Autopsies and the pediatric intensive care unit

The pediatric autopsy can provide great benefits to families at a time when their world is falling apart. It can be invaluable in the processing of grief that families endure, helping them to plan their future. Autopsy results not only provide information but may also provide consolation by giving the family the opportunity to discuss the disease process that resulted in death. Autopsy results also provide information regarding the future and reassurance that appropriate care was given. Failure to perform a postmortem examination denies the family and the clinician knowledge regarding mechanisms of disease, confirmation or inclusion of unsuspected diagnoses, and the presence of iatrogenic complications. This missed information can be both informative to the current family's situation and potentially therapeutic in future cases. If death is the final chapter of life, then the physician's responsible relationship with the parents of the deceased patient should not end until a conference takes place several weeks or months after the child's death. The results of the postmortem examination provide a beginning point for discussion regarding the child's illness and death, the parents responses and coping, and the opportunity to help the family make sense of and bring closure to one of life's greatest crises.