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Requesting Consent for an Invasive Procedure in Newly Deceased Adults
Robert M. McNamara, MD;
Susan Monti, BSN, MPA, CRNA;
John J. Kelly, DO
JAMA. 1995;273(4):310-312.
Abstract
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Objective.
—Ethical concerns exist over the performance of medical procedures, such as endotracheal intubation, on newly deceased patients without family consent. This study examined the process of obtaining consent for the purpose of performing an invasive procedure in newly deceased adults.
Design.
—A prospective case series.
Participants.
—The families of patients who died during a 5-month period were requested to provide consent to perform wire-guided retrograde tracheal intubation.
Main Outcome Measures.
—Differences between success and failure in obtaining consent including information on the deceased, family reasons for their decision, and the experience of those requesting consent.
Results.
—Consent was requested from 44 families and 26 (59%) agreed to the procedure. This success rate was achieved despite the lack of a prior relationship with the family by the persons requesting consent. Consent was obtained more frequently in unexpected than expected deaths (77% vs 41%, P=.03). There were no differences in success rates for consent for age, race, sex, or do-not-resuscitate status of the deceased. Spouses consented more frequently than children (77% vs 50%, P=.25). The two physicians reported greater comfort in requesting consent than the nurse anesthetist investigator. In one instance, the consent process may have increased the emotional distress of the family.
Conclusion.
—Consent can frequently be obtained from families for an invasive procedure in newly deceased adults. Physicians should reconsider the practice of performing postmortem procedures without obtaining family consent.
(JAMA. 1995;273:310-312)
Author Affiliations
From the Departments of Emergency Medicine (Drs McNamara and Kelly) and Anesthesiology (Ms Monti), The Medical College of Pennsylvania, Philadelphia.
Footnotes
Reprint requests to The Medical College of Pennsylvania, Department of Emergency Medicine, 3300 Henry Ave, Philadelphia, PA 19129 (Dr McNamara).
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