911? Police? Funeral home? Ghostbusters?
Serious question. No rush.
- Your emergency is that your spouse , you guess, has died.
If they need to hand you over to a service, then ambulance service.
your doctor, upon examination, might sign a death certificate and contact a funeral home.
Can depend on location.
I was called about a year ago when a family lost the Patriarch late at night way out in their hunting shack that is only accessed by off road vehicles. I was called because I am on an Ambulance service, but Its a 911 call and no mater how complicated the death seems to the family, its very often easily handled by the 911 system.
Someone with a terminal condition such as Cancer might have everything per-arranged through hospice. In such cases HERE, the death is expected and arrangements are almost always in place so 911 might be informed but no EMS dispatched.
A visit to the funeral home in your area will help with local protocols.
don’t the police have to, technically, investigate all deaths? with hospitals as an exception.
In Australia you would call 000 (our 911) and then they would send out an Ambulance to offer resuscitation or pronounce death.
If it was unexplained or and unforeseen death then the Police would investigate and pass onto Coroner.
Not in Spain, but then, here medical examiners are part of the judiciary and not of the police; in general, a doctor will check out the body and determine whether a medical examiner needs to be called - in turn, the medical examiner determines whether an autopsy is needed or not. For car accidents an autopsy is always necessary, as “he lost control because he was fiddling with the cellphone” isn’t the same as “he had a heart attack while driving and lost control of the vehicle” in terms of accident prevention.
Here you’d call 112 (the general emergency number) and they’d send a medicalized ambulance or a doctor minus the ambulance, based on what the caller describes. If it’s the doctor alone, it will be whomever is on duty for home calls in the nearest ambulatorio (public healthcare office).
- Main reason being that I’m not qualified to declare anyone dead, and if I’m wrong they could be in a state where urgent treatment may make a difference.
In most cases in the US you call 911 if you think someone is dead. While only a few categories of people are allowed to legally declare death in some cases a layperson can make a pretty good determination. As a general rule I’d say if there’s an intact body that’s still warm err on the side of caution.
In the case of my mom’s death we called the hospice, not 911, and they sent a nurse over to officially declare death. Not really necessary, as my sister the MD was present and was pretty sure about the matter, but there are formalities involved. We didn’t call 911 because mom was Do Not Resuscitate so there was no point to doing so.
The police did show up, but the investigation was a formality. They showed up, looked in - yep, dead elderly person in the bedroom, no sign of foul play, death expected due to terminal condition. Then they offered condolences and left.
Of course, for someone non-terminal things would have no doubt been different, both with the call to 911 and the police.
Another vote for calling 9-1-1. I’ve taken that call from the staff from the funeral home when the family had not done so.
That said, we did not call 9-1-1 when my brother died. Terminal illness. Death was expected. Hospice nurse arrived moments later for a regularly scheduled visit and she confirmed what we all knew. We called the funeral home and they did the transport of the body and made a stop by the hospital to have a doctor officially declare him dead.
If the death was expected and no attempts at revival are desired, don’t rush to call 911 if the deceased doesn’t have a DNR bracelet. If the paramedics get there too soon and find a freshly dead person with no DNR bracelet, they will initiate CPR and other rescue measures. This despite protests that the deceased was terminal and didn’t want to be resuscitated.
Wait an hour, in that case, is my advice. Signs of irreversible death at that point should preclude rescue attempts.
Would rescue personnel be able to tell that death occurred an hour or so before, and realize they weren’t called when the person might have been saved?
Maybe. But I wouldn’t call the brief and painful resuscitation of a terminal patient a “save”.
Friends of mine ran into this phenomenon with their 22 year old daughter, who had metastatic cancer. She couldn’t face making herself a DNR, but knew she was dying and was ready for it. She was vegetative for 3 days before expiring, 911 was called (as per the law in their state, since no DNR had been in effect) and paramedics tried to revive her per the required legal protocols (against all hope and reason and mercy.)
Yes, this, please this. Even if the DNR order is on the fridge, the paramedics very likely won’t look for/honor it, in my experience. Just wait a little bit if the deceased didn’t want resuscitation. Otherwise you put the paramedics and then the ER staff in a position they didn’t want to be in - that of not having an advance directive to guide them and hospital policy and cultural expectation that they need to perform rescue measures even if the family is there begging them not to.
“We thought he was sleeping.”
This isn’t suspicious at all… 
Yeah, we can, but what’s the point? There’s not a lot of moral difference between grandma dying of cancer, and grampa having an unobservered cardiac arrest in his Barcalounger. Trying to rescucitate either is futile and cruel.
I agree with you in principle; my question was whether those who allowed her to die and not be briefly and painfully resuscitated, as you refer to in your earlier post, could be held liable for her death.
Thank you. I hadn’t thought of that.
Anything could happen. In my 30 years of medical practice I’ve not encountered this personally with any of my patients who expired naturally.
If she couldn’t make herself sign a DNR, then the logical conclusion is that she wanted to be resuscitated. How is this complicated?
First, you don’t “sign a DNR”. A DNR is a doctor’s order, not a personal advance directive. And that leads to one potential answer: to get a DNR, you have to have a very emotional discussion with your doctor AND have a doctor who you think will be receptive to that decision and not dismiss you, refuse to write the order, talk you into another round of chemo, etc.
Some people believe that getting a DNR means they won’t be treated for anything at all. This isn’t true - a DNR only covers CPR and intubation outside of a surgical setting. It’s not true, but it’s widely believed, and many people won’t ask their doctor for a DNR because they believe it.
Plus a lot of patients view getting a DNR as bad luck, or committing suicide or other complicated emotional and/or religious issues that don’t really reflect their desire to not have CPR done to them, but rather revolve around issues of death and dying in general.
I can’t tell you how many patients will tell me in excruciating detail how they don’t want CPR, don’t want “to be put on a breathing machine”, don’t want feeding tubes, “just…let me go!” But despite all this, they won’t actually talk to their doctor about getting a DNR, nor will they prepare other advance directives like a living will or power of attorney for healthcare*. It’s very, very common.
*And in a prehospital setting (ie. at home or anywhere a paramedic is going to be the one doing CPR) living wills and POAs are not legally binding instruments in the US. A DNR is, but is often overlooked, or not on the right form, or not signed by the doctor.