Guest guest Posted March 4, 2004 Report Share Posted March 4, 2004 http://www.nytimes.com/2004/03/04/opinion/04THU4.html?th What the Body Knows Published: March 4, 2004 It's hard for most of us to think of an autopsy as an essential part of normal medical practice. It seems, somehow, so after the fact. In the past few decades, the rate at which hospitals conduct autopsies has plummeted, to perhaps 5 percent of hospital deaths today, from 41 percent in 1961. No one knows the exact number because the National Center for Health Statistics stopped collecting autopsy numbers after 1994, when the rate stood at 9.4 percent. But autopsies have not declined because they're useless. In fact, most studies confirm that autopsies regularly turn up surprises, including mistaken diagnoses, undiscovered conditions and, in a small but steady number of cases, diagnosis and treatment errors that may have led to death. The numbers are not trivial. One study examined 1,000 autopsies between 1983 and 1988 and found that there were " `major discrepancies' between the autopsy findings and the clinical diagnosis " in 317 cases. Autopsies have dwindled for a number of reasons. Hospitals were once required to perform them to be accredited, but that requirement ended in 1971. Insurance companies do not pay for autopsies. But the problem really lies in our attitude toward them. In recent years, families have become increasingly reluctant to authorize autopsies, and doctors too often believe that modern diagnostic tools like CAT scans and M.R.I.'s have made them obsolete. Yet underlying these reasons is another, more pervasive one: the risk of malpractice suits. An autopsy that uncovers an error in treatment also uncovers the potential for litigation. Never mind that it may improve subsequent diagnoses. An overwhelming amount of what we know about the human body and its diseases was discovered by means of autopsies. X-rays and M.R.I.'s may create the illusion that the human body is now, somehow, translucent, more open to the scientific eye, but the fact remains that in many ways, we are still as opaque as we ever were. Hospitals can discover how well they're doing not only by the number of people they cure, but also by closely examining a reasonable percentage of those they don't cure. To assume that a patient has died of a diagnosed disease is, too often, to assume too much. Search - Find what you’re looking for faster. Quote Link to comment Share on other sites More sharing options...
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