Knowledge and attitudes toward complete diagnostic autopsy and minimally invasive autopsy: A cross-sectional survey in Hanoi, Vietnam

Knowing the cause of death (CoD) plays an important role in developing strategies and interventions to prevent early mortality. In Vietnam, the CoD of the majority of patients who acquired infectious diseases remains unknown. While there are challenges that hinder the use of complete diagnostic autopsy (CDA) in practice, minimally invasive autopsy (MIA) might be a promising alternative to establish CoD in Vietnam. The current study aims to explore knowledge of and attitudes toward CDA and MIA in the wider population in Vietnam. The study was cross-sectional, using structured questionnaires that were disseminated electronically via several websites and as paper-based forms in a national level hospital in Vietnam. Descriptive analyses were performed and where appropriate, comparisons between the healthcare workers and the general public were performed. We included 394 questionnaires in the analysis. The majority of participants were under age 40, living in major cities and currently practicing no religion. 76.6% of respondents were aware of CDA and among them, 98% acknowledged its importance in medicine. However, most participants thought that CDA should only be performed when the CoD was suspicious or unconfirmed because of its the invasive nature. For MIA, only 22% were aware of the method and there was no difference in knowledge of MIA between healthcare workers and the wider public. The questionnaire results showed that there are socio-cultural barriers that hinder the implementation of CDA in practice. While the awareness of MIA among participants was low, the minimally invasive nature of the method is promising for implementation in Vietnam. A qualitative study is needed to further explore the ethical, socio-cultural and/or religious barriers that might hinder the implementation of MIA in Vietnam.