CLINICIAN BELIEFS UNDERLYING AUTOPSY REQUESTS

The aim of the study was to use psychological theory to identify and e valuate factors influencing clinical autopsy requests. A series of pil ot interviews were conducted with 20 clinicians to identify beliefs ab out the benefits and drawbacks, social groups and circumstances influe ntial in the decision to make an autopsy request. The most common beli efs, together with measures of intention to request autopsies, were in corporated into a questionnaire which was distributed among all approp riate clinicians in four hospitals. Statistical analyses identified wh ich beliefs had the most influence on clinicians' intentions to reques t autopsies. A total of 145 clinicians returned the questionnaire, a r esponse rate of 42%. Clinicians were significantly more likely to requ est autopsy the more they thought that the outcome of requesting would be of educational value, would confirm clinical diagnoses, would not distress relatives, would not be time-consuming and that the request i tself would receive support from their consultant. An autopsy request was unlikely in circumstances where clinicians felt uncomfortable when requesting relatives' permission and when the patients were elderly. The fear of causing distress to relatives and the degree of support fr om the clinician's consultant were found to be the strongest predictor s of intention to request autopsies. These are two areas in which inte rvention could help to increase autopsy request rates.