Legal, Social & Ethical Issues During Performing Peri-natal Autopsy in India-A Practical Experience

Obtaining consent from bereaved parents is difficult job. Difficulties are multifaceted. Researchers need to sail through social, ethical, legal, administrative and other barriers in obtaining consent for perinatal autopsy.

To explore the different problems for getting consent from parents to perform perinatal autopsy and identification the root causes of those constrains and the possible way outs in Indian scenario.

A prospective study was done in India between Jan 2011 to Dec 2015 after taking written consent from parents where 110 perinatal autopsy were performed; though 180 parents were approached for consent but 70 parents refused to do so. Data was collected about consent for autopsy, causes of refusal, additional findings and change of clinical cause of death.

Perinatal autopsy were done in 110 cases (61%) and in 70 cases parents (39%) to give consent for autopsy. We obtained additional information in 42 cases (38.18%) and diagnosis was changed in 9 cases (8.18%). Most common cause of refusal to provide consent was socio-cultural (39 cases, 55.71%).

Social factor emerged as the chief problem to obtain consent. Even today at the era of molecular pathology perinatal autopsy is still the gold standard to know the cause of death. Regarding its revival (as it is a dying and declining art), we need all round effort from clinician, pathologist, social worker and all medical care givers.