Is autopsy dead in the ICU?

Excerpt

Over past decades autopsy rates have fallen considerably in hospitals in the United States from a reported 50% in the 1940s to 10% in the late 1980s [1]. Various factors may explain this trend. Firstly, there is a lack of positive stimuli, such as the requirement for a minimum percentage of autopsies among deceased hospitalized patients to maintain residency training programs [2]. Secondly, there is the presence of negative stimuli, such as the potential use of autopsy findings for malpractice litigation. Interestingly, there are no widely known reports indicating that unexpected autopsy findings are likely to lead to litigation, or that autopsy rates have been directly affected by fear of litigation. Furthermore, it is argued that autopsies more often provide a defense against lawsuits rather than provoke them, and that failure to request an autopsy may even be used against a physician in malpractice litigation [3]. Finally, and probably most importantly, cost is a limiting factor when it is reasoned that necropsies do not impact directly upon patient care. Pathologists are also tending to concentrate their always limited time toward diagnostic activities (biopsies and cytologies) for living patients, giving less consideration to postmortem studies. …