Difference between revisions of "Immediately After Someone Dies"

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{{A Death in Your Family TOC}}
{{REVIEWEDPLS | reviewer = [[Helen Low|Helen Low, QC]] and [[Nicco Bautista]]|date= January 2017}}{{A Death in Your Family TOC}}
== Death at home==
When a loved one dies, it often catches us off guard, even if it was expected. During this difficult time, we deal with our grief along with some responsibilities.  
=== Expected death at home===
If this is an expected death and the family member dies at home, it is likely you are already in regular <span class="noglossary">contact</span> with your family doctor and home care nurse. Your deceased family member may have discussed his or her wishes with the doctor or the nurse. In cases where the forms have been signed for "No CPR" (No Cardiopulmonary resuscitation), there is no need to call an ambulance.  


Immediately after the death, you may choose to spend some time with your deceased family member and participate in rituals that are in keeping with your spiritual beliefs. You can take the time you need before calling the family doctor or the nurse. If it is late at night, you may wait until morning before calling.
==Who to contact==
Who to contact immediately after someone dies depends on whether the death was expected or not, and whether it happens at home or in the hospital.  


The family doctor may come to pronounce the death or give the attending nurse permission to pronounce the death. This is often done to provide assurance and support to the family and verify that this was an expected, natural death.  
If a loved one dies at home and their death was unexpected, '''call 911 immediately'''. You should also call your family doctor.  


If the doctor has already signed the form called Notification of Expected Death, a pronouncement <span class="noglossary">will</span> not be necessary.
If a loved one dies at home and their death was expected, '''do not call 911, an ambulance or the police'''. Call family, friends and any spiritual advisor you would like to have present.  


===Removal of the body===
If a loved one dies in hospital, call family, friends and any spiritual advisor you would like to have present.
There is no legal requirement about the timing for the removal of the body from home, although there is a legal requirement about who can authorize the transportation of the body. A funeral home can take the body directly from your home. The funeral home is legally required to obtain verbal or written authorization from the executor or the next-of-kin before removing the body.  


There is no urgency to <span class="noglossary">transfer</span> the body. The Funeral Service Association of BC recommends that the family not wait more than four to six hours after the death has occurred to call the funeral home. For more information, visit [http://www.bcfunerals.com www.bcfunerals.com].
{{PLSTipsbox
| text = If a loved one dies at home and first responders or paramedics are called, they should be shown any “No CPR Form” signed by the deceased. As explained in the section “[[Preparing for the Death of a Loved One#The No CPR Form|The No CPR Form]]”, this form records a person’s decision to not have CPR or other emergency medical procedures provided if they stop breathing or their heart stops beating.
}}
 
==Say your goodbyes==
Immediately after the death, you may choose to spend some time with your deceased loved one and participate in rituals that are in keeping with your spiritual beliefs.
 
If your loved one died in hospital, you can spend some time in the room with them. In general, the hospital will wait for family members to say their goodbyes.
 
The time spent with the body immediately after death can help people deal with the grief of a loved one’s passing.
 
==Pronouncement of death==
After someone has died, their death is “pronounced”. Pronouncing death means giving an opinion that life has ceased based on a physical assessment of the person. Under BC law, it is not required that a healthcare professional do this; a family member can do so by watching the person’s breathing and noting when breathing has stopped.
 
Even though not required under BC law, pronouncement of death by a healthcare professional is widely recognized as sound clinical and ethical practice for care providers. It can also provide assurance and support to family, and verify that this was an expected natural death.
 
As well, pronouncement of death by a healthcare professional is required before a funeral home will transport the body - unless the deceased’s doctor signed the form “[http://www2.gov.bc.ca/gov/content/health/accessing-health-care/home-community-care/care-options-and-cost/end-of-life-care/expected-planned-home-deaths Notification of Expected Death in the Home].  


===Unexpected death at home===
If a healthcare professional is to pronounce the death, contact the family doctor, nurse practitioner or community nurse. You can take the time you need. If it is late at night, you may wait until morning before calling.
If an unexpected death occurs at home, call 911 immediately. You should also call your family doctor. The ''coroner'' may come at the request of the police or the doctor. An ''autopsy'' is not usually performed unless the doctor or coroner asks for one, or if the death was unusual or accidental.  


== Death in hospital==
==Organ and tissue donation==
===Expected  death in hospital===
Your loved one may have made a decision to donate organs and tissue. They may have discussed those wishes with you. Or they may have left instructions in a '''will'''.
If this is an expected death and your family member was in hospital, you would have <span class="noglossary">contact</span> with ''palliative care'' staff. At the death, a family physician or nurse <span class="noglossary">will</span> call you according to your <span class="noglossary">instructions</span>. You can spend some time in the room with your family member. In general, the hospital <span class="noglossary">will</span> wait for the family members to say their goodbyes.


