How well do we communicate autopsy findings to next of kin?

Context: A failure of communication among families, physicians, and pathologists is recognized as a major cause of declining autopsy rates and may be involved in increased litigation.

Objective: To determine how effectively autopsy results are communicated to the next of kin and how satisfied families are with the process from consent to relaying of the results.

Design: A retrospective telephone survey of next of kin of 106 consecutive patients autopsied at a major teaching hospital. The family was asked questions on the process of obtaining consent and the information they received back from health care providers.

Results: Thirty-two percent of relatives indicated that they were not adequately informed as to the purpose of the autopsy. Eighty percent of respondents were notified of or obtained the results. The ways in which the autopsy findings were communicated varied, but 54% were involved in a discussion of the results with a medical professional. More than half of the families wished to have a copy of the results. Two-thirds felt they were satisfied with the explanation of the results, but an important cause of dissatisfaction was the use of unfamiliar medical terminology. When the family's understanding of the cause of death was compared with the diagnoses on the autopsy reports, 65% of families demonstrated an accurate knowledge of the autopsy findings, 28% had a general understanding, and for only 8% was their knowledge judged inaccurate. Overall, 92% of notified respondents felt the autopsy had served a useful purpose, mostly for personal reasons.

Conclusions: We conclude that the autopsy fulfills an important need for many families; however, the purpose of the autopsy and the findings need to be more effectively communicated.