Scots pathologist seeks end to 'abattoir-style' post-mortems

ONE of Scotland's most prominent pathologists has warned that the high level of post- mortem examinations being carried out south of the Border was turning mortuaries into "production-line abattoirs".

Professor Derrick Pounder, head of the Centre for Forensic and Legal Medicine at Dundee University, said around 80,000 unnecessary dissections were carried out each year as part of death investigations in England and Wales.

He argued that the rate could be reduced by 60 per cent if pathologists adopted the method of detailed external examinations pioneered in Tayside.

Prof Pounder's concerns are raised in a paper in the latest issue of the Journal of the Royal Society of Medicine.

He said: "We are not saying we shouldn't perform autopsies. They are absolutely essential in many cases. But what we are saying is that we have to strike the balance in a different way and be more respectful of the rights of families and the views of families, and not simply perform autopsies as a reflex.

"In England and Wales, they have almost become automatic. What they have done is turned it into a production-line system whereby the mortuaries are more like abattoirs and there is so little time spent on the autopsy that the important cases get lost in the large number of routine cases."

Prof Pounder claimed the number of coroner autopsies carried out every year in England and Wales could be reduced from the current figure of 110,000 to around 30,000.

He said: "We need fewer autopsies in which we invest more time to perform them better. We need to change our approach and be much more thoughtful in selecting which deaths we autopsy, rather than carrying out autopsies automatically in large numbers of deaths, and running a production-line system.

"Autopsies must be performed by skilled pathologists, and we simply do not have the people to perform well such large numbers of autopsies.

"The inevitable result is a lowering of autopsy standards and a false sense of security that we have properly investigated the death. Unnecessary autopsies in large numbers of deaths rob us of our most precious resource - the time of skilled professionals."

The report says the rate of post-mortem tests in England is 22 per cent. Scotland's rate is about 12 per cent, although there are wide regional variations.

Prof Pounder added: "Aberdeen and Edinburgh also have a reasonably high external examination rate, but in Glasgow external examinations are almost non-existent. And this is a matter of some concern because the faith communities which object to autopsies are highly concentrated in Glasgow."The Jewish and Muslim communities in Glasgow have been repeatedly campaigning with the Crown Office to increase the external examination rate in Glasgow."

A spokesman for the Coroners' Society of England and Wales said death certification was different to that in Scotland. "It would be helpful if the model described could be subject to research in order to ascertain whether or not it is a reliable method of determining causes of death," he said.

"Coroners in England and Wales would welcome a reduction in the numbers of autopsies provided that alternative methods are shown to be reliable."