Religious sensitivity pitted against the need to know: autopsy of Jewish children in Israel.

BACKGROUND: The aim of the study was to compare autopsy findings with antemortem findings in children who died in a pediatric intensive care unit. MATERIAL/METHODS: Consecutive series of patients who died in the pediatric intensive care unit during 2-year period were used. The study was conducted as a retrospective chart review at community, regional-referral, university-affiliated tertiary medical center of 1200 bed in Israel. RESULTS: Permission was given to perform autopsies on only 10 children (23.8%, mean age 85.7 months) out of the 42 who died during the study period. The mean length of stay in the pediatric intensive care unit prior to death was 13.3 days. Cardiac or hemato-oncologic diseases comprised the major pre-admission diagnoses. The autopsy revealed a major finding that, if known before death, would have altered clinical management in 50% of the patients: pneumonia, pneumonitis as well as intestinal perforation or necrosis. No correlation was found between patient length of stay in the intensive care unit and the autopsy disclosed information. CONCLUSIONS: Our findings support the importance of autopsy assessment in the pediatric intensive care setup. We believe that postmortem examination is also essential for improving the quality of pediatric patient care.