In the palliative care wards of some ''hospices'', the deceased may be taken directly to the funeral home.
[http://transplant.bc.ca BC Transplant] oversees all aspects of organ donation and transplantation in BC. They administer the [https://register.transplant.bc.ca BC Organ Donor Registry].


===Unexpected death in hospital===
If your loved one died in hospital, the staff will look up whether they were registered as a donor in the Registry. If they were, the hospital staff will show you the deceased’s donation decision.
An unexpected death in hospital <span class="noglossary">will</span> be reported to the coroner. In some cases, doctors <span class="noglossary">will</span> ask you to consent to an autopsy of the body or the coroner may be required by law to do one.  


If your child dies in hospital, doctors may ask you to consent to an autopsy. An autopsy is the parent’s <span class="noglossary">decision</span> except where the autopsy is required by law. To find out when an autopsy may be required by law, see the section "[[Immediate_Details_following_a_Death#When_might_a_coroner_be_involved.3F|When might a coroner be involved?]]".
If your loved one was not registered, the hospital staff may ask the family if they wish to have the deceased’s organs and tissue donated. While not legally bound to do so, the family may wish to make this decision based on what their loved one would have wished.


==Questions you may have==
If a donation takes place, the family has an opportunity to say their farewells before the organs are removed. A specialist trained in organ recovery will carefully remove organs and tissue. The body is then prepared for removal to the funeral home of choice.
===What is a medical certificate of death?===
When a person dies in British Columbia, the death must be registered with the BC Vital Statistics Agency. The first step in the process is the completion of the ''medical certificate of death''. This is not the same as the ''death certificate''.


It is the responsibility of the funeral home or funeral provider to ensure they obtain the medical certificate to enable them to register the death.  
Donation of organs and tissue should not cause a delay in the funeral arrangements and you will be able to have an open casket, if you wish.


A doctor or coroner <span class="noglossary">will</span> usually complete and sign a medical certificate of death within 48 hours of the death.
===Body donation===
*'''If the family member died at home''', the family doctor or the coroner <span class="noglossary">will</span> complete the medical certificate of death.
Your loved one may have donated his or her body for anatomical study and medical research. The Body Donation Program at the University of British Columbia medical school accepts bodies for teaching and research purposes.  
*'''If the family member died in hospital''', staff <span class="noglossary">will</span> <span class="noglossary">contact</span> the resident doctor to sign the medical certificate of death, or the funeral home <span class="noglossary">will</span> make arrangements to have the family doctor complete the medical certificate of death.  


Even though the medical certificate is signed and the body is technically released, the funeral home cannot pick up the deceased until the hospital provides permission. In the case of private care hospitals without ''morgues'' or storage facilities, you likely have already given the private facility the name of the funeral home of your choice. Once the doctor or attending professional has pronounced the death and signed the medical certificate, the private hospital would <span class="noglossary">contact</span> the funeral home to remove your family member.  
If the deceased was registered in the program, their personal representative or a healthcare professional should contact the program as soon as possible after the death, by calling 604-822-2578. For more information see the [http://cps.med.ubc.ca/bodyprogram/ Body Donation Program website].


===When might a coroner be involved?===
==Removal of the body==
The [http://www.pssg.gov.bc.ca/coroners/ Coroners Service of British Columbia] is responsible for the investigation of all unnatural, sudden and unexpected, unexplained, or unattended deaths. It is the coroner’s duty to confirm who, how, when, where, and by what means the death occurred. The coroner then classifies the death as natural, accidental, suicide, homicide, or undetermined. Anyone may report a death to the coroner including agencies, hospitals or doctors.
Whether the death took place at home or in hospital, arrangements must be made to remove the body. There are legal requirements as to who can remove the body, where it can be moved to, and who can authorize the removal.
 
Only licensed funeral homes or those issued a [https://www.consumerprotectionbc.ca/consumer-help/looking-for-a-private-transfer/ permit by Consumer Protection BC] may move a body.


If the coroner’s preliminary investigation reveals the death is a natural event, the coroner <span class="noglossary">will</span> consult the family doctor to ensure the nature of death is consistent with the deceased’s medical history. If there is no concern, the family doctor completes the medical certificate of death.
A body can be moved only to a place of cremation or burial, a place where a bereavement ceremony will be held, or a funeral home.


