If a family member has passed away, you may be wondering if a doctor needs to confirm the death. Find out more about verifying and certifying a death in the UK.
Shropshire Funerals are independent, family-run funeral directors based in Oswestry, Shropshire. Our trusted team of experienced funeral directors are here to guide you through each step at difficult times.
Who can verify death?
The British Medical Association, also known as the BMA, guidance is as follows on this subject:
UK Laws
A doctor is not necessary in order to confirm that a death has occurred.
A doctor is not necessary in order to view the body of a deceased person.
A doctor is not necessary in order to report the fact that a death has occurred.
This means that a doctor's legal duty is to notify the deceased's cause of death, not the fact that the death has actually taken place. Doctors, nurses, professionally trained ambulance clinicians, and community care members can confirm that a death has taken place.During the time of the COVID-19 pandemic, the BMA issued a protocol for the remote verification of death.
This protocol enables people who are not medically trained to verify death under the guidance of a trained doctor. The recommended method for this is to use a mobile phone that has a camera installed. There is absolutely no legal obligation for a doctor to either see or examine a deceased's body before they sign a death certificate. This applies across the whole of the United Kingdom.
Should a GP visit?
When it comes to death in the community, the British Medical Association's advice is that if an expected death occurs in a community, then a doctor needs to visit the location as soon as possible.
Although, the doctor needs to prioritise the urgent needs of the living.
When an unexpected death occurs, the British Medical Association recommends a visit by the GP with whom the deceased was registered so that the body can be examined and the death can be confirmed.
Although, this is not a statutory requirement. Some of the British Medical Association's advice on this topic has changed since the start of the COVID-19 pandemic.
The BMA now acknowledges the concern of many doctors that their attendance to cases where the death is very clear, as well as expected, and the verification could have reasonably been performed by someone else either with support from a remote source or independently can create unnecessary risk.
The whole process of attending a community to verify a death draws the professional's attention away from providing care to incredibly sick people who arguably need the care more, as well as creating a lot of additional unnecessary risk of COVID-19 to themselves, their patients, and the people who were looking after the recently deceased.
How to verify death
In order to determine whether or not death has taken place, a very detailed physical examination needs to be carried out. The result of the first inspection should be the body's extreme pallor, especially in the lips and the face, as well as the relaxation of all the facial muscles. This will lead to the body's lower jaw dropping and the eye's staring openly unless, of course, the eyes have been closed.
Any further examination should confirm the following:
- No palpable pulse
- Zero heart sounds on auscultation, or asystole using ECG
- No observable respiratory efforts
- No sound of breathing during auscultation
- Pupils are dilated and not reacting to light
It is important if death is completely unexpected that an external examination of the deceased, and their surroundings, needs to be made. This needs to be done to ensure that there are no apparent factors that are relevant to the deceased's death. For example, vomit, blood, wounds on the body, nearby weapons, alcohol, medication, drugs, notes, and more.
Other signs of death can include:
- No response to painful stimulation
- Zero corneal reflexes
- The cornea has become cloudy
- Rigor mortis may have begun to set in, this will usually occur around three hours after the death
- A much lower temperature. This can depend on the location's ambient temperature, so it may not occur for up to around eight hours
The exact moment of the person's death can be incredibly difficult to recognise, and for a small period of time, after all, respiration has stopped, and the heart has stopped, the individual can still potentially be resuscitated. Under particular conditions, a patient can appear dead if they have not been examined fully.
This is described below:
- Following any prolonged submersion in cold water
- Following the ingestion of any drugs or alcohol
- When either in a coma or hypoglycemic
Verifying and certifying a death
The process of verifying a death involves doing specific checks to ensure that the person has died. If the person has died in their home, then this is commonly done by either a senior nurse or a GP.
If a healthcare professional is already with you and the deceased, then they may be able to verify the death themselves.
If they are not, then you will need to contact the GP practice. They will be able to advise you on what you need to do next.
If a person dies in the evening time, at night, on a bank holiday, or at the weekend, then if you call the GP, then you will be given a number that will get you in contact with a doctor.
If a nurse or a different type of healthcare professional is present when the death takes place, then they should be able to check the person's care plan in order to see exactly what needs to happen next.
Some nurses are trained so that they can verify a death in a person's home; if they are not able to do this, then they will assist you in contacting a GP.
Getting a medical certificate
After death has taken place, a doctor will be needed to certify the death, This is commonly done by a doctor who has seen the person recently. The doctor will complete a medical certificate of cause of death if the death was expected, and they are certain that the death was from natural causes. They will also pass on a "notice to informant".
This will be attached to the medical certificate of cause of death. This will tell you how to register a death. During the current and ongoing coronavirus pandemic, the process for registering a death has changed slightly from how it was before.On some occasions, a GP will need to certify and certify a death at the same time.
Although, if the person who is verifying a death cannot certify it, then you will have to get a medical certificate of cause of death on the following day from a doctor. If at this point, the body is with a funeral director, then the doctor will see the body there.Next, the GP may need to report the death to the coroner.
Commonly this is done when the death was either unexpected, sudden, or if the death was related to the individual's job in some way. If the death is reported to the coroner, then try not to worry. The coroner may then decide that the deceased's cause of death is clear and that no further investigations are needed.
On the other hand, they may investigate when and why the death took place, as well as potentially do a post-mortem. If you have any concerns relating to this process, then contact the coroner's office to find out what will happen next.The medical certificate of cause of death is the document that you need to take to your local council's registrar's office. The local council is where the death occurred. You can find out details about the local register offices on the government website.
Getting support
Support from a nurse
If you have a nurse or a different type of care professional in the home when the individual dies, then you can tell them if you would rather that they stay. If they do have to leave, then you can try to arrange for a different professional to come to the home and be with you. If you would prefer for the nurse to leave and to be alone, then this can be done too.
If someone dies at a hospice or hospital
Both hospitals and hospices will have their own arrangements for both certifying and verifying a death. They will issue the medical certificate of cause of death and then give you all the information about how to register the death of your loved one.
A member of the staff should offer you advice about contacting a funeral director, although depending on the situation, they may not be able to recommend a specific company to you. You can also ask the member of staff about what you can do next if you are not planning on using a funeral director.
If someone dies abroad
This is a completely different process from when someone dies in the UK. We would recommend asking your local government about this process.
If a post-mortem is needed
If the death of the individual is reported to the coroner, then they may decide that a post-mortem is required. This is an examination of a body with the end goal of finding out what was the deceased's cause of death. A post-mortem is done by a pathologist who will be working for the coroner's office.
Once the pathologist has made a conclusion on the cause of death, the coroner will send out a form to the registrar that states the cause of death. They will also send a certificate for cremation in a situation where the body is to be cremated.
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