Attitudes toward autopsy in unexpected death: a nationwide survey of physicians and risk managers in Japanese teaching hospitals

Med Sci Law 2010;50:60-66
doi:10.1258/msl.2010.010004
© 2010 British Academy of Forensic Science

 

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Attitudes toward autopsy in unexpected death: a nationwide survey of physicians and risk managers in Japanese teaching hospitals

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Original Articles


Etsuko Kamishiraki MA * ,
Shoichi Maeda PhD ,
Jay Starkey MD  and
Noriaki Ikeda MD PhD *


* Department of Forensic Pathology and Sciences, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka City, Fukuoka 812-8582, Japan
Graduate School of Health Management, Keio University, 4411 Endo, Fujisawa, Kanazawa 252-8530, Japan
University of California, San Diego, UCSD School of Medicine, 9500 Gilman Drive, 0742, La Jolla, CA 92093-0742, USA

Correspondence: Etsuko Kamishiraki. Email: ekamishi{at}forensic.med.kyushu-u.ac.jp

Context: Autopsy is a useful tool for understanding the manner and causeof death in unexpected patient death. The information aboutthe opinions of physicians and risk managers in Japan regardingautopsy is limited.

Objective: To describe and evaluate the opinions of physicians and riskmanagers at Japanese teaching hospitals regarding forensic autopsy.

Design, setting and participants: Cross-sectional study of all residency programme directors andrisk managers completing a survey in January 2009. Specificclinical scenarios where autopsy would be essential to determinewhether medical error occurred and whether medical care contributedto the death of the patient were presented. Respondents gavetheir opinion regarding the necessity of autopsy and their beliefsabout if they would actually recommend it.

Results: Of 1113 eligible physicians and 1113 eligible chief risk managementofficers, 466 physicians (41.9%) and 599 risk managers (53.8%)responded. The majority of physicians and risk managers reportedthey would recommend an autopsy in cases of unclear medicalerror or unclear cause and effect relationship of medical careand patient death; however, 10% or more of physicians and 25%or more of risk managers (depending on the situation) reportedthat they would not recommend an autopsy. Risk managers wereless likely than physicians to recommend and believe that autopsywas necessary.

Conclusions: The majority of physicians and risk managers in Japan wouldrecommend autopsy and believe in its necessity in cases of unexpectedpatient death.

Attitudes toward autopsy in unexpected death: a nationwide survey of physicians and risk managers in Japanese teaching hospitals
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