tailieunhanh - Báo cáo y học: "The role for autopsy in the intensive care unit: technological consideration"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: The role for autopsy in the intensive care unit: technological considerations. | Pompilio Critical Care 2010 14 426 http content 14 4 426 CRITICAL CARE LETTER L_ The role for autopsy in the intensive care unit technological considerations Carlos E Pompilio See related review by De Vlieger et al. http content 14 2 221 In their excellent review De Vlieger and colleagues 1 confirmed the steady decrease of nonforensic autopsies a well-documented phenomenon in Europe the United States 2 and Latin America including Brazil Figure 1 . However the causes usually attributed to explain this phenomenon from my point of view are not causes but consequences of a change occurring with regard to the concept of disease. The concept of disease should be considered as what truly rules the art and science of medicine giving direction to procedures as well as yielding pathways to research. Hofmann 3 argues that Figure 1. Rate of autopsied versus certified deaths at Hospital das Clinicas da Faculdade de Medicina da Universidade de Sao Paulo from 1994 to 2006. Modified from 5 . the contemporary concept of disease is technologically constituted. That means technology provides the physiological biochemical and morphological entities that are applied in defining diseases . I believe the decline of clinical autopsy is the result of a rearrangement of conceptual frameworks working on the contemporary medical rationality 4 . Trying to convince intensive care doctors about the value of autopsies based only on their value per se will not work 5 . The autopsies must aggregate value to the procedure itself new techniques and new insights as pointed out by De Vlieger and colleagues. In fact a new status in medical rationality is needed otherwise the decline will continue. Competing interests The author declares that he has no competing interests. Published 5 July 2010 References 1. De Vlieger GYA Mahieu EMJL Meersseman W Clinical review What is the role for autopsy in the ICU Crit Care 2010 14 221. 2. Shojania KV Burton EC The vanishing nonforensic