Many physicians find the request for autopsy to be one of the most difficult and unpleasant aspects of pediatrics. Lack of preparation, their own emotional reactions, and ambivalence about the necessity of autopsies contribute to this. This article offers an approach to the autopsy that emphasizes its importance to families and to pediatrics, and suggests a role for the physician at the time of the child's death that is both professionally and personally gratifying.
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References
1.
Katz, J., and Gardner, R.: The intern's dilemma: The request for autopsy consent. Psychiatry Med.3: 197, 1972.
2.
Vatdes-Dapena, M.A.: The causes of neonatal mortality: An analysis of 501 1 autopsies in newborn infants. J. Pediatr.77: 366, 1970.
3.
Fitzgibbons, J.P., Nobrega, F.T., Ludwig, J., et al.: Sudden, unexpected, and unexplained death in infants. Pediatrics43: 980, 1969.
4.
Hasson, J.: The autopsy: The key to quality control in medical care. NY State J. Med.72: 2509, 1972.
5.
Pruntting, J. : Introduction to a symposium on autopsy and the law. Bull. NY Acad. Med.47: 736, 1971.
6.
Lindemann, E. : Symptomatology and management of acute grief . Am. J. Psychiatry101: 141, 1944.
7.
Engel, G.: Grief and grieving. Am. J. Nurs.64: 93, 1964.
8.
Friedman, S.B. : Psychological aspects of sudden death in infants and children. Pediatr. Clin. North Arn.21: 103. 1974.
9.
Friedman, S.B. : Management of fatal illness in children. In: Green, M., Haggerty, R., Eds. Ambulatory Pediatrics, Philadelphia, W. B. Saunders, 1968 , p. 753.
10.
Friedman, S.B. , Chodoff. P., and Mason, J.W.: Behavioral observations on parents arrticipating the death of child. Pediatrics32: 610, 1963.
11.
Kottler, A. : The Jewish attitude on autopsy. NY State J Med57: 1649, 1957.
12.
Halpern, W. : Some psychiatric sequelae to crib death. Am. J. Psychiatry129: 398, 1972.
13.
Bergman, A. : Psychological aspects of sudden unexpected death in infants and children. Pediatr. Clin. North Am.21: 115, 1974.
14.
Munan, L., Kelly, A., and Cote, R.: Do the right children have necropsies? Arch. Dis. Child.50: 620, 1975.
15.
Anonymous: To get consent for a post—what the top hospitals say and do. Resident Physician13: 56, 1967.
16.
Bergman, A. : Sudden infant death syndrome. Postgrad. Med.51: 156, 1972.
17.
Holmes, L.: Congenital Malformations. N. Engl. J. Med, 295: 204, 1976.
18.
Solnit, A.J. , and Green, M.: Psychologic considerations in the management of deaths on pediatric hospital services. I: The doctor and the child's family . Pediatrics24: 106. 1959.
19.
Schowalter, J.: How do children and funerals mix? J. Pediatr.98: 139. 1976.
20.
Klaus, M.H., and Kennell, J.H.: Maternal-infant bonding. Saint Louis, C. V. Mosby, 1976, p. 216.
21.
Kischhoff, J. , and O'Brien, N.: After the child dies. J. Pediatr.88: 140, 1976.
22.
Cobb, B.: Psychologic impact of long illness and death of a child on the family circle . J. Pediatr.49: 746, 1956.
23.
Friedman, S.B.: Management of the death of a parent or sibling. In: Green, M., Haggerty, R., Eds. Ambulatory Pediatrics, Philadelphia, W. B. Saunders, 1968, p. 780.
24.
Share, L.: Family communication in a child's fatal illness. Omega3: 187, 1972.
25.
Cain, A.C., Fast, I., and Erickson, M.E.: Children's disturbed reactions to the death of a sibling. Am. J. Orthopsychiatry34: 741, 1964.
26.
Heffron, W.A. , Bommelaere, K., and Masters, R.: Group discussion with the parents of leukemic children. Pediatrics,52: 831, 1973.
27.
Cullberg, J.: Mental reactions of women to perinatal death. In: Morris, N., Ed.: Psychosomatic Medicine in Obstetrics and GynecologyNew York, S. Karger, 1972. Cited in Klaus, M., Fanaroff, A.: Care of the High-Risk Neonate. Philadelphia, W. B. Saunders, 1973 , p. 109.
28.
Binger, C., Ablin, A.R., Feuerstein, R.C., et al.: Childhood leukemia: Emotional impact on patient and family . N. Engl. J. Med.280: 414, 1969.
29.
Friedman, S.B. : Psychological aspects of sudden death in infants and children. Pediatr. Clin. North Am.21: 103, 1974.
30.
Green, M., and Solnit, A.J.: Reactions to the threatened loss of a child: A vulnerable child syndrome. Pediatrics34: 58, 1964.
31.
Brazelton, T.B.: Anticipatory guidance. Pediatr. Clin. North Am.22: 533, 1975.
32.
Szybist, C.: The subsequent child. Pamphlet published by the National Foundation for Sudden Infant Death, New York.
33.
Poznanski, E.O.: The "replacement child": A saga of unresolved parental grief. J. Pediatr.81: 1190, 1973 .
34.
Mandell, F. , and Wolfe, L.: Sudden infant death syndrome and subsequent pregnancy. Pediatrics56: 774, 1975.
35.
Angrist, A. : Pleas for realistic support for the autopsy in the changing medical setting. Bull. NY Acad. Med.47: 758, 1971.
36.
Rogers, M.: Personal Communication.
37.
Artiss, K., and Levine, A.: Doctor-patient relations in severe illness. N. Engl. J. Med.288: 1210, 1973.
38.
Todres, I.D. , Howell, M., and Shannon, D.: Physicians reactions to training in a pediatric intensive care unit. Pediatrics53: 375, 1974.
39.
Rothenberg, M.: Reactions of those who treat children with cancer. Pediatrics40: 507, 1967.
40.
Schowalter, J.: Death and the pediatric house officer. J. Pediatr.76: 706, 1970.
41.
Rosini, L.A. , Howell, M.C., and Todres, I.D.: Group meetings in a pediatric intensive care unit. Pediatrics53: 371, 1974.