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Year : 2013  |  Volume : 27  |  Issue : 3  |  Page : 163-164

Demise of medical autopsy

1 Department of Pathology, Regional Institute of Medical Sciences, Imphal, Manipur, India
2 Department of Plastic Surgery, Regional Institute of Medical Sciences, Imphal, Manipur, India

Date of Web Publication19-Feb-2014

Correspondence Address:
Nepram Sanjib Singh
Department of Plastic Surgery, Regional Institute of Medical Sciences, Imphal, Manipur
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0972-4958.127381

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How to cite this article:
Laishram RS, Singh NS. Demise of medical autopsy. J Med Soc 2013;27:163-4

How to cite this URL:
Laishram RS, Singh NS. Demise of medical autopsy. J Med Soc [serial online] 2013 [cited 2020 Oct 19];27:163-4. Available from:

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],[4],[5],[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. Pathologist's perspective: Many pathologists describe autopsy as the ultimate medical consultation [13] and the ultimate audit. [14]

  Demise of Medical Autopsy Top

Several factors have been implicated in the decline. The most common primary factor is related to clinicians denying autopsy. The reasons for denying includes distaste for the procedure [15] and a belief that autopsy can add nothing extra to the clinical picture as modern investigative techniques are more accurate. [16] Another reason could be related to the diminishing clinical interest and their increasing clinical confidence in their antemortem diagnosis. [17]

Various pathological studies highlighted the discrepancy rate between the cause of death clinically before and after autopsy. [18],[19],[20]

Another major reason is the public resistance to autopsies related to organ retention as highlighted by the media. [21]

  Virtual Autopsy Top

Autopsy performed using only advanced radiographic techniques and it Amy be useful for identifying diagnosis that traditionally have been identified by medical autopsy. However, further studies are required to confirm these preliminary results. [22]

  Conclusion Top

A strict emphasis must be made on the importance of autopsy in medical education by the concern authorities. In the present era of strict medical audit, we should not ignore the contribution made by autopsy to medical education. Promoting public support for autopsies is another agenda to work upon.

  References Top

1.Hill RB, Anderson RE. The recent history of the autopsy. Arch Pathol Lab Med 1996;120:702-12.  Back to cited text no. 1
2.Dehner LP. The medical autopsy: Past, present, and dubious future. Mo Med 2010;107:94-100.  Back to cited text no. 2
3.Lauder I. Auditing necropsies. BMJ 1991;303:1214-5.  Back to cited text no. 3
4.Start RD, McCulloch TA, Benbow EW, Lauder I, Underwood JC. Clinical necropsy rates during the 1980s: The continued decline. J Pathol 1993;171:63-6.  Back to cited text no. 4
5.McKelvie PA, Rode J. Autopsy rate and a clinicopathological audit in an Australian metropolitan hospital - Cause for concern? Med J Aust 1992;156:456-62.  Back to cited text no. 5
6.Anderson NH, Shanks JH, McCluggage GW, Toner PG. Necropsies in clinical audit. J Clin Pathol 1989;42:897-901.  Back to cited text no. 6
7.O'Grady G. Death of the teaching autopsy. BMJ 2003;327:802-4.  Back to cited text no. 7
8.Loughrey MB, McCluggage WG, Toner PG. The declining autopsy rate and clinicians' attitudes. Ulster Med J 2000;69:83-9.  Back to cited text no. 8
9.Lundberg GD. Medicine without the autopsy. Arch Pathol Lab Med 1984;108:449-54.  Back to cited text no. 9
10.Hill RB, Anderson RE. The uses and value of autopsy in medical education as seen by pathology educators. Acad Med 1991;66:97-100.  Back to cited text no. 10
11.Galloway M. The role of the autopsy in medical education. Hosp Med 1999;60:756-8.  Back to cited text no. 11
12.Benbow EW. Medical students' views on necropsies. J Clin Pathol 1990;43:969-76.  Back to cited text no. 12
13.Revitalizing the ultimate medical consultation. College of American Pathologists Foundation Conference on the Autopsy. Snowmass, Colo., July 20-23, 1983. Arch Pathol Lab Med 1984;108:437-512.  Back to cited text no. 13
14.Gambino SR. The autopsy. The ultimate audit. Arch Pathol Lab Med 1984;108:444-5.  Back to cited text no. 14
15.Hull MJ, Nazarian RM, Wheeler AE, Black-Schaffer WS, Mark EJ. Resident physician opinions on autopsy importance and procurement. Hum Pathol 2007;38:342-50.  Back to cited text no. 15
16.Nemetz PN, Tanglos E, Sands LP, Fisher WP Jr, Newman WP 3 rd , Burton EC. Attitudes toward the autopsy - An 8-state survey. MedGenMed 2006;8:80.  Back to cited text no. 16
17.Sinard JH. Factors affecting autopsy rates, autopsy request rates, and autopsy findings at a large academic medical center. Exp Mol Pathol 2001;70:333-43.  Back to cited text no. 17
18.Cardoso MP, Bourguignon DC, Gomes MM, Saldiva PH, Pereira CR, Troster EJ. Comparison between clinical diagnoses and autopsy findings in a pediatric intensive care unit in São Paulo, Brazil. Pediatr Crit Care Med 2006;7:423-7.  Back to cited text no. 18
19.Shojania KG, Burton EC, McDonald KM, Goldman L. Changes in rates of autopsy-detected diagnostic errors over time: A systematic review. JAMA 2003;289:2849-56.  Back to cited text no. 19
20.Goldman L, Sayson R, Robbins S, Cohn LH, Bettmann M, Weisberg M. The value of the autopsy in three medical eras. N Engl J Med 1983;308:1000-5.  Back to cited text no. 20
21.Ayoub T, Chow J. The conventional autopsy in modern medicine. J R Soc Med 2008;101:177-81.  Back to cited text no. 21
22.Wichmann D, Obbelode F, Vogel H, Hoepker WW, Nierhaus A, Braune S, et al. Virtual autopsy as an alternative to traditional medical autopsy in the intensive care unit: A prospective cohort study. Ann Intern Med 2012;156:123-30.  Back to cited text no. 22


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