Declining post-mortems: a cause for concern.

There is no doubt that the autopsy is useful. Almost invariably additional diagnoses come to light during a post-mortem (PM) examination. In a significant proportion of cases (25%), the PM alters the diagnoses completelv.' In a prospective survey of 1000 necropsies, Cameron et."al. , found that the main clinical diagnosis was not confirmed in 39% of cases? The autopsy also serves as a check on the appropriateness of therapy and is a valuable lesson against similar mistakes being made in future. It provides data on both old and new diseases; this may follow from single case reports or of compiled data from several cases. Not only may the natural history of a disease be studied to advantage but the effects of investigative! diagnostic procedures, drug therapy and surgical intervention may also be observed.