Ethics Consult: Tell the family about Corpse Mix-Up at the morgue?

Welcome to Ethics Consult – an opportunity to discuss, debate (respectfully) and learn together. We choose an ethical dilemma from a true but anonymous patient care case. You are voting on your decision in the case, and next week we will reveal how you all made the call. Bioethicist Jacob M. Appel, MD, JD, will also consider an ethical framework to help you learn and prepare.

The following case is customized from Apple’s 2019 book, Who says you’re dead? Medical and ethical dilemmas for the curious and concerned.

The morgue at a community hospital serves the anatomy lab at a nearby medical school. Every year, dozens of dying patients in the hospital – often retired doctors and nurses – agree to donate their bodies for dissection of first-year medical students.

Loretta Scarpetta, MD, chief pathologist, is taking leave. She leaves her assistant, Hans Minoret, MD, in charge of the morgue while she’s away. When she returns, she reviews Minoret’s work and discovers that a terrible mistake has been made: the body of a patient (“Jed”), who was to be sent to the family for cremation, was actually sent to the anatomy laboratory for dissection, while a corpse donated to the laboratory (“Bud”) was instead released to a funeral home.

The defect occurred over 3 months earlier and Jed’s body has already been embalmed in formaldehyde and dissected by medical students. Bud’s body has probably been cremated. Scarpetta fears that the revelation of the morgue’s mistake, which is now irreversible, will cause unnecessary and possibly extreme distress to the surviving family members. In contrast, if she hides the error – and changes the records – there is no way they will ever know.

Jacob M. Appel, MD, JD, is director of ethical education in psychiatry and a member of the Institutional Audit Committee at the Icahn School of Medicine at Mount Sinai in New York City. He holds an MD from Columbia University, a JD from Harvard Law School and a Bioethics MA from Albany Medical College.

And check out some of our previous Ethics Consult cases:

Should Doc illegally help with suicide in serious circumstances?

Give heart transplant to death row inmates?

The Politician’s Medical Secrets Leaked?

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