Reliability of a Presumptive Diagnosis in Sudden Unexpected Death in Adults

THE VALUE of autopsy performance in establishing a cause of death, assisting in the determination of the manner of death, comparing the premortem and postmortem findings, producing vital statistics, and monitoring the public health, among other things, has been documented for many decades.1 In all legal jurisdictions of the United States and most other countries of the world, autopsy is not performed after every death. In some hospitals in the United States and in some other countries, autopsy is routine after almost every death. Since the Joint Commission on Accreditation of Hospitals recently eliminated its requirement of a certain fixed percentage of autopsies on deaths occurring in the hospital, many now believe that the American autopsy percentage has dropped to new modern lows. In these days of compulsory peer review, government involvement in quality of medical practice, frequent liability suits, questions of industrial health and environmental epidemiology, and the