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Mon Mar 26 16:09:52 BST 2007

Is your hospital part of any trauma system? Could they "require" it?

-----Original Message-----
From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org]
On Behalf Of Bjorn, Pret
Sent: Monday, March 26, 2007 8:01 AM
To: Trauma &amp; Critical Care mailing list
Subject: Autopsy Requests: Scripting & Best Practices

Maine is a state like many in the U.S. WITHOUT mandatory autopsy for
trauma deaths -- there simply isn't the money for it.  As such, deaths
are referred to local Medical Examiners (mostly general medicine folk),
who have a look at the record and the corpse and determine whether a
necropsy would help -- for lack of another motivation -- to determine
foul play.  In short, if you can make it look like accidental
blunt-force injury, you can probably get away with murder around here.

My hospital provides autopsy (gross post mortem only) for trauma deaths
where the cause is unknown, or when performance issues are in play.
Problem is, these are voluntary and subject to consent of the family.
Getting consent is a neat trick, though.  I wonder if anyone out there
is in the same boat, and suffers varying responses from loved ones to
the option of autopsy.  

Specifically, I'd be very grateful for any advice on how to present the
issue to families in the most productive manner possible.  Is there any
winning script, or are there key phrases that maybe we haven't thought
of?  

I think our surgeons are very sensitive and encouraging, and quick to
point out that the service is underwritten by the hospital (should be
obvious to families, but isn't); but there's a predictable visceral
reaction to the request that we haven't been able to overcome.

Thanks for your thoughts and advice.

Pret Bjorn, RN
Bangor, ME USA

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Autopsy Requests: Scripting & Best Practices