Physicians' attitudes toward the autopsy of patients with AIDS

In spite of the value of autopsy in modern medicine, autopsy rates continue to decline. This decline has been especially pronounced for patients who die of acquired immunodeficiency syndrome (AIDS). In this paper, we assess the attitudes of house officers toward the autopsy in AIDS patients. The survey encompassed 112 internal medicine housestaff (IMHS) and 37 pathology housestaff (PHS) at two New York City university hospitals that care for large numbers of AIDS patients. A self-administered questionnaire rated attitudes and practices concerning the autopsy in AIDS patients. Of IMHS, 83%, and of PHS, 89% answered the questionnaire. The vast majority of IMHS felt that the autopsy rate in persons dying of AIDS was too low; only 39% of PHS shared their view. Of the PHS, 36% felt the rate was too high and should be decreased. These PHS felt the autopsy rarely resulted in useful information and unnecessarily exposed the pathologist to human immunodeficiency virus (HIV) infection. The IMHS wanted more formal training in methods of discussing these issues with the patient and family. We conclude that there is a need for postgraduate teaching programs to educate on issues concerning the autopsy. Specifically, the IMHS need instruction on communicating with the family about the autopsy, and the PHS need instruction on the risks of acquiring AIDS from occupational exposure.