Ethics and Law

Question 1

How do you verify death?

Answer 1

1. Check for response (verbal and pain)
2. Carotid pulse
3. Heart sounds (2 mins)
4. Breath sounds (2 mins)
5. Pupils fixed and dilated
   DOCUMENT

Question 2

How do you fill out a cause of death?

Answer 2

1a) The thing that directly caused death eg haemorrhage
1b) The thing that led to the direct cause of death eg. diverticulitis
2) Any contributing diseases

Question 3

What can you not record as a cause of death?

Answer 3

Giving these as the sole CoD:
Cardiac arrest
Any of the failures
Old age

Question 4

When should a death be referred to the coroner?

Answer 4

• Unknown cause of death
• Sudden or unexpected death
• Deceased not seen by doctor within 2 weeks of death
• Suspicious circumstances
• If the death may be due to accident, harm, suicide
• Related to employment
• Related to abortion
• Occurred during an operation or under anaesthesia effects
• During or shortly after being in police custody
• While detained under MHA
• During pregnancy or within 12 months of pregnancy

Question 5

To sign a cremation form you must:

Answer 5

• Have seen the patient before or after death eg. been the treating physician
• Have examined the patient

Question 6

To certify a death you must:

Answer 6

• Be a qualified doctor
• Have seen the patient in the last 2 weeks of life and been involved in their care (eg. treating them during hospital admission that led to death)

Question 7

If a patient dies following an episode of chest pain and has a history of ischaemic heart disease, but no investigations were carried out, what should be done?

Answer 7

Refer to the coroner. It is not possible to say definitively what the cause of death was eg. MI? PE?

Question 8

T/F. Deaths involving any substance must be reported to the coroner

Answer 8

False. Deaths involving alcohol or tobacco do not need to be reported, but deaths involving any other drugs must be.

Question 9

When can an autopsy be performed?

Answer 9

1) Consented/’hospital’: if the family and Drs agree, to confirm cause of death, check response to treatment, for learning, etc.
2) Medicolegal: any of the requirements for coroner review.

Question 10

Which legislation oversees the use of body parts/cadavers?

Answer 10

Human Tissue Act 2004

Question 11

What are some reasons for breaking confidentiality?

Answer 11

• Doing so is in the best interests of the patient or society (eg harm to others)
• Statutory requirements eg. Road Traffic Act 1988, Prevention of Terrorism Act 1989, Public Health Act 1984
• Public interest

Question 12

What occurs after a death? Describe the process

Answer 12

• Treating doctor verifies the death
• Doctor fills out the MCCD and discuss with the medical examiner
• Depending on death, may go to the coroner for autopsy