Cultural differences and ethical issues in the problem of autopsy requests

Cross-cultural ethical issues pervade medical care in Texas. This preliminary study concerns the particular issues that arise when an Anglo-American physician requests an autopsy from a Mexican-American family. The study quantified differences in autopsy rates between Mexican-American and Anglo-American patients at one San Antonio hospital. Mexican-Americans had higher rates for patients dying between the ages of 21 and 40, and after 80. Anglo-Americans had higher rates for all other age groups. Differences in autopsy rates between Mexican-American and Anglo-Americans ranged from 5 to 18 autopsies per 100 deaths and varied by age group. The study also involved 33 interviews concerning Mexican-American and Anglo-American culture. Interviewees identified four sources of relevant differences: (1) medicine's professional values, (2) beliefs about the power of medical science to control disease, (3) beliefs about keeping cadavers whole and unmutilated, and (4) beliefs about the sentence of the soul after bodily death. An appreciation of these value differences is the basis for requesting autopsies in culturally sensitive ways.