Perceptions of the ethical acceptability of using medical examiner autopsies for research and education - A survey of forensic pathologists

Background.-Forensic pathologists face difficult moral questions in their p ractices each day. Consistent ethical and legal guidelines for autopsy tiss ue use extending beyond usual clinical and legal imperatives have not been developed in this country. Objective.-To obtain the perceptions of medical examiners regarding the eth ical acceptability of autopsy tissue use for research and education. Method.-A written, self-report questionnaire was developed and piloted by a multidisciplinary team at the University of New Mexico, Albuquerque. All i ndividuals who attended a platform presentation at the National Association of Medical Examiners Annual Meeting in September 1997 were invited to part icipate, Results.-Ninety-one individuals completed the survey (40% of all conference registrants and approximately 75% of presentation attendees). Sixty-three percent of respondents had encountered an ethical dilemma surrounding autop sy tissue use, and one third reported some professional ethics experience. Perspectives varied greatly concerning the ethical acceptability of using a utopsy tissues to demonstrate or practice techniques (eg, intubation, brach ial plexus dissection) and of fulfilling requests to supply varying kinds a nd quantities of tissues for research and education. Most respondents indic ated that consent by family members was important in tissue use decisions. Respondents agreed on the importance of basic values in education and resea rch, such as integrity, scientific or educational merit, and formal institu tional approval of a project. Characteristics of the decedent did not influ ence decisions to release tissues, except when the individual had died from a mysterious or very rare illness. Attributes of medical examiners, with t he exception of sex, also did not consistently predict responses. Conclusion.-Significant diversity exists in beliefs among medical examiners regarding perceptions of the appropriate use of autopsy tissues for educat ion and research. There is need for further inquiry and dialogue so that en during policy solutions regarding human tissue use for education and resear ch may be developed.