Death of the teaching autopsy
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《英国医生杂志》
Respondents to the education and debate articles on the death of the teaching autopsy and on obtaining consent for autopsy unanimously agreed that this is a sorry state of affairs.1 2 Most other countries seem also to be faring no better than New Zealand.
The value of the procedure is not well publicised or communicated, even within the medical profession. Recommendations to remedy this include educating the population at large and generally raising awareness of and thus interest in teaching autopsy. Jacob George, cardiology research fellow in Dundee, suggests that "With the gradual decline in hospital postmortems, medical schools should seriously look into the coroner's postmortem as an effective teaching tool."
Medical professionals are called on to set a good example by donating their bodies to research. "If my body is not suitable for dissection by medical students I would like it to be used in the autopsy room," writes Owen Wade, a retired professor from Stratford on Avon. Journalists should write about the subject in a more positive light than is currently the case. Such exemplary behaviour might result in a greater willingness among the public to give consent to the procedure.
The importance of sound anatomical knowledge for high tech modern imaging techniques is emphasised. The dead have everything still to teach us. As Dinesh N Ratnapala, a resident medical officer in Queensland, writes, "not learning from autopsies is akin to a trainee mechanic never seeing the inside of car engines."
Michael Bamber, a general practitioner in Grantham, points out that "The events of Bristol and Alder Hey, as well as cost, have pressured coroners' pathologists not to perform histological and microbiological examinations, which further contributes to the downgrading of the quality of the autopsy."
A heavy workload is cited by two histopathologists as a serious hindrance to obtaining consent for autopsies. According to Christopher Womack from Peterborough, "There are currently 200 vacancies for histopathologists in England and Wales... An additional complication is that coroners' cases fall outside the existing and proposed new NHS consultant contracts."
So, with the exception of Cuba, the overall picture is worrying: for medical students and junior doctors, who do not learn essential skills, and for future patients, whose doctors may not be au fait with the inner workings of their bodies.
Birte Twisselmann, technical editor
BMJ
Competing interests: None declared.
References
Electronic responses. Death of the teaching autopsy. bmj.com 2003;327:802-4 (accessed 8 Jan 2004).
Electronic responses. Obtaining consent for autopsy. bmj.com 2003 (accessed 8 Jan 2004).
The value of the procedure is not well publicised or communicated, even within the medical profession. Recommendations to remedy this include educating the population at large and generally raising awareness of and thus interest in teaching autopsy. Jacob George, cardiology research fellow in Dundee, suggests that "With the gradual decline in hospital postmortems, medical schools should seriously look into the coroner's postmortem as an effective teaching tool."
Medical professionals are called on to set a good example by donating their bodies to research. "If my body is not suitable for dissection by medical students I would like it to be used in the autopsy room," writes Owen Wade, a retired professor from Stratford on Avon. Journalists should write about the subject in a more positive light than is currently the case. Such exemplary behaviour might result in a greater willingness among the public to give consent to the procedure.
The importance of sound anatomical knowledge for high tech modern imaging techniques is emphasised. The dead have everything still to teach us. As Dinesh N Ratnapala, a resident medical officer in Queensland, writes, "not learning from autopsies is akin to a trainee mechanic never seeing the inside of car engines."
Michael Bamber, a general practitioner in Grantham, points out that "The events of Bristol and Alder Hey, as well as cost, have pressured coroners' pathologists not to perform histological and microbiological examinations, which further contributes to the downgrading of the quality of the autopsy."
A heavy workload is cited by two histopathologists as a serious hindrance to obtaining consent for autopsies. According to Christopher Womack from Peterborough, "There are currently 200 vacancies for histopathologists in England and Wales... An additional complication is that coroners' cases fall outside the existing and proposed new NHS consultant contracts."
So, with the exception of Cuba, the overall picture is worrying: for medical students and junior doctors, who do not learn essential skills, and for future patients, whose doctors may not be au fait with the inner workings of their bodies.
Birte Twisselmann, technical editor
BMJ
Competing interests: None declared.
References
Electronic responses. Death of the teaching autopsy. bmj.com 2003;327:802-4 (accessed 8 Jan 2004).
Electronic responses. Obtaining consent for autopsy. bmj.com 2003 (accessed 8 Jan 2004).