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Question from the Road: Religion Prevents Autopsy?

We all know that not enough autopsies are performed these days. From my perspective, fewer autopsies means more families will go without answers, not receive closure, and possibly be frozen in their grief. Clearly, we need to encourage more autopsies when things go wrong.

Recently, during a Grand Rounds presentation, a physician threw me a curve ball question on this topic: "What do you do if you know the family's religion or ethic customs prevents or forbids an autopsy?"

Answer: Don't make assumptions, and don't be afraid to ask the question in a respectful manner. Let the family confirm (or not confirm) your hunches. You don't want to make a wrong assumption that a person or family is part of certain religious clan or ethnic group ....it's an easy mistake to make. Moreover, just because somebody practices a certain faith or hales from a particular spot on the globe, doesn't mean they automatically subscribe to every tenant of their religion or all of the usual ethnic customs. How many Catholics do you know who use birth control, or eat meat on Fridays during Lent?!? Lots!

If, however, the family confirms your suspicions, then you have to be respectful but you can also tactfully say some version of the following: "I respect your beliefs and traditions...I just want you to fully understand that we may not be able to understand how your family member died without an autopsy." And then drop it. That may be the end of it...or the family might receive a special dispensation from their religious leader, or they may simply decide their need to know is more important than a religious rule or ethnic tradition. It's up to them.

Of course, factually document all of these conversations in the medical record.

Got a question about disclosure and apology? Call Sorry Works at 618-559-8168 or e-mail doug@sorryworks.net.





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