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Attitudes toward clinical autopsy in unexpected patient deaths in Japan: a nation-wide survey of the general public and physicians
  1. Etsuko Kamishiraki1,
  2. Shoichi Maeda2,
  3. Jay Starkey3,
  4. Noriaki Ikeda4
  1. 1Department of Social Welfare, University of Kochi, Kochi, Japan
  2. 2Graduate School of Health Management, Keio University, Fujisawa, Kanagawa, Japan
  3. 3Department of Internal Medicine, University of California, San Diego, California, USA
  4. 4Department of Forensic Pathology and Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
  1. Correspondence to Dr Shoichi Maeda, Keio University, Graduate School of Health Management, 4411 Endo, Fujisawa, Kanagawa 252-8530, Japan; sho-ichi{at}umin.ac.jp

Abstract

Context Autopsy is a useful tool for understanding the cause and manner of unexpected patient death. However, the attitudes of the general public and physicians in Japan about clinical autopsy are limited.

Objective To describe the beliefs of the general public about whether autopsy should be performed and ascertain if they would actually request one given specific clinical situations where patient death occurred with the additional variable of medical error. To compare these attitudes with previously obtained attitudes of physicians practising at Japanese teaching hospitals.

Design, setting and participants We conducted a cross-sectional study of the general public. We sent standardised questionnaires in 2010 to a randomly selected non-physician adult population using a survey company for participant selection. Respondents gave their opinions about the necessity of autopsy and how they might act given various clinical scenarios of patient death. We compared these results with those of a previous survey of Japanese physicians conducted in 2009.

Results Of the 2300 eligible general adult population, 1575 (68.5%) responded. The majority of the general public indicated they believed an autopsy was necessary. However, in cases of unclear medical error or unclear cause and effect relationship of medical care and patient death, the general public were much less likely to indicate they would actually request an autopsy than were physicians (p<0.0001). Currently in Japan the debate about the role autopsy should play in the case of error related to death is underway. The results from this study will be important in informing related decisions.

  • Pathology
  • Quality of Health Care
  • Malpractice
  • Negligence
  • Tort Law

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