Sci Eng Ethics DOI 10.1007/s11948-016-9760-7 LETTER

Consented Autopsy and the Middle-East Magdy A. Kharoshah1 • Syed Ather Hussain2 Mohammed Madadin3 • Ritesh G. Menezes3

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Received: 20 January 2016 / Accepted: 26 January 2016 Ó Springer Science+Business Media Dordrecht 2016

Abstract Consented autopsy is almost non-existent in the Middle-East where established social and cultural beliefs regarding the procedure might discourage family members from requesting a consented autopsy. Evidence suggests that new information is obtained from consented autopsies. It would not be in the best interest of medicine if social and cultural misconceptions succeed in erasing the existence of consented autopsies entirely. Keywords

Consented autopsy
Middle-East
Muslim culture

Introduction There has been a drastic decline in the number of consented autopsies across the globe in the last few decades (Turnbull et al. 2015). Consented autopsy is almost nonexistent in the Middle-East where established social and cultural beliefs regarding the procedure might discourage family members from requesting a consented autopsy.

Discussion In Muslim culture, performing an autopsy is considered inconsiderate, disfiguring and a violation of the dead body. Moreover, Islam demands that the time lag between death and burial of the corpse is kept as short as possible. Although the & Ritesh G. Menezes [email protected] 1

Forensic Medicine Centre, Dammam, Saudi Arabia

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Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan

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Forensic Medicine Division, Department of Pathology, College of Medicine, King Fahd Hospital of the University, University of Dammam, Dammam, Saudi Arabia

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Quran and Hadith are silent on the topic of autopsies, there is one Hadith which says ‘‘Breaking the bone of a dead person is similar (in sin) to breaking the bone of a living person’’ (Madadin and Kharoshah 2014). For decades, scholars have extrapolated the meaning of this Hadith to the context of autopsies and have argued that autopsies are forbidden in Islam. However, in the year 1952 the Head of the Islamic School of Jurisprudence in Egypt issued a ruling which asserted ‘‘necessity allows the forbidden’’ and thus granted permission for forensic autopsies in instances of unnatural deaths (Madadin and Kharoshah 2014). This eventually led to an official acceptance of consented autopsies by an Islamic Ruling Committee in the year 1982 as the procedure offered a better understanding of lethal medical diseases and promised substantial advancement in medicine (Al-Adnani and Scheimberg 2006). However, this shift in the religious mindset didn’t concomitantly uproot deep-seated social and cultural misconceptions regarding consented autopsies. This explains the non-existence of such a concept in some of these countries based on social customs. Disapproval of consented autopsy arises mainly from personal interpretations and anxiety, and so the best approach would be to counsel the family members and address their underlying concerns. Doctors should also be more flexible in adjusting the time duration of the autopsy to suit the family’s customs better. Strides in imaging techniques have significantly reduced the number of consented autopsies performed. But despite these advances research studies have discovered that new information is obtained in one-fourth of the autopsies (AlAdnani and Scheimberg 2006). It would not be in the best interest of medicine if social and cultural misconceptions succeed in erasing the existence of consented autopsies entirely. Funding No specific grant from any funding agency in the public, commercial, or not-for-profit sectors was received. Compliance with Ethical Standards Conflict of interest All the authors have no financial or non-financial competing interests.

References Al-Adnani, M., & Scheimberg, I. (2006). How can we improve the rate of autopsies among Muslims? BMJ, 332, 310. Madadin, M., & Kharoshah, M. A. (2014). Autopsy in Islam and current practice in Arab Muslim countries. Journal of Forensic and Legal Medicine, 23, 80–83. Turnbull, A., Martin, J., & Osborn, M. (2015). The death of autopsy? Lancet, 386, 2141.

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