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  Criteria for Autopsies

 

 

 

Policy Synopsis

Autopsies are valuable as a medical procedure and resource for assessing and improving patient care, discovering and increasing knowledge about diseases and disease processes, and augmenting clinical and basic research, among other uses. Ideally, autopsies should be requested on every death, but guidelines are provided to determine where autopsies should be especially encouraged. Institutional recommendations should be established in consultation with the pathologist and other medical staff.

Policy

The College of American Pathologists advocates the autopsy as a valuable medical procedure and resource for assessing the quality of patient care, evaluating clinical diagnostic accuracy, determining the effectiveness and impact of therapeutic regimens, discovering and defining new and/or changing diseases, increasing the understanding of biological processes of disease, augmenting clinical and basic research, providing accurate public health and vital statistical information and education as it relates to disease, and obtaining medical-legal factual information.

The College of American Pathologists recommends that a request be made for autopsy on every death. It is, however, recognized that performing an autopsy on every death may not be possible. Deaths in which an autopsy should be especially encouraged are:

  • Deaths in which autopsy may help to explain unknown and unanticipated medical complications to the attending physician.
  • All deaths in which the cause of death or a major diagnosis is not known with reasonable certainty on clinical grounds.
  • Cases in which autopsy may help to allay concerns of the family and/or the public regarding the death, and to provide reassurance to them regarding same.
  • Unexpected or unexplained deaths occurring during or following any dental, medical or surgical diagnostic procedures and/or therapies.
  • Deaths of patients who have participated in clinical trials (protocols) approved by institutional review boards.
  • Unexpected or unexplained deaths which are apparently natural and not subject to a forensic medical jurisdiction.
  • Natural deaths which are subject to, but waived by, a forensic medical jurisdiction such as a) persons dead on arrival at hospitals; b) deaths occurring in hospitals within 24 hours of admission; and c) deaths in which the patient sustained or apparently sustained an injury while hospitalized.
  • Deaths resulting from high-risk infectious and contagious diseases.
  • All obstetric deaths.
  • All perinatal and pediatric deaths.
  • Deaths at any age in which it is believed that autopsy would disclose a known or suspected illness which also may have a bearing on survivors or recipients of transplant organs.
  • Deaths known or suspected to have resulted from environmental or occupational hazards.

The College of American Pathologists position on autopsies is provided for information purposes. While the CAP makes general recommendations as to when autopsies are desirable, every institution should establish their specific recommendations by means of consultation between the pathologist and the rest of the medial staff. Proper personnel and other resources must be committed in support of this activity. For further information refer to CAP practice guidelines.

Revision History

Revised February 1991
Revised February 1994
Reaffirmed February 1997
Reaffirmed May 2000