https:\/\/people.com\/pathologist-arrested-after-remains-of-more-than-30-unborn-babies-found-in-garden-11997776<\/a><\/p>\nThere seems to be a paradoxical view of this kind of thing today, both with fetal and “regular” remains.\u00a0 It has always been a vexing issue.\u00a0 I’m going to assume that these fetuses are from abortions, commonly called “Products of Conception” here in the US.\u00a0 They are evaluated by a surgical pathologist to make sure there’s not some problem like a molar pregnancy, and then usually disposed of as biological waste.\u00a0 At least that’s what happened the last time I looked at them many years ago.\u00a0 So there’s a bit of a paradox here.\u00a0 These fetal parts probably would just be incinerated and disposed of had they remained at the hospital, but now it’s an outrage that they were buried.<\/p>\n
It’s not as simple as that, of course.\u00a0 There are the issues here of medical information,\u00a0 privacy, etc.\u00a0 Her actions if the presentation in the news article is correct, is pretty outrageous.\u00a0 It’s not clear what this pathologist was doing, after all.\u00a0 I presume she’s a surgical pathologist and not a forensic pathologist.\u00a0 And, miscarriages are often treated differently than abortion remains.\u00a0 Some parents want a full burial for a stillbirth, and God bless them for it.\u00a0 But I am a bit bemused at the attitude that it’s an outrage that these products of conception were not treated with respect when they are classified as waste at he hospital and there’s no outrage about that.\u00a0 Nobody outside the pro-life community seemed to be concerned with the way Planned Parenthood treats fetal tissues.<\/p>\n
Ah well.<\/p>\n
In Forensic Pathology, there are problems that come and go.\u00a0 Back when I was in training four decades ago, we did not return organs to the body following an autopsy.\u00a0 Instead, they were collectively put in large 55 gallon drums.\u00a0 Once a month, a priest would come by and say words over the drum, and it would be sent out for cremation and disposal as waste.\u00a0 Nobody seemed to have a problem with it.\u00a0 Then, some time in the 1990s or so, people started getting upset about it and demanded that the organs be buried with the body.\u00a0 That’s not a problem for an ME office in general, though it’s a technical issue for the embalmer; since the blood vessels to the organs are cut, they can’t infuse the organs with preservative as easily.<\/p>\n
The only time it becomes an issue is when we need to retain an organ for extra studies.\u00a0 This happens most commonly with brains retained for formal neuropathologic evaluation, since these brains usually have to be fixed in formalin for 1-2 months before examination in order to make them firm enough to work with. It turns out that dissecting a brain “fresh” is very inexact because of the soft and rather mushy texture of the brain.\u00a0 It’s OK for big things like big hemorrhages, huge tumors, burst aneurysms, and such.\u00a0 But it’s simply not sufficient if you have suspicion of a small, but significant lesion.\u00a0 And, for some more esoteric diseases, it may be useful to ask a neuropathologist with special training in looking at brains to take a look. That means that the body has been long been buried or cremated by the time we are done with the organ.\u00a0 \u00a0Moreover, a normal pathologic evaluation of a fixed brain is pretty destructive.\u00a0 The brain is sliced into small slices and then portions are further cut out for special processing.\u00a0 The fixed brain slices frequently fracture into pieces upon handling.\u00a0 Thus, at the end of the procedure, there’s not a brain-looking brain, but a jar of brain pieces.\u00a0 The procedure I’ve seen for dealing with this varies from jurisdiction to jurisdiction.\u00a0 Most of the places I know of treat these pieces a medical waste — they are incinerated and disposed of.\u00a0 However, I have heard of offices that contact the family and ask if they want the jar. I’ve seen that happen a couple of times personally; both times the family said to dispose of it.<\/p>\n
Another organ that is sometimes, but less often, retained is the heart.\u00a0 The results of analysis are similarly destructive.\u00a0 \u00a0Many years ago, I retained a heart for external consult with an outside cardiac pathologist.\u00a0 I noted that I had sent it out for consultation in my report.\u00a0 The wife of the decedent called and was outraged that her husband was buried without her heart.\u00a0 I talked to her for a couple of hours that day, trying to get her to understand why it was important that someone with more expertise in cardiac pathology than I look at the organ.\u00a0 She was crying and profoundly agitated.\u00a0 Then in passing, as I was going through my procedure, I said that I put a portion of the apex of the heart into the bag of organs which was returned to the body.\u00a0 She immediately settled down.\u00a0 It wasn’t important to her that the *entire* organ was returned to the body, just part of it.\u00a0 So, we ended the call on amicable terms.\u00a0 Go figure.<\/p>\n
During the 2000s, this concern seemed to peak, with some state-level laws being proposed to enforce return of things to the next of kin.\u00a0 Then, in the past decade or so, the issue seems to have waned.\u00a0 Some places I’ve heard of, mostly outside of the US have taken this to an extreme, insisting that blood that passively drained from the body be collected and returned, and that even such things as histologic slides and paraffin blocks be returned.\u00a0 I don’t see how that would be workable, since slides and blocks can be important in trial years after the death.<\/p>\n
There’s a balance to be maintained, of course.\u00a0 We as Forensic Pathologists always want to be respectful both to the dead and to the families of the dead.\u00a0 There’s an old joke among physicians that pathologists become pathologists because we don’t like to deal with people.\u00a0 The opposite is true for us in forensics.\u00a0 We spend hours and hours talking to families, lawyers, police, etc.\u00a0 Part of our training is how to deal with issues regarding our cases in a way that is frank and complete, but also respectful and compassionate.\u00a0 With respect to retaining tissues, we want to be as accommodating as possible to the wishes of the next of kin, but at the same time, we must be able to do the analyses we need to do.\u00a0 It is inevitable that there will be tension between these two needs on occasion.<\/p>\n","protected":false},"excerpt":{"rendered":"
Here’s a story of a Polish pathologist who was discovered to have been taking fetuses from the hospital to her…<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-2822","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"_links":{"self":[{"href":"https:\/\/wordpress.forensicpath.us\/index.php\/wp-json\/wp\/v2\/posts\/2822","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/wordpress.forensicpath.us\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/wordpress.forensicpath.us\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/wordpress.forensicpath.us\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/wordpress.forensicpath.us\/index.php\/wp-json\/wp\/v2\/comments?post=2822"}],"version-history":[{"count":4,"href":"https:\/\/wordpress.forensicpath.us\/index.php\/wp-json\/wp\/v2\/posts\/2822\/revisions"}],"predecessor-version":[{"id":2826,"href":"https:\/\/wordpress.forensicpath.us\/index.php\/wp-json\/wp\/v2\/posts\/2822\/revisions\/2826"}],"wp:attachment":[{"href":"https:\/\/wordpress.forensicpath.us\/index.php\/wp-json\/wp\/v2\/media?parent=2822"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/wordpress.forensicpath.us\/index.php\/wp-json\/wp\/v2\/categories?post=2822"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/wordpress.forensicpath.us\/index.php\/wp-json\/wp\/v2\/tags?post=2822"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}