===What is an autopsy?===
The removal must be authorized by a representative or relative of the deceased according to a [http://canlii.ca/t/84mx priority order set out under BC law]. The priority order begins with the personal representative named in the deceased’s will, followed by the deceased’s spouse, adult children (in age descending order), adult grandchildren and so on. If the person at the top of the priority order is unavailable or unwilling to give instructions, the right to give instructions passes to the person who is next in priority.
Either the coroner or the doctor can <span class="noglossary">order</span> an autopsy if they cannot determine the cause of death or if the death took place in suspicious circumstances. A trained pathologist performs the autopsy. The autopsy is usually carried out within 48 hours. When the autopsy is completed, the coroner releases the body to the next-of-kin. Funeral arrangements can then go ahead.  


If the autopsy is not required by law, next-of-kin must sign a consent form before an autopsy can be done. Before you give consent for an autopsy, make sure that you understand the reasons for the autopsy. Keep a copy of the signed autopsy form. You can refuse to give consent for an autopsy, unless it is required by law.
The authorization to remove the body can be made by telephone. However, the funeral home must not dispose of the body until it receives written authorization from the representative of the deceased.


You can request an autopsy. If you ask for an autopsy and it is not ordered by a doctor or coroner, you <span class="noglossary">will</span> have to pay for it. Ask ahead of time how much it <span class="noglossary">will</span> cost.  
===Your loved one may have made arrangements===
Your deceased loved one may have made arrangements with a funeral home, and may even have prepaid for services. They may have left instructions in a will.  


The results of the coroner’s investigation are released in a public document called a ''judgment of inquiry''. It is available by request from the Regional Coroner’s office. The report incorporates information from all agencies involved in the death, including police, ambulance, and hospitals. It also contains the findings of the autopsy. The autopsy report itself is confidential and is released only under certain conditions.
If prior arrangements have not been made, contact a funeral home. For information on funeral homes in your area, contact the BC Funeral Association at [http://www.bcfunerals.com/ www.bcfunerals.com] or 1-800-665-3899.


In some cases there <span class="noglossary">will</span> be an inquest. A coroner’s inquest is a formal <span class="noglossary">court proceeding</span> that allows for the public presentation of all evidence relating to a death. The coroner has a fact-finding role, not a fault-finding role. The inquest does not decide criminal or civil liability.
{{PLSTipsbox
| text = If the deceased was a member of a '''memorial society''', check with the funeral home to see if they have a contract with that society. If not, ask whether they will agree to provide services for the same cost as the memorial society.
}}


===What information does the funeral home need right away?===
===If the death happened at home===
[[File:flower small.jpg|300px|thumb|right|link=]]
If the death happened at home, call the funeral home when you are ready. It is not necessary to call immediately; take time to call the relatives and friends you want to be with you.
Your deceased family member may have made arrangements with a funeral home, and may even have prepaid for services. He or she also may have left <span class="noglossary">instructions</span> in a will. Check to see if they made prior arrangements. If they have not been made, <span class="noglossary">contact</span> a funeral home. A funeral home representative may visit your home to help you make the arrangements.  


If the deceased was a member of a memorial society, check with the funeral home to see if they have a contract with that society. If not, ask whether they <span class="noglossary">will</span> agree to provide services for the same cost as the memorial society.
If the form "[http://www2.gov.bc.ca/gov/content/health/accessing-health-care/home-community-care/care-options-and-cost/end-of-life-care/expected-planned-home-deaths Notification of Expected Death in the Home]" has been completed, authorizing the funeral home to transport the body without pronouncement of death by a healthcare professional, you need to wait at least one hour after the breathing has stopped before calling the funeral home to remove the body.


You <span class="noglossary">will</span> need to provide the funeral home with certain personal information about the deceased:
===If the death happened in hospital===
*full name,
If the death happened in hospital, provide the hospital with the name of the funeral home that has been selected. The hospital may prefer to contact the funeral home, or ask that you call the funeral home. You may be asked to sign a form authorizing release of the body from the hospital.
*residential address,
*date and place of birth,
*date of death,
*place of death,
*name of <span class="noglossary">spouse</span> (maiden name required),
*name of parents (mother’s maiden name required) and places of birth,
*Social Insurance Number,
*personal health number on the deceased’s BC Care Card,
*any military service or veterans affairs numbers,
*occupation,
*length of time in occupancy,
*marital status, and
*name of executor.


