Death Pronouncement

Pronouncement of Death
The pronouncement of death is not a reserved medical act or a delegated medical function. There are no laws governing the event when death is expected nor are there laws defining who is qualified to pronounce death in such circumstances. An unexpected death must be reported to the coroner, pursuant to s.9(1) of the Coroners Act.

The completion of a Medical Certificate of Death is the legal responsibility only of a physician or a coroner.

Pronouncement of death is undertaken in practice and by custom to formalize the occurrence of death, and is done to reassure relatives and the public that a patient is, indeed, deceased before being treated as such. The actual pronouncement can be reassuring to the family and can contribute to the dignity of the end of a person’s life. The skills to pronounce death are not exclusive to physicians. Other regulated health professionals may also possess the requisite skills.

Physicians are advised to ensure that longterm care facilities, palliative care units and hospices with which they are associated develop policy and procedures with respect to pronouncement of death when death has been expected.

Increasingly, patients with terminal illnesses are being cared for in their own home, rather than being hospitalized. In those circumstances where death is expected, physicians should provide specific guidance to the family and/or caregivers as to how to proceed when life has ceased. The Joint Protocol for Expected / Planned Home Deaths in British Columbia clarifies the process and procedures involved in managing anticipated natural home deaths in the context of terminal illness.