Certifying and registering death Flashcards
Definition of death?
“Death is the irreversible loss of the capacity for consciousness, combined with the irreversible loss of the capacity to breathe.”
There is no definition in law
There is a concept of “brain stem death” - “the irreversible cessation of the integrative function of the brain stem equates w/ death”.
What is the law regarding registering a death?
A REGISTERED MEDICAL PRACTITIONER w/ license to practise signs a certificate in the prescribed form stating to the best of his knowledge & belief the cause of death
Who else can certify the death?
Any registered medical practitioner e.g. paramedics, doctors or nurses - Births and Deaths Registration Act, 1953.
Usually the Doctor who attended the patients last illness
- This is no longer required due to Corona Virus act.
- So long as the doctor was involved in the last 28 days of care they can certify death.
Lead consultant has ultimate responsibility
If you cannot fulfil above, must refer death to HM coroner
What is the purpose of a death certificate?
Enables family to register death
Provides explanation of how/why patient died
informs research into health effects of exposure to a wide range of risk factors
Helps w/ census data
What does death certificate look like?
Familiarise yourself!
How to complete cause of death section?
1a- immediate, direct cause of death
1b- go back through sequence of events/ conditions that led to death/ main cause (1a)
1c- conditions/events that lead to 1b
2 - Other significant comorbidities that didn’t cause death.
If completed properly- condition on lowest completed line of par 1 will have caused all of the conditions of lines above it.
June Morbid- 87y old lady who suffered w/ advanced Parkinson’s disease & has been admitted 4 days earlier w/ aspiration of pneumonia which did not respond well w/ treatment. Mrs Morbid peacefully passed away last night. How to fill birth certificate?
1a- Aspiration of pneumonia
2- Parkinson’s disease
What to avoid for causes of death?
Avoid old age alone
never use natural causes alone
avoid organ failure alone
avoid terminal events, modes of dying & other vague terms i.e. terms that do not identify a disease e.g. cardiovascular event- could mean stroke or myocardial infarction
What is the role of medical examiner?
Independent senior doctors whose role is to ensure the death certificate accurately reflects the cause of death
- All deaths will be subject to either medical examiner scrutiny or coroner’s investigation
Agree the proposed cause of death & accuracy of the death certificate
Discuss the cause of deathw/ the team & establish if there are any questions or concerns about care before death.
Inform local mortality arrangements.
Answer any questions families have
What is the role of the HM coroner?
They are independant Judicial Officers of the Crown - all new coroners are lawyers.
They find out who, how, where & when someone died
They can order a post mortem if the cause of death is unknown.
What should be reported to the HM coroner?
Identity of person unknown
Unexplained death
Recent surgery before death
No attending doctor abled to complete certificate of death
Violence, trauma or injury
Self-harm
Neglect
Undergoing treatment or procedure of a medical nature
Injury or diseased to employment
Poisoning
Exposure to toxic substance
Death in custody or state detention
Suicide
What are the 2 methods of getting a post mortem?
1- coroner orders it to try & determine cause of death
- does not need consent from family
- Must be done by a suitable practitioner as soon as possible.
- coroner must release body as soon as possible, usually 28 days.
- If post mortem confirmes natural causes of death, inquest isn’t needed.
2- agreed upon by hospital & family to gain fuller underrstanding of deceased’s illness or cause of death &/or to enhance future medical care
Either way, needs to observe the Human Tissue Act, 2004 !!!
What is an unnatural death?
No legal definition but needs a suspicion of foul play or other wrong doing.
E.G.
- medical treatment for an non-fatal condition that leads to death.
- respiratory diseases linked to asbestosis because of employment.
- violent death e.g. RTC, fall, struck by lightning, deliberate killing or assult leading to death.
E.g. pneumonia caused by long period of immobilisation following a fall which results in fractured hip- unnatural death
elderly person died due to hear failure because heart muscle has aged & deteriorated- natural death
What is the purpose of an inquest?
- NAME of deceased
- HOW, WHEN & WHERE they died.
- The MEDICAL CAUSE of death as required by the death certificate.
- Verdict- conclusion
The inquest is about fact finding not appotioning blame.
Who can attend an inquest?
Public & press
Coroner decides who they want to give evidence.
Relatives (can also be legally represented)
Trust solicitors represent staff.