===What is involved in the death registration?===
==Registering the death==
After the funeral home has received the medical certificate of death and obtained the personal information about the deceased, they can complete the Death Registration form. This form goes to Vital Statistics.
When a person dies in British Columbia, the death must be registered with the [https://gov.bc.ca/vitalstatistics BC Vital Statistics Agency]. Registration creates a legal record of the death. It also results in the issuing of a death certificate, which survivors will need to apply for benefits and to settle the legal and business affairs of the deceased.


===What do I need to know about death certificates?===
The funeral home typically handles the death registration, which consists of these steps:
The funeral director <span class="noglossary">will</span> ask you how many "original" death certificates you <span class="noglossary">will</span> require. The fee is set by Vital Statistics and may change at any time.  
# '''A medical certificate of death is completed'''. A doctor, nurse practitioner or '''coroner''' completes and signs a '''medical certificate of death''' within 48 hours after the death, and forwards it to the funeral home. The certificate states that the person has died and the cause of death. The funeral home will typically make arrangements to have the certificate completed.
# '''The funeral home obtains information about the deceased from a relative or friend'''. The information includes the deceased’s date and place of birth, date and place of death, name of spouse, full names and birthplaces of parents, the name of any personal representative named in their will, and the method of “disposition” of the body (burial or cremation).  
# '''The funeral home registers the death.''' When the funeral home has the medical certificate of death and the necessary information about the deceased, the funeral home completes a death registration form with the Vital Statistics Agency.


You <span class="noglossary">will</span> need the death certificate to notify the institutions that handled the deceased's affairs. Some institutions <span class="noglossary">will</span> require either the original document or a notarized copy of the death certificate, while others <span class="noglossary">will</span> accept a regular copy. You may wish to <span class="noglossary">order</span> two originals, then have additional "certified true copies" prepared by a notary public or a lawyer.  
{{PLSTipsbox
| text = The funeral home will ask you how many “original” death certificates you will require. There is a cost for each original certificate: to [https://www2.gov.bc.ca/gov/content/life-events/death/death-certificates order one directly from BC Vital Statistics] costs $27. For most estates, two original death certificates should be sufficient.
}}


Almost all funeral homes in BC are registered as "registrars" of Vital Statistics. They administer the documentation onsite and can produce the death certificate. This means that for up to three months, the funeral home can produce more death certificates upon request.  
After registering the death, the funeral home is provided with the requested number of original death certificates and a disposition permit.


After that time, you must apply directly to the office of Vital Statistics in Victoria; the processing may take four to six weeks.  
The '''[https://www2.gov.bc.ca/gov/content/life-events/death/death-certificates death certificate]''' is a certified extract of the information provided on the death registration. The person looking after the '''estate''' of the deceased will need to produce the death certificate whenever they are required to provide proof of death - for example, to cancel a driver’s licence or to settle insurance policies. Some institutions will require the “original” death certificate or a notarized copy, while others will accept a regular copy. You may wish to order two originals, then have additional “certified true copies” prepared by a notary public or a lawyer if needed.


Anyone may <span class="noglossary">order</span> and receive a death certificate for a person who has died in British Columbia. The <span class="noglossary">release</span> of a death certificate is not limited to immediate family.
The '''disposition permit''' is a permit to dispose of human remains or cremated human remains. It is illegal in BC to bury or cremate a body unless you have a disposition permit.


===How can I get information about the cause of death?===
==Common questions==
The medical certificate of death contains information about the cause of death. Neither the death registration nor the death certificate has that information.  
===When might a coroner be involved?===
If a loved one dies unexpectedly, whether at home or in hospital, a '''coroner''' may become involved. A coroner is an appointed official who investigates all unnatural, sudden or unexpected deaths in BC.


If you are a member of the immediate family, you can obtain a certified copy of the medical certificate of death by requesting it from the family doctor, the coroner involved, or the doctor who originally signed it. Only immediate family members are eligible to obtain a certified copy of the medical certificate of death.
Anyone may report a death to the coroner, including doctors, hospitals, care homes, police, or funeral homes.


===What is a disposition permit?===
===What does a coroner do?===
When the death is registered, a ''disposition permit'' is produced along with the death certificate. The permit typically has three parts: one each for the funeral home, person conducting the funeral cemetery or crematorium.  
The coroner will investigate to determine when, where, and how the death occurred.


