Death - the final complication

Good Medical Practice: A Code of Conduct for Doctors in Australia

AHPRA provide a code of conduct for practitioners by which practitioners are judged in the event of an incident. The following is a direct quote from that code:

3.12 End of life care

3.12.10 Communicating bad news to patients and their families in the most appropriate way and providing support for them while they deal with this information.
3.12.11 When your patient dies, being willing to explain to the best of your knowledge, the circumstances of the death to appropriate members of the family and carers, unless you know the patient would have objected.

8.8 Medical reports, certificates and giving evidence:

  • Your community places trust and authority in you to sign documents such as death certificates.
  • You should complete these honestly, accurately and verify the content and opinions to the best of your knowledge.

Medical Certificate of Cause of Death

  • Take this very important document very seriously.
  • Contact the Coroner’s office or MIPS if you need clarification.
  • Write a certificate if you have an opinion regarding the cause of death from reading the medical records or talking to other practitioners (even if you have never seen the patient or the body).

Please note: Treat a deceased patient’s medical records with confidentiality when it comes to a family request ensuring there is permission of the Executor of the Estate.

Reporting deaths to the Coroner

Requirements for reportable deaths vary in each jurisdiction. Scenarios include situations where:

  • the death was unexpected and the cause is unknown
  • the death was violent or unnatural
  • the death occurred during or as a result of an anaesthetic
  • death of an infant under one year old
  • the person was ‘held in care’ or in custody immediately before they died
  • The identity of the person who has died is unknown
  • a doctor is unable to sign a death certificate giving the cause of death.

If in any doubt ring your State’s Coroner office for advice.

Death the final complication graph 

Your duty to the Coroner

  • You must assist the Coroner and meet requests for information in a timely manner.
  • Send a copy of the medical records to the Coroner – keep originals safe.
  • You may be required to provide a statement addressing issues specified - advise your hospital/employer and MIPS to obtain advice and assistance.
  • You may require legal representation for an inquest.
  • Doctors or a health service may become an ‘interested party’ to the investigation, in which case the Coroner’s office will contact you and request information (records and or a statement).
  • As a treating doctor, request a copy of the completed Coroner’s report.

FAQs

  1. Can I view the records? Yes, it is recommended you access them before signing a certificate.
  2. Can I speak to other practitioners? Yes this is recommended.
  3. How long can I take to decide? In most states – 48 hours.
  4. I haven’t seen the deceased recently… There is no requirement except in the:
  5. I haven’t seen the body… There is no requirement if you have been treating the patient however it’s prudent to do so if possible. 
  6. I don’t know the exact cause of death although I know it was natural causes. You must form an opinion as to the probable cause of death. 
  7. The deceased wasn’t my patient. I have never seen them. There is no requirement for you to have treated the person. However, extra care is required to obtain necessary evidence for you to consider the cause.
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References

Medical Board of Australia

Codes, guidelines and policies: medicalboard.gov.au

Dental Board of Australia

Policies, Codes, Guidelines and FAQ: dentalboard.gov.au

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The materials provided are for educational purposes only. Whilst all reasonable care has been taken in preparing these materials, including the accuracy of the information supplied, MIPS does not accept any liability whatsoever arising out of the use or reliance of the information provided. Contact MIPS 24/7 Clinico-Legal Support 1800 061 113 or education@mips.com.au for specific advice.