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Why have an autopsy done on a loved one? Peace of mind, pathologist says

by Thomas Gaudio
April 14, 2011


Getting a room full of people who regularly deal in death to squirm is probably hard to do. But not for Dr. Ben Margolis.

As the pathologist clicked through a slideshow of dissected organs Wednesday, a shot of blood-soaked lungs sparked murmurs and gasps in the roughly 60-person crowd at the Worsham College of Mortuary Science in Wheeling.

Students joined members of the Funeral Directors Services Association of Greater Chicago. They paid close attention to Margolis, whose office is in Chicago, as he passionately described the psychological and legal benefits of autopsies to the deceased’s next of kin.

Graphic images aside, Margolis’ main point to funeral directors was that a postmortem done at a funeral home aids the grieving process of the decedent’s family and friends — whether by easing anxiety, acting as a second opinion to a hospital autopsy or for other reasons — by providing a definitive cause of death.

Autopsy results can also inform surviving family members about possible genetic diseases and conditions they may be able to prevent or mitigate, said Margolis, who is an associate member of the funeral directors association.

“Technical information from an autopsy helps families to be at peace,” he said.

Christine Torino, a student at the Worsham College of Mortuary Science, agrees autopsies could assuage grieving families. When her mother died in April 2003 of a suspected brain aneurism, she was “mad at my dad for not having it [an autopsy] done. The hospital made an assumption based on the signs. I just wanted clarification.”

Torino also wanted to know if her mother’s cause of death could be hereditary. “It makes you scared. Is there something you can do to prevent it?”

David McKee was impressed by Margolis’ presentation but doesn’t feel the same about most autopsy specialists he has met.

“My experience hasn’t been great in the past with pathologists,” said the funeral director at Chapel Hill Gardens West Funeral Home in Oakbrook Terrace. “They don’t always come across as competent.”

Terry Sullivan, a funeral director at Adams-Winterfield & Sullivan Funeral Home in Downers Grove, didn’t see much need for Margolis’ services.

“It’s informative but how much of this you’ll use later on is questionable,” he said. Sullivan, who was there to earn continuing education credits for his state director’s license, estimates that less than one percent of the cadavers the funeral home prepares for burial undergo autopsy.

Postmortem rates have significantly declined in the U.S. and worldwide during the past few decades, according to Dr. Elizabeth C. Burton in a 2010 article on Medscape.com, part of consumer healthcare information provider WebMD.

Rates have decreased from 19.1 percent of all deaths in 1972 to 8.3 percent in 2003, reported the United States National Center for Health Statistics, she wrote in the article.

Reasons include rising costs and a “shift in care — older and sicker patients are dying in long-term facilities and in the hospice care setting,” wrote Burton. The average cost for an autopsy was $1,275, according to the most recent published data, her article stated.

Autopsy costs aren’t usually covered by insurers so “costs may be passed on to the next of kin of the deceased at the discretion of the hospital or individual pathologist performing the procedure,” Burton wrote.

Margolis, who performs autopsies when families seek one through a funeral home, said his average charge of $1,600 is paid by the family.

Although Chapel Hill Gardens West Funeral Home only arranges one or two autopsies every year, McKee said he often dissuades families from having their loved ones autopsied because of the lack of qualified examiners.

Then there are older clients who have trouble accepting what is very likely the natural passing of a partner. “If an 85-year-old woman wants an autopsy on her 85-year-old husband who had a heart attack, we discourage it,” McKee said.

In some cases hospitals, motivated by a fear of being sued for causing wrongful deaths, try to persuade families to let them perform autopsies, Margolis said. But angered spouses, parents and children may refuse if they feel the hospital was negligent.

Margolis advised funeral directors to be honest, thorough and communicative with families who request autopsies: “Give them what they didn’t get in the hospital.”