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Tess Vigeland: We had a segment on taxes a few minutes ago. And now, death. In 1985, autopsies were performed on 14 percent of the 2 million deaths that year. Because of hospital cutbacks and slimmed-down insurance coverage it's dropped to about 10 percent. For many families, answers and results now come at a price.
Marketplace's Caitlan Carroll prepared this report.
Vidal Herrera: OK, this is where we place the bodies here. And we actually use this wall here as leverage.
Caitlan Carroll:Former crime scene investigator Vidal Herrera walks around the cold, white-tiled room where he and his staff perform autopsies. Herrera's not at a hospital. He runs his own private autopsy company in Los Angeles. He says families come to him looking for answers.
Herrera: I mean, the definition of autopsy is seeing for oneself. You can never . . . an X-ray can't ever cover everything. You have to feel it, smell it, touch it yourself.
Most people assume that hospitals routinely perform autopsies. In fact, if the death was not suspicious or unexpected, say cancer or a heart attack, an autopsy typically won't be performed.
You can pay a coroner's office to perform an autopsy. In Los Angeles, it costs more than $6,000. There's also a handful of private companies around the country that usually do the procedure for less. At Herrera's 1-800-AUTOPSY, he charges families around $3,000.
Herrera: I think what they're basically looking for is honesty, an answer. What happened? Please tell me what happened.
Marcella Adams called Herrera after her mother died. Her mother was being treated for circulation problems at the hospital. She was given medication and had a terrible allergic reaction. Adams believes that contributed to her mother's death. Now she wants to sue the hospital for malpractice. And she's counting on the autopsy to be a key piece of evidence.
Marcella Adams: Look. Look at what happened there. See.
Adams displays the graphic photos of her mother's body. The pictures show large lesions in her skin that Adams says are part of the allergic reaction.
Adams: The pictures are very revealing and then when you add the pictures to the autopsy, to the results, you know, it's so clear.
Autopsy pictures can be gruesome. And the process is invasive. Pathologists remove the organs and take tissue samples. Herrera says that level of detail is necessary because, like Adams, many of his clients use the results in court cases. But he says it's still the hospital that determines cause of death.
Herrera: Because we cannot officially give "This is what the cause of death is" because our doctor is not the attending physician. Many, many times we find a different cause of death and the doctor will give his opinion.
Even if there's no dispute over the cause of death, autopsies be a good source of important information. The head of Johns Hopkins University Pathology division, Dr. Barbara Crain, says many families order autopsies not only to understand the past but also to see into their own medical future.
Barbara Crain: For example, did a patient with cancer also have significant coronary artery disease? Were there other diseases such as Alzheimer's disease that might have implications for other family members in the future?
Before ordering an autopsy, Crain advises families to decide what questions they want answered. She also says it's better to talk early with family members about autopsies.
Crain: Those are very hard things to bring up. In some ways they're easier when people aren't sick, so that there's not so much emotion involved.
And there isn't much time to decide on an autopsy. It must be performed within about 72 hours of death. When it comes to private autopsies, there isn't a lot of information to go on. The National Association of Medical Examiners has a list of private autopsy providers but it doesn't make endorsements.
Families should keep in mind an autopsy may not answer all of their questions. But Crain still sees the search for answers in an autopsy both as a necessary quality control for hospitals and a way for families to put their concerns to rest.
In Los Angeles, I'm Caitlan Carroll for Marketplace Money.