Beckwith J B
Department of Pathology, Children's Hospital, Denver, Colorado.
Pediatr Clin North Am. 1989 Feb;36(1):29-36. doi: 10.1016/s0031-3955(16)36614-7.
Requesting an autopsy is never a pleasant or comfortable experience, either for physician or for family members. Sometimes the family has had previous unhappy experiences with this procedure, and certainly many clinicians have been repelled by sights, sounds, and behaviors they have observed in morgues. Such experiences can have far-reaching negative effects and reflect poorly upon the profession of pathology. Berger's important paper contains important messages for pathologists concerned with the performance of pediatric autopsies and for clinicians requesting consent. His paper should be read and heeded by both groups. Several studies have looked at factors that might affect autopsy rates, especially in perinatal deaths. Early separation of mother from baby emerged as an important factor in one of these, whereas maternal age, race, and sociocultural background played no important role. One of these studies investigated attitudes and experiences of the requesting physicians, and found these factors to be key determinants in the family's response to a request to perform a postmortem examination. One result of that study was that more experienced physicians were more likely to request a postmortem examination, and to receive an affirmative answer. The pediatric postmortem examination remains an indispensable part of clinical management. Its importance for science, clinical practice, and medical administration is beyond question. However, its greatest and most unique value is to the families of the deceased children. Clinicians and pathologists must continue to work together to ensure that this procedure is performed whenever indicated, that the information gained is maximized, and that the results are communicated to the family promptly, accurately, clearly, and with sensitivity.(ABSTRACT TRUNCATED AT 250 WORDS)
无论是对医生还是对家庭成员来说，要求进行尸检都绝非愉快或轻松的经历。有时，家属此前在这个过程中有过不愉快的经历，而且许多临床医生肯定也对他们在停尸房所看到的景象、听到的声音和观察到的行为感到反感。此类经历可能会产生深远的负面影响，也会给病理学专业带来不良影响。伯杰的重要论文为关注儿科尸检工作的病理学家以及要求获得同意的临床医生传达了重要信息。这两个群体都应该阅读并重视他的论文。有几项研究探讨了可能影响尸检率的因素，尤其是围产期死亡案例中的因素。其中一项研究发现，母亲与婴儿的早期分离是一个重要因素，而母亲的年龄、种族和社会文化背景则没有起到重要作用。其中一项研究调查了提出要求的医生的态度和经历，发现这些因素是家属对尸检请求回应的关键决定因素。该研究的一个结果是，经验更丰富的医生更有可能要求进行尸检，并得到肯定的答复。儿科尸检仍然是临床管理中不可或缺的一部分。其对科学、临床实践和医疗管理的重要性毋庸置疑。然而，它对已故儿童的家庭具有最大且最独特的价值。临床医生和病理学家必须继续共同努力，确保在有指征时进行这一程序，使获取的信息最大化，并及时、准确、清晰且体贴地将结果告知家属。（摘要截选至250词）
