Since 1950, pathologists in the U.S. have gone from conducting autopsies on nearly half of all patients who died in hospitals to less than 5 percent of them. In part, that’s because advances in imaging technology have given physicians more confidence in their diagnoses. But “our ability to determine the cause of death is pretty bad unless you do an autopsy,” says Mary Fowkes, a pathologist at Mount Sinai Hospital in New York. She says about a quarter of autopsies reveal something the clinician did not know about the patient’s cause of death.
But pathologists say autopsies offer a level of detail that doctors can’t see in the living. “When you’re able to see what’s happening at the level of the cells, you just have a broader picture of the potential mechanism by which the disease is happening,” says Amy Rapkiewicz, a pathologist at NYU Langone Health. Those benefits could seem especially important with the onset of Covid-19 — a novel illness with effects on the body that scientists and physicians are still scrambling to understand.
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