The autopsy: a professional responsibility in assuring quality of care

Forty years ago, the value of autopsies was widely recognized as new diseases were discovered or clarified and scientific technology advanced greatly. Despite the autopsy's strong foundation, its value is not currently being properly conveyed to physicians or patients. Although autopsy-related policy exists, these policies have had little effect on increasing or even maintaining adequate autopsy rates. More recently, the autopsy has fallen on hard times, with US hospital rates now below 5%. The reasons for the decline in rates are multifaceted and include a lack of direct reimbursement for the procedure, lack of defined minimum rate standards, overconfidence in diagnostic technology, and the fear of litigation. Regardless of the reasons for the declining rates, the ethical and professional reasons for increasing the number of autopsies are far more important.