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I have carried with me since my indoctrination at medical school by
pathologists the notion that the post-mortem is the gold standard in
diagnosis - and it is this thought which fortifies my conversation with
patients' families when we the medical team feel a post-mortem is
Although i have long had anecedotal doubts about the validity of post
-mortems, i have never come across such striking evidence for their
Anecdotes aside, is it not possible that post-mortem examinations
have fallen behind the latest developments in medicine on 2 counts.
Firstly, clinical governance has grown rapidly into an everyday necessity
for physicians who must continuosuly justify their own practice and
expense. Secondly the vast increase in laboratory tests and radiological
examinations, whilst not superceding a tissue diagnosis, have nevertheless
proved effective tools in diagnosis. Has pathology failed to keep up in
In conclusion, i look forward to new standards being developed for
postmortem examination affording me greater confidence in broaching this
delicate subject with families.