards and certificates recognizing continuing medical education should give credit for autopsies secured by attending physicians and for attendance at autopsy gross organ reviews where clinical correlation is stressed. However, only interested, qualified pathologists have the necessary skill to make the autopsy an enlightening experience for the contemporary physician. Specialty boards should establish and enforce minimum autopsy standards for accreditation of training programs not only in pathology but in all clinical specialties. Medical students should be taught not only why autopsies should be performed, but also how to request autopsies. They must confront and gain insight into their own emotions regarding death, and, equally important, they must learn what to expect, and in fact demand, from the pathologist performing the autopsy. The public, third party payers, and the government must recognize that the autopsy is a valuable service in the quality control of the delivery of heath care. An active educational program about autopsies for the lay public on the part of organized medicine and particularly organized pathology should be instituted. The public should be educated to accept the request for postmortem examination with more enlightenment, even to the stage that they themselves will demand that postmortem examinations be performed (which, in the Netherlands, is not all unusual).
|Original language||English (US)|
|Number of pages||3|
|Journal||New York State Journal of Medicine|
|State||Published - Dec 1 1976|
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