REQUESTING CONSENT FOR AN INVASIVE PROCEDURE IN NEWLY DECEASED ADULTS

Objective.-Ethical concerns exist over the performance of medical proc edures, such as endotracheal intubation, on newly deceased patients wi thout family consent. This study examined the process of obtaining con sent for the purpose of performing an invasive procedure in newly dece ased adults. Design.-A prospective case series. Participants.-The fami lies of patients who died during a 5-month period were requested to pr ovide consent to perform wire-guided retrograde tracheal intubation. M ain Outcome Measures.-Differences between success and failure in obtai ning consent including information on the deceased, family reasons for their decision, and the experience of those requesting consent. Resul ts.-Consent was requested from 44 families and 26 (59%) agreed to the procedure. This success rate was achieved despite the lack of a prior relationship with the family by the persons requesting consent. Consen t was obtained more frequently in unexpected than expected deaths (77% vs 41%, P=.03). There were no differences in success rates for consen t for age, race, sex, or do-not-resuscitate status of the deceased. Sp ouses consented more frequently than children (77% vs 50%, P=.25). The two physicians reported greater comfort in requesting consent than th e nurse anesthetist investigator. In one instance, the consent process may have increased the emotional distress of the family. Conclusion.- Consent can frequently be obtained from families for an invasive proce dure in newly deceased adults. Physicians should reconsider the practi ce of performing postmortem procedures without obtaining family consen t.