"Of all medical procedures, the autopsy is perhaps the most emotionally charged," says Dr. Andrew Saladino, a Baltimore pathologist who heads a committee on automatic pathology for the College of American Pathologists. Even pathologists who advocate autopsy are sometimes troubled by the decision of whether to permit an autopsy on a family member. Here are questions and answers on some of the concerns families often raise about autopsy.
Who grants permission for an autopsy?
This varies from state to state, but it is usually the next of kin. If the death was suspicious, the medical examiner can order an autopsy.
Does my religion prohibit autopsy?
Islam and orthodox Judaism do not permit autopsy. "But there's usually a balancing issue," says Saladino, "that the autopsy is acceptable if it will save the life of another person-and the knowledge gained during autopsy might do just that."
My loved one has suffered enough. Why should I permit an autopsy?
"This is the most common concern," Saladino says. "I often sit down with the family and say, 'An autopsy can help us bring value to this person's death. This person can touch the lives of other suffering people by contributing to the knowledge of the physicians who will be treating those other people.' "
What if the funeral home discourages an autopsy?
This seems to be less common today than in the past. Previously, some morticians discouraged autopsy because it sometimes complicated embalming and delayed final arrangements. A carefully performed autopsy, says Dr. Marie Valdes-Dapena, professor of pathology and pediatrics at the University of Miami School of Medicine, will not hinder embalming. The body is not mutilated or dismembered; the incisions are not noticeable and will not prevent the deceased from being viewed during the funeral.
Will an autopsy delay final preparations?
Yes, probably no more than 24 hours.
How do I get the results of a family member's autopsy?
Usually the attending physician will volunteer the results. If not, ask him or her. Pathologists usually prefer to have the family deal directly with the attending physician. If you have trouble obtaining the results, request them from the chief of staff at the hospital.
Can I authorize or deny permission for my own autopsy?
Some states recognize a "living will," in which you decide ahead of time what physicians and your family will do if you become incapacitated or when you die. It allows you to permit or forbid an autopsy. This can save the family from extra anguish. For example, Valdes-Dapena discovered shortly after her father died that he had willed his body to the anatomy department at Temple University School of Medicine. "I was relieved," she recalls, "that I didn't have to say 'Yes, you can do the autopsy.' That decision was already made."