Decrease in the frequency of autopsies in Denmark after the introduction of a new autopsy act

Abstract

New techniques have influenced the attitude to the autopsy and contribute to a de-emphasis on the importance of post-mortem examination. Since 1990, new Danish legislation has provoked a dramatic fall in the autopsy rate, which had already declined from 45% in 1970 to 35% in 1980. In the first half of 1990 the rate was 24% in the second half of that same year it had fallen to 16% (

Source: The Danish National Institute of Health, 1992). The clinicians now seem to manage without the autopsy to confirm or correct their daily diagnostics. They also seem to be of the opinion that they do well without this "final checklist". The autopsy, however, is still an important tool in understanding, correcting and improving future diagnosis. Therefore, post-mortems should again be carried out as a matter of course and common practice. The following proposals are all aimed at obtaining a higher autopsy rate: The 1990 legislation on autopsy should be changed so that permission to perform a post-mortem can be given in due time, before the supposed death, preferably by the patient himself and obviously with the right to a subsequent change of mind. It is of great importance that the Public Health Service informs both the public and health workers in general about the nature and importance of the autopsy. Likewise, doctors and health workers in general should be educated in how best to give information to patients. Pathologists should, through a more uniform and exact practice, encourage the clinicians to a renewal of the close collaboration concerning the facts revealed by the autopsy, both in their everyday practice and in scientific projects in general.