Attitudes toward autopsy in unexpected death: A nationwide survey of physicians and risk managers in Japanese teaching hospitals

Context: Autopsy is a useful tool for understanding the manner and cause of death in unexpected patient death. The information about the opinions of physicians and risk managers in Japan regarding autopsy is limited. Objective: To describe and evaluate the opinions of physicians and risk managers at Japanese teaching hospitals regarding forensic autopsy. Design, setting and participants: Cross-sectional study of all residency programme directors and risk managers completing a survey In January 2009. Specific clinical scenarios where autopsy would be essential to determine whether medical error occurred and whether medical care contributed to the death of the patient were presented. Respondents gave their opinion regarding the necessity of autopsy and their beliefs about if they would actually recommend it. Results: Of 1113 eligible physicians and 1113 eligible chief risk management officers, 466 physicians (41.9%) and 599 risk managers (53.8%) responded. The majority of physicians and risk managers reported they would recommend an autopsy in cases of unclear medical error or unclear cause and effect relationship of medical care and patient death; however, 10% or more of physicians and 25% or more of risk managers (depending on the situation) reported that they would not recommend an autopsy. Risk managers were less likely than physicians to recommend and believe that autopsy was necessary. Conclusions: The majority of physicians and risk managers in Japan would recommend autopsy and believe in its necessity in cases of unexpected patient death.