Autopsy (cont.)

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What are the benefits of autopsies?

Benefits for families: For families, the autopsy has both tangible and psychological benefits. Uncertainty regarding the cause of an individual's death can delay payment of insurance benefits. The autopsy can also uncover genetic or environmental (for example, a bacterium or fungus) causes of disease that could affect other family members. Psychologically, the autopsy provides closure by identifying or confirming the cause of death. The autopsy can demonstrate to the family that the care provided was appropriate, thereby alleviating guilt among family members and offering reassurance regarding the quality of medical care. Lastly, the autopsy is a mechanism that enables the family to participate in medical education and research.

Benefits for the clinician and hospital: The procedure can confirm the accuracy of the clinical diagnoses and the appropriateness of medical care. The autopsy findings can be utilized to educate physicians, nurses, residents, and students, thereby contributing to an improved quality of care.

Benefits to society: Many of the benefits of the autopsy are experienced by society as a whole. The autopsy aids in the evaluation of new diagnostic tests, the assessment of new therapeutic interventions (drugs, devices, surgical techniques), and the investigation of environmental and occupational diseases. Autopsy data are useful in establishing valid mortality statistics. Data derived from death certificates in the absence of autopsy data have repeatedly been shown to be inaccurate. New medical knowledge on existing diseases that is derived from autopsy-based research is clearly important for everyone. Remarkably, new diseases continue to emerge which can only be fully investigated by autopsy.

Who pays for autopsies?

Presently, there is no direct funding to hospitals or doctors for autopsies. As part of the federal government's Medicare funding to hospitals, reimbursement for autopsies is theoretically included in fixed payments that hospitals receive. Thus, the federal government contends that it is paying for autopsies. Since these funds are not specifically earmarked for autopsies, they may not reach the pathology department or pathologist. Managed care organizations consider the autopsy to be built into their hospital contracts. However, these organizations have stated that they are willing to reimburse for autopsies if and when they are convinced of their value. Sometimes in hospital autopsies performed at the request of physicians, the autopsy is not billed to the patient's family, but they should check with the hospital performing the service. This is different from autopsies the family requests of private pathologists, which may lead to charges billed to the deceased's next-of-kin.

In our litigation-oriented society, a growing proportion of private-pay autopsies are motivated by distrust, anger, and a desire to sue the potentially responsible physician(s) and hospital. Several groups of pathologists and business persons throughout the country are marketing their autopsy services through direct mail, newspapers, funeral homes, and online. Whether the quality and objectivity of these private autopsies will match those of general hospitals and academic medical centers remains to be determined.

Medically Reviewed by a Doctor on 1/27/2014

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