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The Medical Directive

Nicholas J. Hardin, MD
JAMA. 1990;263(8):1069. doi:10.1001/jama.1990.03440080041018.
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To the Editor.—  After reading the article entitled "The Medical Directive: A New Comprehensive Advance Care Document" by Drs Emanuel and Emanuel,1 I would suggest an addition to their document, namely, permission for autopsy.The consideration of autopsy is similar to that of organ donation. Often, patients have not made their wishes known, and the decisions about autopsy fall to the next of kin, who is upset and may not be able to consider the matter objectively.It is my opinion that autopsy permission should be mentioned in virtually the same breath as organ donation and might reasonably follow that section on their Medical Directive form. Appropriate wording might be as follows:I understand that my organs and tissues may not be acceptable for transplantation into another person, but could still be useful for therapy, research, or medical education or as medical information that might be relevant to my


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