Why have doctors stopped asking for autopsies? Will a different type of autopsy change this?

The traditional autopsy has been in dramatic decline for many years. This trend can be reversed by also offering the “Diagnostic and Management Autopsy” or “DMA” that involves a review of the many diagnostic decisions made before death, without any anatomic dissection postmortem. The DMA is an expert review by specialists in the diagnostic decisions related to the apparent cause of death.1 The experts may be from pathology or other departments, but they know well the primary disease suffered by the decedent. An example of a DMA is a review of a patient death from a coronary stent thrombosis by a group of experts in coagulation and vascular disorders. It was recently recommended that in addition to offering a traditional autopsy to the next of kin, the DMA also be offered. There is, and always has been, a need to know the medical appropriateness of diagnostic and treatment decisions for all patients, so that care can be continuously improved, in the midst of rapid and continuous medical practice changes. To show the special advantages of a DMA, consider these selected comparisons between the traditional autopsy and the DMA for both the next of kin and the physician: