Postmortem Blood Culture

Autopsy has historically played a critical role in our understanding of normal anatomy, disease and treatment efficacies, or adverse effects of medications. Despite the importance of autopsy as a teaching tool, it is now limited to an ancillary role in modern medical education ( 1 ). This effect may continue to be amplified as physicians who did not observe autopsies during their training are less likely to request an autopsy later on in the course of their careers ( 2 ). In the 1970s, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) eliminated the requirement for a minimum autopsy rate from its accreditation process, and Medicare stopped reimbursing for autopsies in 1986 ( 3 ). Reasons physicians do not request an autopsy have reportedly included trepidation regarding the lack of training on how to seek autopsy permission, fear of offending the family, and fear of malpractice litigation. In addition, confidence in contemporary diagnostic technology and the ever present desire to reduce health care spending have also been cited as reasons ( 2 , 4 – 9 ). Given the forces aligned against this procedure, autopsy rates have declined in the United States and other Western countries over the past 3 decades ( 4 ). Unfortunately, the sequelae of this decline include the loss of an established teaching tool along with the inability to identify and correct clinical errors and missed diagnoses ( 4 ).