Running Head: CONSENT TO AUTOPSY

Consent to Autopsy
Adrianna Haight
Salt Lake Community College

CONSENT TO AUTOPSY

Introduction
Should consent be required for an autopsy? In an article titled, Is Consent to Autopsy
Necessary? Cartesian Dualism in Medicine and Its Limitations, by Megan Lane and Christian J.
Vercler, it presents the case of a patient named Ms. Foster. This ethical situation looks at the
relationship between consent of a family for an autopsy and the concern of a doctor over possible
legal ramifications.
Ms. Foster came to the hospital with complaints of struggling to breathe. The hospital
conducted a series of tests and discovered that she had fluid surrounding one of her lungs, also
known as pleural effusion. The doctor, who the paper names as Doctor Zinker, is a cardiac
surgeon and decided that the best course of action is to drain the fluid. After the fluid is drained,
Ms. Foster developed an unstable blood pressure and is treated with vasopressors. Despite the
best efforts of the medical staff, Ms. Foster died. Doctor Zinker would like to order an autopsy to
determine if his actions had been behind the death of his patient.
The complication behind ordering an autopsy is that it requires the consent of the family.
When Doctor Zinker goes to the family they become reluctant to allow him to order the autopsy.
They request a reason for why the autopsy would be necessary in Ms. Fosters case. Doctor
Zinker, then, faces the decision of telling the family that he is concerned that he did something to
contribute to her death and open himself up for a lawsuit, or letting the case go.
Medical autopsies, which examine a body after death with the intention of determining
what caused the death, can play an important role in helping a doctor improve their skill. By
knowing what they did wrong, they can correct the actions and look for better approaches to
helping patients when dealing with similar situations in the future. Some other benefits that are

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listed in the article are, It can provide closure for a grieving family, data for quality
improvement, or evidence for criminal prosecution.
There are several ethical considerations when it comes to autopsies. What kind or respect
does the body deserve after death? Family members can find the idea of cutting open and
examining the organs of a deceased family member disturbing, but doing so can provide valuable
and important data. With that consideration, should the benefit of performing an autopsy
outweigh the familys desires, who are only looking at the situation from a personal perspective?
Thesis
For this papers purposes, it will assume that the interests of the patient are passed on to
the family. This paper will evaluate the conflicting interests of keeping the familys preferences
in mind, while contrasting the medical benefits that an autopsy can have for medical
professionals in their field.
The common thread, when it comes to autopsies, is that they should not be conducted
without good reason. The general belief of society is that the decision of an autopsy should be
made by the family, in cases where there is concern of malpractice, or by a judge, if there is
concern about someones involvement in the death. Value is placed on that body because it
belonged to a loved one before their passing.
This paper argues that autopsies are an important medical tool that should be utilized by
medical institutions. The familys wishes are important and need to be taken into consideration
when it comes dealing with the body of their deceased family member. However, there should be
a way in place that doctors can order an autopsy without fear of facing legal ramifications for
any possible mistakes. One way could be eliminating the need for a doctor to obtain consent,
except for when the family has an objection on religious grounds. Another way that was

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suggested in the article Is Consent to Autopsy Necessary? Cartesian Dualism in Medicine and
Its Limitations, by Megan Lane and Christian J. Vercler is that doctors place a greater emphasis
on apologizing for mistakes and a grief counselor is present when delivering news.
Body
The situation presented is unique, in that it deals with the human body after death. The
actions of the physician charged with conducting the autopsy cannot kill the patient and any
wishes of the deceased would have to have been made before their death. This means that the
actions will not impact the quality of life for the patient, but could influence the quality and
treatment for others based off of what is learned from their death.
The medical indications of the patient are terminal. They are dead and any actions taken
after they are proclaimed dead will not bring them back to life. At this point, we diverge into two
competing fields of view: that of the family and of the doctor who wishes for an autopsy. The
harm caused by the autopsy will not impact the patient, but it will cause emotional distress to the
family. Another consideration is that the patient will not benefit from any of the results that are
found by the autopsy.
In the medical situation that is presented of Ms. Foster, she has not given consent for the
autopsy. Her family has been given jurisdiction over any actions that are taken at this point and
they would like a logical reason to delay the funeral and have an autopsy performed. In the
article titled, Is Consent to Autopsy Necessary? Cartesian Dualism in Medicine and Its
Limitations, by Megan Lane and Christian J. Vercler, it states that the worth of the body comes
from the living. In the article is says, This worth is constructed through others memories of and
respect for the deceased person. So, the decision must be made of whether the worth that the

