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Aaron LarsonPerson was signed in when posted
11:16 AM ET (US)
The original article addressed the squeamishness of family members. That's certainly a factor in some cases. I didn't go into the other factors raised in the editorial, as my interest was more on the "CYA" issue.

Anybody who really wants an autopsy, at least in most parts of the nation, can pay for a private autopsy. I imagine that there are parts of the country where there may be a shortage of qualified practitioners, but around here it isn't difficult to find an expert to perform or review an autopsy.
04:03 PM ET (US)
Yeah, you knew that I was going to comment on this one. ;-)

What you say is indeed one cause of the low rate of autopsy. However, it is far from the main cause. In the majority of cases where an autopsy might be indicated, the lack of one is usually due to a refusal by family members to acquiesce to the request, due to either religious beliefs, squeamishness, desire to just let the relative rest in peace, or other non-scientific reasons.

In addition, on a number of occasions when my pathologist spouse has believed that he may be looking at a medicolegal case and has requested an autopsy by the coroner/medical examiner -- who generally has the authority to order an autopsy, overriding the family's wishes -- he has been refused (perhaps because they're already overwhelmed with cases, or because they prefer to make their afternoon golf date).

He then has had to perform the autopsy himself, and since he is not trained in medical forensics, it is quite possible that he might miss something a forensic pathologist would catch. This is assuming that he or the clinician can even get the family to agree to it.

On the flip side, autopsies are frequently requested by family members who are determined to find someone to blame for the fact that medicine simply cannot fix everything or save everyone's life (a.k.a. frivolous autopsies).

I have to believe that these are pretty common situations around the country. However, I am always willing to look at results from scientific studies that contradict my own beliefs and perceptions...

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