POSTMORTEM PROCEDURES IN THE EMERGENCY DEPARTMENT - USING THE RECENTLY DEAD TO PRACTICE AND TEACH

In generations past, it was common practice for doctors to learn lifes aving technical skills on patients who had recently died. But this pra ctice has lately been criticised on religious, legal, and ethical grou nds, and has fallen into disuse in many hospitals and emergency depart ments. This paper uses four questions to resolve whether doctors in em ergency departments should practise and teach non-invasive and minimal ly invasive procedures on the newly dead: Is it ethically and legally permissible to practise and teach non-invasive and minimally invasive procedures on the newly dead emergency-department patient? What are th e alternatives or possible consequences of not practising non-invasive and minimally invasive procedures on newly dead patients? Is consent from relatives required? Should doctors in emergency departments allow or even encourage this use of newly dead patients? Several factors su ggest that postmortem practice and teaching is necessary: the importan ce of clinical competence when performing lifesaving procedures, socie ty's need to maintain and expand the cadre of medical personnel with l ifesaving skills, and the inadequacy of alternative teaching methods. Doctors are ethically compromised when, instead of doing postmortem pr actice, they either use patients in the operating room without consent or delay pronouncing death during resuscitations to practise and teac h. Contrary to what is often claimed, there is neither a legal nor a m oral basis for requiring relatives' consent for minimally invasive and non-invasive postmortem procedures. The obligations society has place d on emergency doctors dictate that they encourage the use of the rece ntly dead for the practice and teaching of non-invasive and minimally invasive lifesaving procedures. The medical profession has a duty to o penly acknowledge this need and to educate the public about it.