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The Virtues of the Virtual Autopsy
Hugh Pickens writes "Maryn McKenna writes in Scientific American that the standard autopsy is becoming increasingly rare for cost reasons, religious objections, and because autopsies reveal medical mistakes, making doctors and hospitals uncomfortable. Researchers in several countries have been exploring the possibility that medical imaging might substitute a 'virtual autopsy' for the more traditional variety. 'So few autopsies are being done now that many medical students get out of school never having seen one,' says Gregory Davis. 'And yet in medicine, autopsy is the most powerful quality-control technique that we have and the reason we know as much as we do about many diseases and injuries.' The process, dubbed 'virtopsy,' combines MRI and CT scanning with computer-aided 3-D reconstruction to prove causes of death for difficult cases, which included drownings, flaming car crashes, and severe injuries to the skull and face. Since 2004 the U.S. military has performed x-rays and CT scans on the bodies of every service member killed where the armed forces have exclusive jurisdiction — that is, not just on battlefields abroad but on U.S. bases as well. 'It allows us to identify any foreign bodies present, such as projectiles,' says Edward Mazuchowski. 'X-rays give you the edge detail of radio-opaque or metallic objects, so you can sort out what the object might be, and CT, because it is three-dimensional, shows you where the object is in the body.' A study conducted among intensive care unit patients in Germany compared diagnoses made before death with the results of both traditional and virtual autopsy in 47 patients and with only virtual autopsy in another 115 whose families refused standard autopsy. Virtual autopsies confirmed 88 percent of diagnoses made before death, not far behind the 93 percent rate for traditional postmortem exams. 'The findings so far are mixed,' says Elizabeth Burton of Johns Hopkins University. Virtual autopsy, she says, 'is better for examining trauma, for wartime injuries, for structural defects. But when you start getting into tumors, infections and chronic conditions, it's not as good, and I doubt it will ever be better.'"
The Virtues of the Virtual Apostacy
...cost reasons, religious objections, and because autopsies reveal medical mistakes, making doctors and hospitals uncomfortable.
Say what? Does anyone else see that last reason list as completely asinine with regards to not doing an autopsy? Ok, maybe the religious one is a silly objection, but there's no need to go against the religious beliefs of the deceased/close family members, at least as long as foul play isn't a concern. But, because it might reveal the f*ck-ups of the quack that took your tonsils out? Yeah, I'm not getting the point of that one...
Deja Moo: The distinct feeling that you've heard this bull before.
don't have time to read all that - can anyone summarize?
From TFA: "...and because autopsies reveal medical mistakes, making doctors and hospitals uncomfortable..."
Isn't the point of autopsy to find the reason for death? Even if it is a mistake of some hack in a white coat? Really?
I wonder how much x-rays can be improved if you don't care at all about the dose.
No – it makes complete rational sense. You want other hospitals to do autopsies – you want other people to bear the expense, the time, the embarrassment of mistakes gone wrong (and the potential lawsuits) to do the basic research that will help you.
It is a classic (and I mean classic) of things not getting done because the positive externalities are not captured.
...cost reasons, religious objections, and because autopsies reveal medical mistakes, making doctors and hospitals uncomfortable.
Say what? Does anyone else see that last reason list as completely asinine with regards to not doing an autopsy? Ok, maybe the religious one is a silly objection, but there's no need to go against the religious beliefs of the deceased/close family members, at least as long as foul play isn't a concern. But, because it might reveal the f*ck-ups of the quack that took your tonsils out? Yeah, I'm not getting the point of that one...
remember, corporations aren't just people, they can get their feelings hurt, and they might get sued which would make them sad.
Now if you'll just check the 520 page electronic contract you signed in 2 point type before agreeing to surgery, you'll see that your first born child is now our indentured servant ...
Wouldn't giving a dead soldier a CT scan be a very dangerous thing to do, considering that the soldier's body could be filled with undetected pieces of metal?
For the foreseeable future it will take a real doctor's mark one eyeballs to recognize a tumor, the prick of a needle, several kinds of trauma, or the wrong kind of fluid in various places. Bad, bad idea unless your only purpose is to hide the truth.
If video games influenced behavior the Pac Man generation would be eating pills and running away from their problems.
.. own the bodies of deceased personnel (in as far as OKing the autopsy) if the member dies on a base or a battlefield. Wonder if that's in the Terms and Conditions when you sign up...
"The greatest lesson in life is to know that even fools are right sometimes" - Winston Churchill
the standard autopsy is becoming increasingly rare for cost reasons, religious objections,
Is there any major religion other than "Cult of the Dead" that America is slowly devolving into in which autopsies are forbidden?
"because autopsies reveal medical mistakes, making doctors and hospitals uncomfortable."
And? if we don't own up to mistakes, we never learn. Not to mention medical Malpractice. Seriously. This had NO RIGHT to be in the article, except to inflame people and make it a media-bait.
If I was an intern, I think I would be more emotionally impacted by cutting into what used to be a living person, rather than staring at some innards on a monitor. The loss of this may hinder the education of medical students.
- I stole your sig.
This story is misleading, there are more and more private practices that are doing autopsies, relying on the county corner has always been a problem is some cases, and the reasons for private pratices are due to medical fuck ups, and families wanting to know for sure if there was a foul up from surgery, or if the doctors missed a diagnosis, that would have kept that person alive. There is a story from frontline on PBS over this, I believe that corners were giving false autopsy results on patients who deaths were because of medical malpractice.
And yes these private practices go through the required training to perform a correct and accurate atuospy, about the same as the idiot who has extensive education but still manages to screw up, and not just a few times, several times a year.
I assist with autopsies and have performed over 500 this year alone. We do more and more cases a year, not less. And we almost never hear of religious objection. Maybe once a year. Maybe. This article is so wrong I'm disgusted even seeing it on here.
Famous last words, as well as being the second evidence of protectionism of the 'profession' of medicine. The first was the reason NOT to autopsy as making medical staff uncomfortable as it might reveal mistakes. The second downplaying of the technology's potential is typical. Machines are already on-par with humans for diagnostic accuracy virtually anywhere they've been used. The machine's problem is that when a mistake is made, it can't baffle the patient with BS to talk their way out of a lawsuit nor do they have a profession ready to leap to their defense.
"Consensus" in science is _always_ a political construct.
Pickens apparently knows not what a paragraph is. Jamming everything into one paragraph is the mark of an amateur writer.
I am an MD as well. I have absolutely never heard of this. Most physicians I know are constantly lamenting the fact that autopsies are rare. We want to know just as much as the patient's family. Think of reading a mystery novel missing the last chapter!
It is mostly cost that is the reason for not doing autopsies any more.
The other factor that I have not yet seen mentioned yet: physicians feel uncomfortable asking for this immediately after death. The family is grieving, many people are offended (religiously) by requests for autopsy, and in many cases organ donation was just discussed - and in our minds that is a much more important decision that needs to be made. Finally, many people want to hold a viewing, and they don't understand that this is absolutely doable after autopsy. Pathologists take great care to preserve the external appearance of the body.