Persuasive Essay On Hospital Autopsies

The word “Autopsy” means ‘to see with one’s own eyes,’ (2) and is a procedure that has been performed since the time of (LOOK UP IN NOTES). Not every death that occurs is subjected to an autopsy – this would be time consuming and expensive. Yet the situations that require such a procedure are different for every state. In fact, there is no federal standard when it comes to autopsy requirements or procedures – a surprising fact, considering the sheer number of years the human race has been practicing the procedure.
(INVASIVE) In hospital autopsies have declined worldwide over the last few decades – the most drastic coming from Sweden, whose rates have dropped from 80% to under 40% in a single decade alone. Many first world countries in the present day, including the United States, report these procedures at a rate of less than 10% - a number that is frustrating

when it comes to pathology education and research. A majority of this decline has been attributed to a rise in declining autopsy requests by the next of kin – due either to personal or religious reasons - but other reasons, such as a fear of litigation over a missed diagnoses and changes in the priorities of hospital staff have also contributed. Though traditional autopsies have been called “the gold standard” and have changed little in terms of general procedure over the years, this drastic decline in traditional autopsies has prompted a need for an alternative. (1)
(NON INVASIVE) Since the accidental discovery of x-rays in 1895, the world has been fascinated with the images produced of the inside of the human body. In just over one hundred years, simple x-rays have developed in different modalities, each one developed for a specific area of medicine or part of the body. No invasive procedures are needed to see a broken ankle, a cancerous mass, or even internal bleeding, and this realization has crossed over into the world of autopsies. Where a traditional post mortem examination is invasive, the virtual examination is exactly the opposite, and leaves the body intact for the personal and religious reasons of the family while still gathering information about the cause of death. But what sorts of information can Computed Tomography (CT) scan or a Magnetic Resonance Image (MRI) show us? Is there anything these virtual autopsies can miss?
In a study performed by a Cohort group (1) a group of Doctors attempted to address this question. Out of a particular number of patients that passed during a five month period, this cohort performed a series of Postmortem CT scans and MRIs, as well as the traditional autopsy methods, and compared their findings – not just to each other, but also to the antemortem diagnoses. Out of the 298 total diagnoses made across the board, traditional autopsies missed 40. A majority of the missed diagnoses were traumatic fractures, pericardial effusions, and pneumothoraces. (1) This supported by another study (4) that compares the shortcomings of both the virtual and traditional examinations. Fractures and air embolisms are stated as being difficult to detect in a traditional examination, supporting the finds of the cohort study.
With the Virtual examinations, the cohort group found that 62 of the 298 diagnoses were missed. Most of these consisted of Myocardial infarctions and cancer. These diagnoses could have been missed due to a lack of comparable data through the use of CT scans (3), as the utilization of such instrumentation has been around for mere decades, at most. So while both types of examinations have their weak points, they do compliment and overlap each other enough to convey a full picture.
Most of the strong points of the virtual examination have been determined through its use in forensics. (3) Many cases that are presented to a Forensics lab are homicides or suicides, through which the use of a foreign object is used as a weapon. Through the use of X-rays, CT scans, and 3D remodeling, many details can be flushed out that would be missed through a traditional examination. For example, bullets often disintegrate upon passing through the body, but their path can easily be overlooked during a traditional autopsy. In fact, the path can even be destroyed on accident, rendering the evidence invalid. Scans can determine the presence of foreign objects and their path through the body without destroying the body’s architecture or the evidence involved.
Within the fields of medicine, autopsies are invaluable when it comes to education and research.

Though our knowledge of the human body has developed drastically, there will always be more to learn, especially in the field of pathology. In addition to education, this procedure is also used to improve the quality of care that healthcare workers provide for their patients, especially in terms of undetermined diagnoses. Post mortem examinations can help to better identify pathologies, and allow a “hands on” approach that cannot be obtained readily.
All in all, though the use of a virtual examination is more widely accepted by a patient’s next of kin and can supply decent information as to a cause of death, nothing can replace the hands on approach that is educating our Doctors and interns. Instead, the use of digital imaging should be utilized as an invaluable asset to the postmortem examination process by aiding in the weak areas of a traditional examination. Perhaps, in time, the technology of these scans can be improved upon, but until then, traditional autopsies will remain the gold standard in

education.