Attitudes of relatives to autopsies of elderly patients

The attitudes of 233 relatives to autopsy of elderly medical patients (mean age 82 years) who died in a district general hospital were examined prospectively. Forty-three (18%) relatives were asked permission for autopsy, 24 (56%) agreed and 19 (44%) refused. Of 190 (82%) relatives whose permission was not sought, 109 (57%) would have agreed and 81 (43%) would have refused permission had they been asked. Advancement of medicine and reassurance about the correct diagnosis were the main reasons for consent, while dislike of autopsy, family distress at disfigurement of the body and the patient 'having suffered enough' were the main reasons for refusal. Living near rather than with the deceased (64% vs 45%; chi 2 = 6.985, p = 0.01) and being a male rather than female relative (63% vs 49%; chi 2 = 3.879, p = 0.05) were predictive of a positive response to autopsy. Of the 39 autopsies performed, 24 (9.6%) followed relatives' permission and 15 (6%) were at the request of the coroner. The overall autopsy rate of 16% was lower than the rate recommended for medical audit (35%). Although there is a need for educating relatives about the benefits of autopsy, a more urgent study is required to find reasons for the low request by medical staff.