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family places on that body, is more than the worth of what could be learned from obtaining an
autopsy.
Many members of society find something repulsive in the idea of performing an autopsy
on a deceased family member. The main objection is the idea of opening the body and subjecting
it to an invasive procedure to investigate the cause of death. However, in most cases the medical
workers who perform the autopsy are looking to treat the body with respect. In an informational
pamphlet that was created by St. Judes Childrens Research Hospital it explains that autopsies
are performed in an, Atmosphere of dignity and respect. It goes on to explain that the family
can still have an open-casket funeral and that there will be no signs that the autopsy was ever
performed.
Another possible argument against an autopsy are religious grounds. Health
professionals have found ways to work with the beliefs of a religion that still allow for an
autopsy. St. Judes, and many other hospitals, allow families to dictate that they would like
organs returned to the deceased family member after an autopsy has been performed, which
appeases many peoples religious beliefs.
Care providers at a hospital are human, which means that they make mistakes. In the
article titled, Autopsies Contribute Valuable Scientific Data, But Theyve Become Rare, it
states that, Studies have repeatedly shown that autopsies turn up contradicting causes of death.
For example, a doctor blames pneumonia, but an autopsy reveals that it was actually a tumor.
Even with the medical advances that we have today, it is still possible for a doctor to miss
something or come up with a wrong diagnosis. When a mistake is made and a patient dies, the
best way of determining the mistake and correcting it in future treatment is through discovering
what went wrong. Autopsies are the best tool to use when making this determination.

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The number of autopsies being performed on deceased patients is dropping. In an article

titled, Autopsies Contribute Valuable Scientific Data, But Theyve Become Rare, it states,
The Joint Commission on Accreditation of Hospital (now called The Joint Commission) used to
require hospitals to perform autopsies on at least 20 percent of patients who died on premises.
By doing these autopsies it gave hospitals feedback into what the causes behind patient deaths
were and allowed them to search for ways to improve their systems. The article goes on to
inform the reader that the requirements were changed in 1970 and hospitals no longer have the
pressure of performing a certain number of autopsies. The knowledge that could be utilized
through an increased number of autopsies should be taken advantage of by hospitals.
One method of looking to increase the number of autopsies that are performed for
educational purposes is reevaluating the consent process. A proposed modification is that consent
be removed so that an autopsy could be performed without the familys consent, unless the
familys objection stems from their religious affiliation. It could also allow that a doctor not have
to release their findings. This would allow for physicians to learn from possible mistakes without
fearing that legal action will be taken against them. However, this idea takes control away from
the family and puts them at odds with the doctor.
The solution that is proposed by the article, Is Consent to Autopsy Necessary? Cartesian
Dualism in Medicine and Its Limitations, is that doctors look to their approach to asking for an
autopsy. The article argues that if doctors were to admit to concern of a mistake and be willing to
apologize for it, families would be less likely to take legal action against the doctor. The article
also suggested having a grief counselor present when delivering the request. This method
maintains the importance of respecting the familys wishes, but still leaves some concern for the

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doctor. There are likely to be cases where a family will choose to pursue legal action, regardless
of the doctors apology.

Conclusion
There may not be a perfect solution when it comes to the situation of asking for an
autopsy. However, it is important the body is treated with respect and the familys wishes is taken
into consideration. It is also important that autopsies are conducted and used to further medical
knowledge. While there are flaws with both proposed solutions, the best decision that is
available, is for doctors to be forthright when concerned that they have made a mistake. By
expressing compassion and empathy, it will, hopefully, lead to a greater understanding between
medical providers and patients.

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References
Giving Consent for an Autopsy. (2010). Retrieved August 05, 2016, from
https://www.stjude.org/content/dam/en_US/shared/www/patient-support/do-youknows/gen-info-autopsy.pdf
Lane, M., MD, & Vercler, C. J., MA. (n.d.). Is Consent to Autopsy Necessary? Cartesian
Dualism in Medicine and Its Limitations, August 16 - AMA Journal of Ethics. Retrieved
August 05, 2016, from http://journalofethics.ama-assn.org/2016/08/ecas2-1608.html
The Dominican Friars of the Province of St. Albert the Great. (n.d.). Retrieved August 05, 2016,
from http://opcentral.org/blog/autopsy-ethical-religious-considerations
Zhorhov, I. (2016, May 27). Autopsies contribute valuable scientific data, but they've become
rare. Retrieved August 08, 2016, from http://www.newsworks.org/index.php/local/thepulse/94037-autopsies-still-contribute-valuable-scientific-data-but-theyve-become-rare