The Autopsy: Knowledge, Attitude, and Perceptions of Doctors and Relatives of the Deceased

Abstract

Context.—Despite the crucial role that autopsy plays in the development of the science and practice of medicine, autopsy rates have been declining throughout the world in recent decades. Objective.—To identify factors influencing the acceptance of autopsies in Nigeria. Design.—Cross-sectional survey of the knowledge, attitude, and perceptions of doctors and relatives of deceased patients on factors influencing acceptance of autopsy at the University College Hospital, Ibadan, Nigeria. Results.—Only 38% of relatives had satisfactory knowledge about autopsy and about 50% of doctors knew that physicians' desire for autopsy should not override patients' consent. Doctors identified difficulty in obtaining consent from relatives of deceased patients, administrative problems in requesting autopsy, and delay in obtaining autopsy report as major reasons responsible for the decline in autopsy requests, whereas relatives of the deceased cited fear of mutilation, concerns about delaying the funeral, and objection by the patient before death as reasons for refusal to grant permission for an autopsy. Sociodemographic factors such as age, occupation, religion, ethnicity, and level of education significantly influenced willingness to give consent for autopsy. Conclusions.—There is need for concerted effort on the part of clinicians, pathologists, the public, and the government to resuscitate and sustain the practice of autopsy in Nigeria.

Rumor surveillance in support of minimally invasive tissue sampling for diagnosing the cause of child death in low-income countries: A qualitative study

“…Although mistrust related to informal payments was only reported from Mozambique, the practice of informal payments to get service in hospitals exists in all of the countries included in the study [50,51]. The participant's religious concerns about body mutilation have also been identified in previous studies [52][53][54][55]. Islam and some Christian sects prohibit the removal of organs or the disfigurement of dead bodies [56,57], so some residents had concerns because they confused MITS with full autopsies.…”

Autopsies and quality of cause of death diagnoses

“…The dramatic reduction in clinical post-mortem examinations is a global phenomenon and has been reported on all continents for several decades. [21][22][23][24][25] In countries such as the United Kingdom, the number of clinical autopsies is less than 1%, although most countries show numbers that are close to the autopsy rates in Sweden, that is, 11%. Turnbull et al 25 describe the hospital autopsies in the UK 2013 as extinct in a quarter of the UK NHS Trusts and endangered in the rest.…”

An In-Depth Examination of Reasons for Autopsy Acceptance and Refusal in Northern Tanzania

“…Disfigurement has been reported as a reason for families to decline postmortem in other African countries and is considered a comparative advantage to less invasive MITS procedures. 9,27,36 Although concerns about misappropriation of organs were commonly referenced, these beliefs were not primary reasons for refusal. Similar apprehensions about selling organs for transplantation and manufacture of medications have been reported in neighboring Uganda and Zambia, signaling their prevalence and raising questions about these concerns.…”

“…Research examining attitudes toward autopsy in Nigeria found fears of mutilation of the body and funeral delay were among the most common explanations for refusal. 9 In Zambia and Uganda, where the proportion of families accepting CDA was 25% and 38%, respectively, reasons for refusal included that knowledge of the cause of death was no longer useful, death certificate was already issued, transport of the body had been arranged, desire to avoid delays in the burial, and satisfaction with the clinical diagnosis. 10,11 Notably, religious and cultural practices were rarely mentioned.…”