What’s a Pronouncement of Death? And How Do You Get One?

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Certified Care Manager, Aging Life Care Professional, and National Master Guardian Emeritus

When a loved one dies, how do you know they are really gone? Across the world, religious and cultural beliefs inform people’s opinions about death and dying. When a death occurs, it is a legitimate question, as nearly everyone wants to know that this is the end.

For someone who is dying, they may end up sleeping a lot and appear to lose consciousness when, in fact, they are in a semi-state of consciousness. You or other family members may think that the person has died, but only an authorized person by the state can pronounce death based on specific criteria. 

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The pronouncement of death is not simply a declaration that someone is gone. It is a solemn and sacred moment, as well as the transition that permits the family and healthcare providers to grieve. Many important tasks follow someone’s death, as many may know even if they aren’t familiar with the terms “pronouncement of death” and “death certificate.” 

Knowing what happens when you die can help you cope with the shock. With the pronouncement of death, you have the right to remain with the body of your loved one for some time. State law determines the amount of time you can stay with the body before a mortuary arrives to collect the body.

Generally, a few days is acceptable unless the person is in the hospital. If your loved one dies in the hospital, the time you have will depend on the need for the room and other factors determined by the hospital. If you need more time, it doesn’t hurt to ask for it. 

What’s a Pronouncement of Death? 

A pronouncement of death is the act of determining that the person has a permanent, irreversible cessation of all biological functions that sustain life. Death is determined by assessing these physical changes:

  • The heart stops beating. If the person has a “do not resuscitate” order then CPR will not be performed to restart the heart.
  • There is no pulse.
  • The person has stopped breathing, and oxygen is not sustained with a ventilator. 

Brain death is when the brain shows no signs of electrical activity. A person can be declared brain dead but kept alive with a ventilator and other artificial means to keep someone “alive.” The definition of brain death is confusing and inconsistently defined.

Not everyone accepts the notion of brain death as being a definition of death. Someone may be kept alive through artificial means for organ harvesting for an organ donor. You may not know immediately what to do when someone dies, and it can be more difficult depending on the location of their death.

If your loved one is in the hospital, staff members such as nurses and others handle many of these details. But at home, you need to follow the appropriate steps to get a death pronouncement so you can proceed with calling the mortuary. Every responsibility to the estate and remains of the deceased person starts with the death pronouncement. 

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What’s Included in a Death Pronouncement Form?

The death pronouncement form will differ from state to state, but generally, the form must include specific information, such as the following:

  • How the death was determined
  • Cause of death if known and under what circumstances
  • The approximate time that death occurred.
  • The practitioner’s name and credentials who makes the death pronouncement
  • The location of the death. Is it in a facility or at home?
  • All demographic information about the deceased person plus relatives present
  • Mortuary information if known
  • Any resuscitation efforts or DNR orders
  • Is an autopsy required or requested?
  • Is the deceased person an organ donor? 
  • If not, there should be documentation of any discussions with family about organ donation. There are federal guidelines that must be followed for organ donations. 
  • If a coroner or medical examiner is required

There is a mix of information in a pronouncement of death, but a pronouncement may provide more context regarding a person’s death than a death certificate.

What’s the Difference Between a Pronouncement of Death and a Death Certificate?

The death pronouncement precedes the death certificate. A death certificate is an official declaration of death issued by the government. It includes the cause of death, location, and time of death.

A death certificate is a legal document that you need to settle the estate, access benefits, arrange for the funeral, make insurance claims, or close any accounts of the deceased person. If you are the executor of the estate, you must have death certificates to carry out your duties.  Officials can also use death certificates to review the cause of death if the circumstances surrounding the death were suspicious. 

Some people may not be aware that health officials use death certificates to contribute to statistical databases that compile causes of death. This data influences policy regarding the leading causes of death. Public health policies depend on the data from death certificates as a valuable source of information about causes of death and illnesses that cause mortality. 

Obtaining a death certificate depends on the state where you live. Some states require that you demonstrate your relationship to the deceased person and show proof of that relationship. In other states, any individual can request a copy of the death certificate.

In general, people may request up to ten copies of the death certificate to ensure they have enough copies to settle the estate. You can order the death certificates from the funeral home or the state or county in which the person died.

Who Can Pronounce a Death?

Who can pronounce a death depends on the county and state where you live. State statutes govern who can make this pronouncement, but it must be medical personnel.

For example, in New York, the law does not require a physician to make a death pronouncement. But in Minnesota, the death pronouncement must be made by licensed medical certifiers such as physicians, advanced practice nurses, physician assistants, coroners, or medical examiners.

In other states, emergency medical technicians and registered nurses can make a pronouncement of death. Medical personnel can make the pronouncement if your loved one is in a hospital, on hospice, or nursing home. But what if someone dies at home? In that case, call 911, and depending on the state law, your loved one might be transported to an emergency room where they will be declared deceased. 

What Do You Use a Death Pronouncement Form For?

The death pronouncement is the official declaration of the end of life. It is a legal requirement as well as a marker for those close to the deceased loved one to say goodbye and start the process of grieving. 

At the time of the pronouncement, you and your family may take steps that can be overwhelming but necessary. Losing someone can bring about emotions that might be mixed depending upon the relationship you have to the deceased person and the circumstances of the death.

If death was expected, you may have had some time to prepare. On the other hand, you may be overwhelmed with grief and loss due to an unexpected death.

Once the pronouncement is made, consider following these steps:

Contact all relevant parties

You will have to call a mortuary, and make sure to have the pronouncement of death to present to any mortuary. Call the one selected before death, or if one has not been chosen, you can choose one. Mortuaries are accustomed to people contacting them at all times of the day and night, and they can respond.

If you suspect that the person may have a plan already in place, contact people who might know where to find this information. 

Make sure to contact all the necessary people, such as your family members and close friends. If you are unable to do so, delegate this task to someone else.

Locate important documents

You will also want to obtain copies of the death certificates. Without the death certificates, you can’t move forward. Alongside the death certificate, you will need to find their last will and testament. Most people designate an executor who will manage the estate.

If there is no will, you may want to meet with an attorney to find out the next steps. If there is a will, there is a legal process of executing the will, called probate. This is done at the county or city probate office.

Make an inventory of assets

Marshaling assets can take some time if you don’t know where everything is. It is not unusual for family members to find bank accounts or cash they didn’t know existed. You won’t have permission to access these accounts without the death certificate and the authority to do so.

Nowadays, some people pay using online or automatic billing. You may need passwords and other important login information to access those accounts.

When you make an inventory of these assets, having a pronouncement of death and the subsequent death certificate can help you cancel services such as cell phone, subscription services, cable, and others.

Alongside cancellation of any services, if you are the executor of the will, you may need to notify the social security administration, life insurance company, and all banks and financial institutions. For added protection, you may also want to send death certificates to credit agencies to prevent fraud. 

Sometimes lost in all of the duties when someone dies are the people affected by losing a loved one. The pronouncement of death is a time to focus on yourself and others profoundly affected by the death. If your loved one dies in hospice or in a medical facility, social workers are available to support you through this process. 

Settling someone’s estate is exhausting and time-consuming. Take the time you need to take care of yourself by reaching out to your friends, family, and spiritual advisors. If necessary, seek out grief counseling to get you through. 

How to Make a Pronouncement of Death

You can now see how complicated death is. The legal requirements and the emotional impact collide in confusing and overwhelming ways. A pronouncement of death provides the springboard for the experience of loss and communion with family and friends.

But it also starts the process of your responsibility to your loved one to honor their wishes and take care of the material remains of their life.

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