Organ-limited autopsies. Obtaining permission for postmortem examination of the urinary tract.

Abstract

To develop a systematic pre- and postmortem program for obtaining permission for autopsies limited to the urinary tract. Comparison versus historical control of autopsy permission using a new process comprising premortem education, modification of the permission process, and autopsy limited to the urinary tract. Patients, family members, and healthcare providers associated with a nursing home. Education of healthcare providers and family members and modification of autopsy consent and performance. Permission rate and demographic characteristics of patients and family members giving permission. Of the 361 patients who died during the study, we received permission for postmortem examination of the urinary tract for 129 (36%). This was substantially better than the autopsy rate in the year prior to the study, 0.6%. A significantly higher permission rate was associated with patients and contact persons of white race, a higher level of education of the contact person, a nonrelative contact person, and two or fewer individuals making the decision. Permission for organ-limited autopsies can be obtained with a systematic approach.