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Mon Mar 26 18:52:39 BST 2007

Pret,
I would recommend speaking to the folks who do your organ donation
recruitment.  They are well versed in how to phrase these requests with the
understanding of how difficult it is to ask for parts of a loved one.  If
you don't have a state wide system let me know and I'll be glad to put you
in touch with the agency that covers our side of the state.  I have found
them to be very approachable and helpful.
Bif

             "Bjorn, Pret"                                                 
             <pbjorn at emh.org>                                              
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             03/26/2007 05:02                                      Subject 
             AM                        Autopsy Requests: Scripting & Best  
                                       Practices                           

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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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