ORGAN-LIMITED AUTOPSIES - OBTAINING PERMISSION FOR POSTMORTEM EXAMINATION OF THE URINARY-TRACT

Objective.-To develop a systematic pre- and postmortem program for obt aining permission for autopsies limited to the urinary tract. Design.- Comparison versus historical control of autopsy permission using a new process comprising premortem education, modification of the permissio n process, and autopsy limited to the urinary tract. Participants and Setting.-Patients, family members, and healthcare providers associated with a nursing home. Intervention.-Education of healthcare providers and family members and modification of autopsy consent and performance . Main Outcome Measure.-Permission rate and demographic characteristic s of patients and family members giving permission. Results.-Of the 36 1 patients who died during the study, we received permission for postm ortem examination of the urinary tract for 129 (36%). This was substan tially better than the autopsy rate in the year prior to the study, 0. 6%. A significantly higher permission rate was associated with patient s and contact persons of white race, a higher level of education of th e contact person, a nonrelative contact person, and two Or fewer indiv iduals making the decision. Conclusion.-Permission for organ-limited a utopsies can be obtained with a systematic approach.