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Opinion 9.2.3

Performing Procedures on the Newly Deceased

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Medical training sometimes involves practicing procedures on newly deceased patients, in particular, critical medical skills for which adequate educational alternatives are not available. Such training must balance protecting the interests of newly deceased patients, their families, society, and the profession with the need to educate health care providers.

Physicians should work to develop clear institutional policies for performing procedures on newly deceased patients for training purposes. Before medical trainees practice any procedure on a newly deceased patient, the supervising physician has an ethical responsibility to ensure that: 

  1. The interests of all parties are respected and the risks and benefits of permitting the procedure have been carefully considered, including: 
    1. the rights of deceased patients and their families; 
    2. benefits to trainees and society; 
    3. risks to trainees, staff, the institution, and the profession. 
  2. The procedure is carried out: 
    1. as part of an appropriately structured training sequence; 
    2. in a manner and an environment that is respectful of the values of all involved parties. 
  3. Permitting trainees to perform the procedure is in keeping with the previously expressed preferences of the deceased individual regarding handling of the body or procedures performed after death. 
  4. Permission for a trainee to perform the procedure is obtained from the decedent’s family if the individual’s preferences are not known. Procedures should never be performed for training purposes if the decedent’s wishes are not known and permission is not available from an appropriate surrogate. 
  5. The procedure is entered in the medical record.
AMA Principles of Medical Ethics: I, V
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Informed consent to medical treatment is fundamental in both ethics and law. Patients have the right to receive information and ask questions about recommended treatments so that they can make well-considered decisions about care.
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Informing a patient’s family that the patient has died, is a duty that is fundamental to the patient-physician relationship; In this process, physicians should give foremost attention to the family’s emotional needs and the integrity of the patient-physician relationship.
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Confidentiality

Physicians have an ethical obligation to preserve the confidentiality of information gathered in association with the care of the patient. With rare exceptions, patients are entitled to decide whether and to whom their personal health information is disclosed.