Doc, why can’t you certify my mother’s death at home?

I recall a case some years ago, where I was called to certify the death of an elderly lady who was bedridden, with a previous history of stroke. She apparently passed away peacefully at home but there was a forehead bruise from a recent fall (this was made known to me by her family). …

Doctors can certify the death of patients who pass away at home if the cause of death is known, AND if the death is due to natural causes.

For patients who are have sufficient documentation regarding their medical history* (e.g. medical reports, discharge summaries, lab tests), certifying the cause of death can be quite straightforward. For example, patients under home hospice services generally have documentation of their condition in a file kept at home. In this case, one can work out and make an assessment of the likely cause of death.

The situation under which the patient passes away is also important, in order to decide if the death at home can be certified. Unnatural causes of death such as due to falls, injury (trauma), traffic accidents, medication errors, etc. cannot be certified, and requires the coroner to take up the case. There are clearly serious medico-legal implications for deaths occurring under these circumstances.

… I declined to certify the death of the above patient, explaining the proper procedures to the family. The family was understanding of the situation and agreed that it was best to inform the police in order that proper protocol be followed…

 

 

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