Death causes ‘often proved wrong’

Press, 28 July 1989, Page 7

Death causes ‘often proved wrong’

PA Auckland A leading pathologist has claimed “disturbing inaccuracies” in clinical diagnoses of the causes of death. Up to 30 per cent of clinical diagnoses are proved wrong on autopsy, Professor Jeremy Jass said last evening.

Professor Jass, head of the department of pathology at the Auckland University School of Medicine, made the comments during his inaugural public address.

He called for a radical revitalisation of the role of the hospital autopsy.

The need for such autopsies was increasing at the same time as the number being performed was decreasing, he said. “At present only between 5 and 10 per cent of patients dying in hospital have an autopsy. The ideal is 100 per cent.”

Extension of the use of autopsies as widely as suggested would aid teaching, diagnosis, and medical audit, Professor Jass said. Unlike a coroner’s autopsy, which is ordered when a cause of death, or a death is unnatural, there is no legal requirement for an autopsy when a patient dies either at home or in a hospital as a result of a serious illness that was being treated by a physician.

It is the attending physician, with the consent of relatives of the deceased, who request that an autopsy be performed.

Professor Jass said that too often, clinicians were making incorrect diagnoses as to the cause of death. “It has been shown that clinicians have become more confident in their ability to state the cause of death.

“Worryingly, it has also been shown that this confidence is totally unfounded,” he said. Between 10 and 30 per cent of clinical diagnoses of the cause of death were proved incorrect on autopsy, he said.