Ethical and socio-cultural aspects of autopsy in biomedical settings in low and middle- income countries

Complete diagnostic autopsies (CDA) remain the gold standard for determining cause of death, but performing them in low- and middle-income countries (LMICs) is challenging. Facilities are inadequate, skilled staff scarce and public acceptance low. A minimally invasive autopsy (MIA) procedure involving organ-directed sampling has been proposed as an alternative. Oxford University Clinical Research Unit (OUCRU) is evaluating the use of MIA in Vietnam, but the method’s ultimate effectiveness will depend on its public reception. The public view on post mortem examinations and consent for them are complex and under-researched. 

I will use interviews, focus groups and participant observations to assess the practice and perceptions of autopsy in Vietnam and Nepal. I will investigate socio-cultural factors surrounding these perceptions and explore ethical barriers preventing autopsy uptake. I will try to determine whether MIA may be more acceptable than traditional forms of post mortem. 

I will then work alongside clinicians to develop more culturally sensitive and appropriate methods of obtaining consent to autopsy.