The slow death of the clinical post-mortem examination: implications for clinical audit, diagnostics and medical education

The adult clinical post-mortem exam- ination has seriously declined in Norwich recently, with only 34 of them (representing 1.4% of deaths in hospital) having been undertaken in 2003. Moreover, the next-of-kin are increasingly restricting the extent of the examination when they give consent. Analogous but less severe changes have occurred in the post-mortem examination of stillbirths and perinates. Many clinicians are unaware of these events, which may come to have wide-ranging detrimental effects. One possible cause is the lack of training of junior medical staff in obtaining consent for post- mortem examination, though other factors are also important.