Grunberg S M, Sherrod A, Muellenbach R, Renshaw M, Zaretsky S, Levine A M
Department of Medicine, University of Southern California Comprehensive Cancer Center, Los Angeles.
Cancer Invest. 1994;12(5):463-8. doi: 10.3109/07357909409021404.
To quantify the role of failure to request consent as a determinant of the autopsy rate, questionnaires asking whether an autopsy had been requested and the reasons for that decision were distributed to primary physicians after each death in a consecutive series of 75 patient deaths. Autopsies were requested in only 56% of cases. Common reasons to request an autopsy included unanswered medical questions (37%), medical education (22%), research protocol participation (16%), or routine policy (14%). When autopsies were not requested, the most common reason was the belief that there were no outstanding medical questions (64%). Follow-up interviews with 14 oncologists and hematologists revealed that 8 generally request autopsies (usually to contribute to medical education or to discover unexpected findings) and 6 generally do not (usually because no unexpected findings are anticipated). Attempts to increase the current low autopsy rate should address the question of when and why physicians are willing to request this procedure.
为了量化未征得同意而导致尸检率下降的具体影响程度，我们设计了调查问卷，在连续75例患者死亡后，向其主治医生询问是否进行尸检以及做出该决定的原因。结果显示，只有56%的病例进行了尸检。要求进行尸检的常见原因包括医学问题未得到解答（37%）、医学教育（22%）、参与研究方案（16%）或遵循常规政策（14%）。未要求进行尸检时，最常见的原因是认为没有未解决的医学问题（64%）。对14名肿瘤学家和血液学家的后续访谈显示，8人通常要求进行尸检（通常是为了医学教育或发现意外结果），6人通常不要求（通常是因为预计不会有意外发现）。要提高目前较低的尸检率，就应解决医生何时以及为何愿意进行这一操作的问题。
