The value of the pediatric postmortem examination.

Requesting an autopsy is never a pleasant or comfortable experience, either for physician or for family members. Sometimes the family has had previous unhappy experiences with this procedure, and certainly many clinicians have been repelled by sights, sounds, and behaviors they have observed in morgues. Such experiences can have far-reaching negative effects and reflect poorly upon the profession of pathology. Berger's important paper contains important messages for pathologists concerned with the performance of pediatric autopsies and for clinicians requesting consent. His paper should be read and heeded by both groups. Several studies have looked at factors that might affect autopsy rates, especially in perinatal deaths. Early separation of mother from baby emerged as an important factor in one of these, whereas maternal age, race, and sociocultural background played no important role. One of these studies investigated attitudes and experiences of the requesting physicians, and found these factors to be key determinants in the family's response to a request to perform a postmortem examination. One result of that study was that more experienced physicians were more likely to request a postmortem examination, and to receive an affirmative answer. The pediatric postmortem examination remains an indispensable part of clinical management. Its importance for science, clinical practice, and medical administration is beyond question. However, its greatest and most unique value is to the families of the deceased children. Clinicians and pathologists must continue to work together to ensure that this procedure is performed whenever indicated, that the information gained is maximized, and that the results are communicated to the family promptly, accurately, clearly, and with sensitivity.(ABSTRACT TRUNCATED AT 250 WORDS)