Doctor (hospital)

Care provided after death

Doctors of all grades who work in hospitals have a key role in caring sensitively and compassionately for patients and supporting their relatives when death occurs and in the immediate period afterwards. Doctors often break the bad news to relatives, explain the cause of death and discuss organ donation and post-mortem examination where appropriate. They record information about the death in the patient’s health record and inform the patient’s GP and other health care services and agencies that the patient had died.

They are also responsible for a number of steps that allow legal registration of the death and a funeral to take place:

  • Verifying life extinct: (verification of death, pronouncing death, confirming death) is the first step
  • Completing the medical certificate of cause of death: is a statutory legal duty of a doctor who has seen and treated the patient in the last 28 days for a natural illness that caused their death. The MCCD is presented at a local council office by the family in order to have the death registered and a death certificate  issued
  • Reporting a death to the Coroner: a doctor has a duty to report any death to the Coroner if it resulted, directly or indirectly, from any cause other than natural illness or disease for which the patient had been seen and treated within 28 days of death
  • Completing Cremation Certificate: for a cremation to take place the signatures of 2 doctors are required on cremation documentation

Works Alongside

  • Relatives
  • Medical and surgical colleagues in other specialties and services
  • Nurses
  • Pathologists
  • Mortuary Technicians
  • Ambulance service
  • Coroners Service/PSNI
  • Clinical Coding Team
  • Administration/secretarial staff
  • Clinical governance colleagues supporting processes in relation to clinical audit,  case review and reporting death

The standard of bereavement care is enhanced when:

  • Good communication is received by the doctor about the death/imminent death especially during shift changes and handover from ‘hospital at night’ teams
  • Information about the death is shared with other members of the team who can provide support, advice and information to the bereaved
  • Follow up appointments are offered to relatives to explain further the cause of death, post mortem examination results etc.
  • Medical certificates of cause of death and cremation certificates  are completed as soon as possible after death to allow families to progress funeral arrangements in keeping with cultural norms
  • Staff in the Coroners Service, for example the Medical Advisor, are available for guidance when a death is reported
  • Healthcare organisations have training, supervision and support systems in place for doctors
  • Departments facilitate remembrance events for relatives that doctors can attend

Standards and Guidelines