The attitudes of patients to their own autopsy: a misconception.

We read with interest the report by Tsitsikas and colleagues about the attitudes of relatives to autopsy in a division of lymphoid malignancies. Their report shows that the attitude of the general public is positive overall and translates into high autopsy rates when the value of the examination is presented honestly and the details of the procedure are adequately explained. We would like to add to this interesting report our previous experience from a prospective opinion survey about the consent of patients for their own autopsy. Interestingly, Tsitsikas and colleagues had an 89% consent rate to autopsy when asking relatives; close to their findings, when we used a questionnaire, 86% of the individuals and 94.6% of health professionals were not opposed to their own autopsy. The reasons for opposition encountered by Tsitsikas and colleagues were: one relative found autopsies to be undignifying and another family refused to encounter them. When asking patients, religious belief, body integrity, dignity and respect were the main reasons for refusal. Our work also showed that only 42.5% patients had ever received information about non-coronial autopsies. Surprisingly, only 33.9% of healthcare professional had previously received specific information about medical autopsies. Furthermore, the refusal rate is lower in our study (8.9% vs 6.9%) where a physician explains the autopsy than by giving only a questionnaire to patients. This highlights the efficiency of personalised information. The rate of autopsy refusal by relatives depends on the country, but is similar in these two studies compared with previously published works. A decline in medical autopsy rates has been encountered in most countries. Based on the data mentioned above, we suggest that if information about autopsies is provided to the public and specific information is provided to healthcare professionals, the autopsy rates would be higher.