Urgences-Santé to be allowed to declare death
When somebody dies outside a hospital setting, a doctor has to confirm this officially for the death certificate, but soon Urgences-Santé paramedics* will be able to do this too. The reason given is that it’s kinder on families if they don’t have to wait for hours till an MD shows up; I can’t help wondering whether this change is also being made because it’s cheaper.
*Yes, I know they’re technically EMTs but the article says paramedics and everyone knows it means ambulance workers who are not medical doctors.
Chris 23:26 on 2019-01-08 Permalink
Is the implication that saving money where possible is bad? Though I don’t know the particulars of the tradeoffs in this case, that money could presumably be better used buying drugs, equipment, paying staff, etc.
Kate 23:42 on 2019-01-08 Permalink
Chris, I don’t know enough about the relative risks of having someone not an MD declare death. I suppose in most cases it’s incontrovertibly clear, but what about edge cases? I don’t want an EMT zipping me into a body bag before my time because it might save the system ten bucks.
Chris 23:53 on 2019-01-08 Permalink
I imagine the number of edges cases is vanishingly small. Medical literature probably has numbers. Doctors too sometimes err about someone being dead. Search for “Gonzalo Montoya Jiménez” for example. How many of the errors that EMTs might make wouldn’t also be made by MDs I wonder.
mb 06:28 on 2019-01-09 Permalink
Or here in a long version. Life and death are not as black and white as we’d think.
https://www.newyorker.com/magazine/2018/02/05/what-does-it-mean-to-die
dwgs 11:27 on 2019-01-09 Permalink
I redo my first aid / cpr certification every 3 years. The course is usually taught by retired EMT’s or current ones making a little extra cash (they don’t get paid as much as you might think). In the last course someone asked the instructor about confirmation of death stuff and he said that there are plenty of times when the EMT’s are quite sure but the official word must come from a Dr. in the ER. He mentioned that in those rare cases where someone is declared dead at the scene it’s usually because damage is so severe that there really really can’t be any doubt whatsoever.
Kate 11:51 on 2019-01-09 Permalink
I don’t recall if I’ve told the story about finding a dead guy, years ago. He had clearly died from natural causes but he seemed definitely dead to me. When I later told the story to a doctor friend, he was quite stern with me about laypeople not making the decision whether someone is dead. (911 sent an ambulance anyway, so the outcome was much the same.)
Blork 16:46 on 2019-01-09 Permalink
Am I the only one who wants to HEAR THAT WHOLE STORY?
jeather 17:49 on 2019-01-09 Permalink
I can’t imagine that calling 911 and saying “I found a corpse” or “There’s someone here, I’m not sure if they’re dead or not” would have significantly different results. I think your doctor friend was being obnoxious, emergency services should (and did) know not to trust a random bystander’s “this person looks dead to me!” as proof positive.
Kate 21:50 on 2019-01-09 Permalink
Blork: the story. It was 1992, so no cell phones. I was out for a walk with my friend S., with whom I had recently finished making a video short with the implicit theme of death, some of which had been shot around Mount Royal and Notre-Dame-des-Neiges cemeteries.
It was the day after Halloween, so a Sunday that year, All Saints Day in the Catholic calendar. The following day is All Souls, when the devout pray for all their dead relatives. So when S. and I went for a walk in N-D-des-Neiges on a mellow autumn afternoon, a fair number of people were around, visiting family graves and so on.
We were off the path and walking down through some headstones when S. says to me, “That’s odd, look over there, there’s a man lying on the ground.” We went to look. An older man was lying faceplanted in the turf. There were a few gardening tools around him, and we could see a car, presumably his, parked on one of the cemetery roads nearby. He had fallen down behind a row of headstones so he wasn’t visible to passersby on the road.
There was no sign of any violence. Presumably this man had come up to tidy the family grave before winter and had quietly collapsed. He couldn’t have been there long, as cemetery security would have noticed had his car been there overnight.
An ant walked up next to the man’s ear and something about that and the total faceplant was definitive. Guy was dead. But there were a lot of frail-looking old people around and we didn’t want to scare anybody, so we ran like hell, first for the central office and chapel – all locked up – and then the gates on Côte-des-Neiges, where a caretaker family lived. They called 911.
An ambulance came and S. rode up with them. I followed on foot. It was S. who had to see the man turned over, which she found upsetting.
I can put a specific year on the story because afterwards we decided to see a movie that we hoped might turn us around a bit. It was Waterland, a Jeremy Irons movie – in which there was a scene where a dead guy is dragged out of a canal. That wasn’t the first time I’d encountered that phenomenon (you see a movie or read a story hoping to take the taste of an incident out of your head, but instead it amplifies it) but it was a memorable one.
I never found out what the dead man’s name was and I don’t remember the number or location of his family grave.
Blork 22:19 on 2019-01-09 Permalink
Wow, what a story. Made all the more fascinating by the timing. When I hear stories like this (and hear about ornithologists named “Bird” or geologists named “de la Roche,” etc.) it makes me wonder if this world is real or if we’re all just characters in a crazy novel, or worse; stooges in some galactic psychology study.
This reminds me of a small story from my own wee existence; nothing as serious as a random dead guy. It’s just this: when I was a kid I had never seen a rat, dead or alive, domestic or wild. Then when I was 12 I went to see “Willard,” a weird movie about a misfit who befriends an army of rats. Complications ensue. We saw the movie on a Saturday afternoon, and afterwards, back in my friend’s back yard WE FOUND A DEAD RAT!
OK, it’s nothing, but if you’ve never seen a rat before, how spooky is it to see your first one an hour after watching “Willard?” (Especially when you’re 12.)
(Yeah dead guy between Halloween and All Souls is better…)
TC 01:17 on 2019-01-10 Permalink
Three times, I have been present when someone I loved died. They are there, and then, just not. Very abrupt, done, truly departed from this world. The most recent, an aunt in Florida. We alerted the on duty nurse, who came into her room in the assisted living facility where she lived. She confirmed her death and helped us with the arrangements. My mother and father passed in hospital settings, if medical staff confirmed the death, I wasn’t there. There are signatures on the death certificates.
dwgs 10:57 on 2019-01-10 Permalink
Wasn’t there a Vonnegut novel where it turns out that the protagonist was the only ‘real’ person in the world and the rest of the planet was an experiment devised by aliens to test his reactions?
Blork 13:06 on 2019-01-10 Permalink
@dwgs, are you thinking of “The Sirens of Titan?” The gist of that one is that humans were created by aliens so they could evolve enough to be industrious in order to build a spare part for their space ship. Not unlike humans raising bacterial cultures in order to bake bread or make yogurt.