Role of the Autopsy

Question 1

Define 10 functions of the hospital autopsy

Answer 1

1. Define the cause of death
2. Accuracy of clinical diagnosis
3. Evaluation of treatment
4. Education
5. Medical legal
6. Institutional Quality Assurance
7. Reassurance to loved ones
8. Genetic counseling
9. Research
10. Tissue transplantation
11. Public health
12. Recovery of prosthetic material

Question 2

Define the family hierarchy whereby legal permission for an autopsy can be granted.

Answer 2

1. Spouse
2. Adult son or daughter
3. Parent
4. Adult brother or sister
5. Legal guardian or power of attirny

Question 3

Name 3 reasons for the decline in national autopsy rates.

Answer 3

1. Public resistance
2. Dimminished interest among patholgists
3. Diminishing clinical interest and increasing clinical confidence in ante-mortem diagnosis

Question 4

Discuss why the hospital autopsy is used for institutional quality assurance.

Answer 4

• Prospective audit of clinical and pathological performance
• Clinical significance of autopsy findings
• Quality control of the autopsy itself
• Assessment of clinical factors that might contribute to death

Question 5

List 6 circumstances of death that must be reported to the State Medical Examiner.

Answer 5

1. Death resulting from violence
2. Death following accident
3. Suspicious, unusual or unnatural manner
4. Death in proison
5. Death unattended by a physician
6. Sudden death when in good heath
7. Death in children under 3
8. SIDS

Question 6

State the frequency of major discrepancies between antemortem and post-portem diagnoses today and in the past.

Answer 6

1988 – 24-33%

1991: 30%

Question 7

Describe who pays for a hospital autopsy to be performed.

Answer 7

• Free of charge to patients at DHMC

- Medicare