Autopsy consent practice at US teaching hospitals - Results of a national survey

Background: Autopsy rates continue to fall despite the enduring benefit of the procedure to families and medical science, yet there are few data about the consent process itself. Objectives: To evaluate the current practice of obtaining autopsy consent, by assessing the consent forms currently in use, the knowledge and attitude s of chief residents on the procedure, and the expert opinion of pathologis ts in those institutions. Design: Cross-sectional survey. Settings and Participants: One hundred twenty-seven US teaching hospitals. Results: Of all autopsy cement forms we surveyed, 84.7% contained 7 of 10 e lements recommended by the College of American Pathologists. Only 7.1% of i nstitutions supplied educational materials for the physician, as recommende d by the College of American Pathologists. Overall, 50.1% of chief resident s reported deficiencies in their knowledge of the autopsy procedure. Corres pondingly, greater than 74.5% felt that educational materials would be bene ficial for physicians and the family. Finally, 93.3% of chief residents bel ieved that a limited autopsy should be offered to families, while 68 (90%) of 76 pathologists at these institutions believed that limited autopsies ar e an unsatisfactory alternative to the complete procedure. Conclusions: Chief residents at US teaching hospitals reported substantial deficiencies in their knowledge about autopsy and desire more training on t he consent process. Autopsy consent forms are often lacking information tha t might help physicians and families in making an educated choice about aut opsy. Teaching institutions need to reevaluate the training for the autopsy consent practice.