There are those to whom the contributions of an efficient autopsy service to the overall standard of health care are unquestionable. To many, the postmortem observation lends itself to scientific discovery, stimulates clinical research, maintains public as well as family health, and contributes to jurisprudence, medical education, and pathology training. To these sanguine souls, the relentless and seemingly inexorable decline in autopsy rates is inexcusable.
Various excuses (some more valid than others) have been proffered ad nauseam for declining autopsy rates. Among clinicians, the waning of interest in autopsies has been attributed to a disinclination to face failures, medicolegal misgivings, lack of rapport with the relatives of the deceased, and dissatisfaction with autopsy reports—typically with their timeliness. The apparent disinterest among families of the deceased can be attributed to cultural conviction, religious restraint, fear of defacement, desire to “spare further suffering,” possible delays in interment, and, most often, sheer ignorance about autopsy, including its availability, benefits, and costs. Even pathologists are now considered increasingly reluctant purveyors of postmortem examinations because of other more immediate demands on their time and attention, the perceived underappreciation of their efforts, various remuneration-related issues, and their lack of proficiency in the performance of autopsies, owing mainly to decreasing emphasis on autopsies during training. Although each of the aforementioned issues would need to be addressed if there is to be a revival of the autopsy, all such efforts are destined to fail unless all involved medical professionals, including pathologists, reaffirm their commitment to this crucial procedure and reiterate its central role in medicine—not only in words but also in deeds.