More Autopsies?

The American Medical News published a letter to the editor that was so weird that I have to repeat it here:

Liability concerns are reflected in nation’s low autopsy rate

Regarding: “Declining autopsy rates affect medicine and public health” (Article, Feb. 20):

The fact that only 9% of all deaths in the U.S. were autopsied in 2007 is highly disturbing, especially since a large study in 2005 revealed that approximately 50% of autopsies revealed findings that were unsuspected prior to the patient’s demise.

The reasons for this continuing downward trend and the significant adverse consequences have been repeatedly commented upon. From medicolegal and forensic scientific perspectives, the likelihood of serious consequences and grave injustice in both civil and criminal matters is quite apparent. Educated, intelligent, sensitive people like experienced physicians should be fully aware of these tragic ramifications.

As both a hospital and forensic pathologist, I have been amazed by the frequency of cases in which the attending physician literally attempts to dissuade a family from having an autopsy performed. “It’s not necessary. We know everything already” to “Why should you want to have your loved one cut open?” are among the kinds of comments I have encountered personally.

I believe that the principal factor responsible for this unacceptable decline of autopsies was not referred to in this otherwise informative article. Fear of a malpractice lawsuit — that is the primary reason that doctors do not want autopsies to be done.

In the absence of a thorough postsmortem examination by an experienced pathologist, the cause of death will be officially designated by the diagnosis set forth by the treating physician. This is the regrettable and harsh explanation for this scientifically deplorable and societally unacceptable philosophy.

–Cyril H. Wecht, MD, JD, Pittsburgh

What?  Is he saying that we should do more autopsies so we can have more lawsuits?  Let’s just crank up the costs of healthcare even more while we are it.  Oh, and yes, he is a lawyer as well as a forensic pathologist.   According to Cyril, there are more and more doctors trying to stop families from doing autopsies because they are covering up their tracks.  Are you kidding me?   I have treated over 100,000 patients and I can only think of a handful of autopsies that were done or NEEDED to be done.  That is much less than the 9% performed right now.   And trust me, I am not covering up my tracks.

It just seems to me that this letter to the editor was the most self-serving commercial I have seen in a long time.   To use his phrase, I would call his correspondence “scientifically deplorable and societally unacceptable”.   It sure looks like Cyril needed something to do after he resigned from his position as Allegheny County medical examiner after being indicted on corruption charges.  After a hung jury let him walk I expect we are to see some more letters in the future.  Maybe he can reply to this blog?


12930cookie-checkMore Autopsies?