POSTMORTEM PROCEDURES IN THE EMERGENCY DEPARTMENT - USING THE RECENTLY DEAD TO PRACTICE AND TEACH

In generations past, it was common practice for doctors to learn lifesaving technical skills on patients who had recently died. But this practice has lately been criticised on religious, legal, and ethical grounds, and has fallen into disuse in many hospitals and emergency departments. This paper uses four questions to resolve whether doctors in emergency departments should practise and teach non-invasive and minimally invasive procedures on the newly dead: Is it ethically and legally permissible to practise and teach non-invasive and minimally invasive procedures on the newly dead emergency-department patient? What are the alternatives or possible consequences of not practising non-invasive and minimally invasive procedures on newly dead patients? Is consent from relatives required? Should doctors in emergency departments allow or even encourage this use of newly dead patients? Several factors suggest that postmortem practice and teaching is necessary: the importance of clinical competence when performing lifesaving procedures, society's need to maintain and expand the cadre of medical personnel with lifesaving skills, and the inadequacy of alternative teaching methods. Doctors are ethically compromised when, instead of doing postmortem practice, they either use patients in the operating room without consent or delay pronouncing death during resuscitations to practise and teach. Contrary to what is often claimed, there is neither a legal nor a moral basis for requiring relatives' consent for minimally invasive and non-invasive postmortem procedures. The obligations society has placed on emergency doctors dictate that they encourage the use of the recently dead for the practice and teaching of non-invasive and minimally invasive lifesaving procedures. The medical profession has a duty to openly acknowledge this need and to educate the public about it.