Fluctuations in the rate of autopsy in China

Autopsy has played a unique role in the progression of clinical medicine, medical education, epidemiology, and public health. However, the autopsy rate has been decreasing during the past several decades worldwide, and its necessity is frequently argued. Autopsy-based research in China, a country with the world's largest population, is very important for studying the spectrum and epidemiology of diseases as well as for discovering new diseases. This article summarizes the brief history of autopsy in China and analyzes the cause of its decline in recent decades by reviewing previously published papers, review articles, self-collected materials, and private correspondence. Since the first officially permitted autopsy in 1913, China witnessed the highest autopsy rate between 1950 and 1970, and since then the autopsy rate began to decline as it in other parts of the world. The main reasons for the reduction in autopsy rates in China include negligence by hospital administrators and relevant government authorities, unmotivated clinicians, helpless pathologists, unenforceable regulations and laws, and local cultures and customs.