Ethical and Legal Issues of Death

= • Legal issues surrounding death include issuing the death certificate, labeling of the deceased, autopsy, organ donation, and inquest.

• By law, a death certificate must be made out when a person dies. It is usually certified and signed by the attending physician and filed with a local health or other governmental office. The family is usually given a copy to use for legal matters, such as insurance claims.

• Nurses have a duty to handle the deceased with dignity and label the corpse appropriately. Mishandling can cause emotional distress to survivors. Mishandling can create legal problems if the body is inappropriately identified and prepared incorrectly for burial or funeral.

In circumstances of unusual death, an autopsy (postmortem examination) may be required.
Nurses have a responsibility to be aware of the legal ramifications of death in the jurisdiction in which they practice.

Death and Dying

Concept of death is developed over times, as the person grows, experiences various losses, and thinks about concepts. Humans move from a childhood belief in death as a temporary state, to adulthood in which death is accepted as very real but also very frightening, to older adulthood in which death may be viewed as more desirable than living with a poor quality of life.

Clinical Signs of Approach Death

Traditional clinical signs of death were cessation of the apical pulse, respirations and blood pressure, also referred to as heart lung death.

The new indications of death are:

Total lack of response to external stimuli

No muscular movement, especially breathing

• No reflexes

Flat encephalogram

In instances of artificial support, absence of electrical currents from the brain for at least 24 hours is an indication of death.

Another definition of death is, cerebral death, or higher brain death,

which occurs when the higher brain center, cerebral cortex in

irreversibly unconscious.