Once Routine, Autopsies Have Become Rare


Autopsies were once routine, performed in more than half of hospital deaths and, in some parts of the country, in a majority of deaths that occurred outside hospitals. But over the last few decades, the number of such procedures in the United States has sharply dropped, reports the New York Times.

Hospitals, afraid of being sued over mistaken diagnoses, increasingly forgo autopsies, experts say. The advent of sophisticated imaging techniques like C.T. scans and M.R.I.’s have created an illusion among doctors that the procedure is unnecessary. Grieving relatives, too, are often unwilling to shoulder the cost or wait for autopsies to be completed.

The decline, researchers say, may be gradually eroding the quality of care. A growing number of missed or mistaken diagnoses are going unchecked, depriving doctors of a learning tool. And studies, including one published last week, find that autopsies uncover missed or incorrect diagnoses in up to 25 percent of hospital deaths.

Medical examiners once relied on autopsies to pinpoint diagnostic mistakes, so doctors could know what pitfalls to avoid in the future.

Autopsies unmasked diseases that once baffled scientists, allowing researchers, for example, to link cigarette smoking to lung cancer and providing the first glimpses of AIDS, tuberculosis and heart disease. In some cases, autopsies have also detected hereditary illnesses, providing essential information for surviving relatives.

Sixty years ago about half of Americans who died were autopsied. Today, the rate is probably less than 5 percent, the Times reports.

Link: http://www.nytimes.com/2004/03/02/health/policy/02AUTO.html

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