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Wednesday, December 27, 2006

Best of Grey's Anatomy: Sneaky Autopsy
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Sneakiness abounds in Seattle Grace Hospital. Sneaky trysts in the supply closets, sneaky revelations about personal lives, sneaky procedures involving cutting LVAD wires to save the life of the boyfriend/patient...where does it stop? A while ago, there was a sneaky autopsy, too.

In the last episode of the first series, "Who's Zoomin' Who?", Meredith and Cristina perform an autopsy on the sly, on a patient whose family has flatly refused to consent to the procedure. Legally, of course, this is wrong. An autopsy (unless there are medicolegal implications) always requires the written consent of the next-of-kin of the deceased. Not only do the interns not have the required consent, but the family has expressly forbidden the procedure.

Autopsies are never performed on the whim of doctors to satisfy their intellectual curiosity, even if justified (in this case the docs discover a genetic disease in the family). And performing an autopsy without permission is the same as operating without permission -- grounds not only for dismissal, but also for revocation of a doctor's license to practice.

Ethically, it's also wrong, although the writers want us to decide whether the end justifies the means, giving us potentially life-saving information for the deceased's relatives. Granted, Meredith and Cristina obtained valuable information, but, morally, most people wouldn't be very pleased about wayward interns experimenting clandestinely on the body of a loved one.

Finally, logistically, this would be almost, if not absolutely, impossible to carry off. An autopsy is a medical procedure that isn't a one- (or two-) woman procedure; it is generally performed with the aid of technicians and personnel who help with preparation and processing of the body along with other tasks. It's also highly unlikely that two interns, even as bright as Meredith and Cristina are, could even interpret the autopsy findings without an experienced pathologist as guide.

Giving them the benefit of the doubt and assuming they could manage to perform a secret autopsy, it would be even harder to cover up, afterwards, the evidence of their having done so. Covering their tracks would require thorough washing of the autopsy suite, removal and disposal of contaminated materials, sterilization of contaminated instruments, and covering any and all traces of after-hours activity in the autopsy suite. The personnel at the funeral home would also undoubtedly notice that the body exhibited incisions from the non-permitted procedure, too.

So the autopsy scene, while dramatic, gets a "no" vote on the realism scale. And the hospital's official reaction? Thumbs down here, too. Such an action is grounds for dismissal from the residency program and revocation of medical licenses, and not even the fact that they're both sleeping with senior members of the department would be able to buy them some slack in this situation, were they in a real hopsital.

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Posted by: Melissa Stoppler_MD at 12/27/2006 01:10:00 PM

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