When Should You Order an Autopsy for A Loved One
The tragedy of losing a loved one can be compounded by not knowing why they died. The uncertainty leaves people wondering how the death might have been prevented and often prevents closure to allow the grieving to end. This is especially true when a young person dies unexpectedly. Luke Killian was only 16 years old when he collapsed and died at a football practice. Derek Boogaard was an NHL hockey player who was found dead at his home at age 28. When the cause of death is uncertain, the medical examiner or coroner may order an autopsy be performed to help with the investigation. While autopsies are glamorized by television detective dramas, they are perhaps more useful when performed on people who haven't died from a crime.
The value of autopsies is well established. It helps the physician confirm diagnosis and can also help families understand how and why their relative died. The family can be reassured (or become upset) that the treatment provided was appropriate or not. It may also help predict whether any hereditary diseases might be present. For example, dementia is a common diagnosis but it is the result of an illness. It may make a difference to future generations if that illness was Alzheimer's, Parkinsonism, Huntington's or many other potential illnesses, so that early recognition and treatment can be considered among relatives.
Unfortunately, the rate of autopsies that are performed is decreasing due to a variety of reasons.
Forty years ago, hospitals were mandated to do autopsies as part of their accreditation and to improve quality of care. Only by looking inside could one know what had happened. Technology has progressed and with CT, MRI and PET scans examaning inside the body has never been easier if these technologies are used. Unfortunately, many diagnoses are missed and 2% to 30% of autopsies uncover an unexpected finding. The ability to learn from the patient, even after death, is perhaps the greatest gift that the family can give to the physician, but the family has to be asked for that gift.
The first act that a family physician performs for a patient is signing a birth certificate. The death certificate is the final act. It notes the cause of death and lists contributing factors. Words on a form are harsh and cold and lack the compassion of explanation. The autopsy may help shed some light on the sadness of death.
REFERENCE: Fauci, Anthony S., et al. Harrison's Principles of Internal Medicine. 17th ed. United States: McGraw-Hill Professional, 2008.
Last Editorial Review: 5/24/2011 6:20:02 PM
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