Articles of interest: Elimination of the Autopsy Requirement by CMS

Rueckert J. Elimination of the Autopsy Requirement by CMS. N Engl J Med. 2020 Feb 13;382(7):683-684.

Full-text for Emory users.

The autopsy plays a vital role in quality assurance by providing education and feedback to clinicians regarding diagnostic accuracy, therapeutic efficacy, and medical complications. At our institution, we promote a culture of transparency. Discrepant cases are discussed with the treating physicians and families and are also presented at conferences on morbidity and mortality, to educate a broad audience. As is the case at other academic institutions, our autopsy service provides extensive support of cutting-edge research efforts and hence is not “obsolete.”

CMS is making a mistake. A robust autopsy service plays an important role in providing and maintaining high-quality patient care. By eliminating the autopsy requirement, we are burying opportunities for improvement. The autopsy should be supported, not undermined.

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NEJM Perspective: Learning from the Dead

De Cock KM, Zielinski-Gutiérrez E, Lucas SB. Learning from the Dead. N Engl J Med. 2019 Nov 14;381(20):1889-1891.

Full-text for Emory users.

“Obstacles to exploiting the rich database that the world’s decedents represent include not only the decline in autopsy rates but also a failure to prioritize broader innovative and culturally acceptable research and surveillance. Even information from medicolegal autopsies is not widely shared for auditing or educational purposes. A commitment among the medical and scientific communities to increase research and evaluation involving the dead, including assessments of postmortem investigations short of complete autopsies, could have great public health benefit.” (De Cock, 2019, pgs. 1889-1890)