Medical death certificates in the emergency department: ethical and legal issues
Pinto Pastor P, Herreros B
Affiliation of the authors
Departamento de Medicina Legal, Psiquiatría y Patología. Facultad de Medicina, Universidad Complutense de Madrid, Spain. Instituto de Ética Clínica Francisco Vallés, Universidad Europea de Madrid, Spain. Unidad de Medicina Interna, Hospital Universitario Fundación Alcorcón, Madrid, Spain.
Pinto Pastor P, Herreros B. Medical death certificates in the emergency department: ethical and legal issues. Emergencias. 2021;33:128-34
Summary
The last medical act many emergency physicians must do in the context of caring for a dying patient and mourning relatives is to issue a medical death certificate (MDC). The physician is charged with filling in the MDC in cases that do not involve judicial certification. Ethical conflicts and doubts about the cause of death are common when MDCs are issued in emergencies. This paper analyzes the main ethical and legal issues related to MDCs in this setting. The ethical precepts to bear in mind when a conflict or doubt arises are loyalty to the patient, truthfulness, doing no harm, and using public resources wisely. Physician management of processes surrounding death in the emergency department can be improved by providing staff with better training so that they understand how and when to issue a MDC and what legal requirements are involved.
