The practices of teaching and performing procedures on recently deceased patients are controversial. The most important benefit of these practices is the fulfillment of the recognized need for hands-on practice for students and housestaff, as well as experienced physicians. 21 The setting of the recently deceased patient provides a unique clinical setting with literally no tangible risk to the patient. Following this rationale, physicians so inclined are able to perform these procedures competently on future, living patients, resulting in overall benefit to society. However, informed consent is rarely obtained or available in these settings. Some consider performing procedures without informed consent to be disrespectful, deceptive, or unethical.22
Until formal policies are developed by governing organizations in emergency medicine, emergency physicians must make the choices they judge most appropriate in the specific clinical situations encountered. Factors to be considered, when making such decisions, include the teaching benefit, to the student and his/her future patients, the overall benefit to society, invasiveness and disfigurement produced by the procedure(s), availability of the family and feasibility of informed consent, potential distress to the family, other potential avenues for teaching procedures, and any institutional policies on this issue.
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