Medico-Legal Management of The Deceased Flashcards
The Legal Implications of Death
The death of a person has many other legal implications, including in Criminal law, Inheritance Law, Business Law, and Common Law.
The “administration” process of the death of a person starts with the notification of the death at the Department of Home Affairs (DHA), regulated by the Births and Deaths Registration Act (51 of 1992).
Legal duties under the the Births and Death Registration(BDR) Act
The BDR Act places specific duties on medical practitioners concerning the notification of death, especially for their patients.
These duties are in terms of two specific situations;
- Attended Deaths
- Non-Attended Deaths
Attended Deaths
An attended death is the death of your patient, there is no time limit in place
In effect, this means that the history, medical condition, complications, management, and current condition of the person who died are known to you because you are his/her doctor.
This would include the death of your;
- In-hospital patient, and/or
- Patient if you are their regular general practitioner.
Non-Attended Deaths
The deceased is not your patient and is not known to you.
This would include death notifications of persons without a medical practitioner
Duties that the BDR Act places you in terns of the notification of Deaths
There are two types of duties that practioners have in terms of the notification and of death and they are:
- Duties in terms of attended deaths
- Duties in terms of non-attended deaths
Duties in terms of attended deaths
The attending practitioner has a legal duty to complete the death notification:
- Without delay, and
- Without compensation, and
- With a cause of death.
Duties in terms of non-attended deaths
The medical practitioner has a choice to complete the death notification:
- With or without compensation, and
- With a cause of death.
What is required from the Practitioner in completing the Death Notification Form.
He/She must ascertain a probable cause of death (COD), to the best of their “knowledge and
belief”.
This COD is determined using:
i) the available history (including chronic and recent medical history) and
ii) a post-mortem examination of the deceased.
This underlying COD is noted on the Death Notification Form.
What is a Post-Mortem Examination(PME)
A PME is an examination of the deceased’s body for various purposes including that which are contemplated in the BDR and Inquests Acts.
It includes;
i. Consideration of the available information, and
ii. The external examination of the body of the deceased.
A PME may or may not include an autopsy and special investigations under specific conditions.
What is required from the practitioner in noting the Cause of Death(COD)
He/She must ascertain a preliminary manner of death i.e. if the COD is from Natural Causes or “Other than Natural Causes”.
This will determine if an inquest should be opened to investigate the death circumstances.
The basic determination of the preliminary manner of death is:
Natural causes of death:
All causes of death that are attributed to intrinsic factors including hypertension, cancers, etc.
Other than Natural causes of death:
All causes of death that are attributed to extrinsic factors including all deaths where someone could be held liable for the death.
Regulations Contained in the Natural Health(NH) Act
It is not always easy to determine the preliminary manner of death. This determination
has far-reaching implications.
An unnatural death could be wrongly classified as
natural, the body then cremated, and as such, all evidence would be lost.
The regulations in the NH Act state which causes of death should be considered as “other than natural”, and as such should be referred for a medico-legal post-mortem
examination.
According to the NH Act 61 of 2003,which causes of deaths should be referred for a medicolegal post-mortem examination
- External physical or chemical influences:
Physical influences like GSWs, sharp & blunt force injuries, falls, drowning, lightning
Chemical influences like poisons, recreational drugs and medical drug overdose or side effects
- Acts of omission or commission:
Omission or act where a legal duty existed to act
May otherwise seem to be a natural death
- Procedure-related deaths
- Sudden and unexpected, or unexplained deaths
Deaths under the above circumstances should be considered as “Other than Natural Deaths”, with no distinction between attended and non-attended death notifications.
These deaths need to be investigated as regulated by the Inquests Act.
Legal Duties under The Inquest Act
The Inquests Act places specific duties on all citizens of South Africa, including medical practitioners, to report any suspicious or “other than natural” deaths to the SAPS.
As such, when a Notification of Death is done, regardless of attending circumstances, a death should be reported to the SAPS if the death is suspicious or if due to any external factor.
What Duty does the Inquest Act Place on you in terms of the Death of a Person
The Inquests Act places specific duties on all citizens of South Africa, including medical
practitioners, to report any suspicious or “other than natural” deaths to the SAPS