It is illegal to bury or cremate human remains unless you have a disposition permit issued under the ''[http://canlii.ca/t/84fk Vital Statistics Act]''. Usually the funeral home obtains the permit.
The coroner’s investigation can end in one of three ways:
* '''A determination of natural death:''' The coroner may conclude that the death was due to natural causes.
* '''A coroner’s report:''' The results of the investigation may be released in a coroner’s report. This is a public document setting out the coroner’s findings, including a cause of death and whenever possible, recommendations to prevent future deaths.
* '''A coroner’s inquest:''' The coroner may hold an inquest, which is a formal court proceeding with a jury, held to publicly review the circumstances of a death. The jury hears evidence from witnesses. The coroner helps the jury maintain a fact-finding role, not a fault-finding role. A written verdict is prepared, and includes recommendations to prevent future deaths.  


===Who do I need to notify of the death?===
===How can you get a copy of a coroner’s report or an inquest verdict?===
The first people to notify are the family doctor, the funeral home, and family members.  
Coroner’s reports and inquest verdicts are public documents. For a copy of a coroner’s report, contact the [https://www2.gov.bc.ca/gov/content/life-events/death/coroners-service regional coroner office in your area]. For copies of jury findings and verdicts from coroner’  inquests, see the [https://www2.gov.bc.ca/gov/content/life-events/death/coroners-service Coroners Service of BC website]. See the “[[Where to Get Help for A Death in Your Family|Where to Get Help]]” section for contact details.


If there is no will or executor, the next-of-kin has the right to control what happens to the body of the family member. In some cases, you may wish to know who within the family has priority as next-of-kin, after the executor or <span class="noglossary">spouse</span>.  
===What is an autopsy?===
An '''autopsy''' is a thorough medical examination of a body after death. It may be done to find out how or why a person has died, or to learn about a disease or injury.  


The executor or the administrator is responsible for making funeral arrangements and paying for them from the deceased person’s ''estate''.  
An autopsy is done by a doctor called a pathologist. This type of doctor is an expert in diagnosing diseases.  


Many people and institutions <span class="noglossary">will</span> need to be notified. Tasks may include contacting the federal government about pensions and the land registry about property your family member owned. In most cases, these tasks are not urgent. They can be left to the executor or administrator to handle.
The autopsy is usually carried out within 48 hours of the death. Once it is completed, the body is released to the representative of the deceased. Funeral arrangements can then go ahead.


===What is organ donation?===
===When is an autopsy done?===
Hospital staff may ask if you wish to donate your deceased family members’ organs. Your family member may have left <span class="noglossary">instructions</span> or, as next-of-kin, you can give your consent when they ask if the family member wished to donate organs and tissue.
Family members may ask for an autopsy to be done after a loved one has died. This is called a requested autopsy.
[[File:A_Death_in_Your_Family_contents2.png|thumb|275px|right| link=| <span style="font-size:50%;">Image via www.istockphoto.com</span>]]
Sometimes an autopsy is required by law. This is called a required autopsy.


===What if your deceased family member wished to donate organs and tissue?===
Family members may ask for an autopsy:
He or she may have made a <span class="noglossary">decision</span> to donate organs and tissue and may have discussed those wishes with you. Or the wishes may be recorded in the will.
* when the loved one died from a medical problem that had not been diagnosed before death
* if there are questions about a sudden death that appears to be from natural causes
* if there are concerns about genetic problems that family members may also be at risk for


In BC, the ''[http://canlii.ca/t/843r Human Tissue Gift Act]'' regulates organ and tissue transplants or donations. This law governs donations made after a donor’s death, as well as donations made from one living person to another.
Situations in which the law may require an
autopsy include:
* sudden or unexpected death, such as sudden infant death syndrome (SIDS)
* death caused by an injury, including suicide, murder, an accident, drug overdose, or poisoning
* deaths that are suspicious


The [http://www.transplant.bc.ca/index.asp BC Transplant Society] is responsible for all aspects of organ transplantation in BC. The Organ Donor Registry of the BC Transplant Society has replaced all previous ways of indicating organ donation.  
===Does the family have to consent to an autopsy being done?===
If an autopsy is required by law, a coroner or doctor can legally have it done without the consent of the person’s family or personal representative. But if the autopsy is not required by law, the family or personal representative must give their consent. Most often, a consent form must be signed in front of a witness.


When your family member dies in hospital, the medical staff enters the deceased’s personal health number into the organ registry database. If the deceased is registered in the Organ Donor Registry, the system <span class="noglossary">will</span> send the hospital the form that indicates the deceased’s <span class="noglossary">decision</span>. The medical staff <span class="noglossary">will</span> show you this form.
{{PLSTipsbox
| text = The HealthLinkBC website has a tool that helps family members consider their options: “[https://www.healthlinkbc.ca/health-topics/uz2102 Should I Have an Autopsy Done on My Loved One?]”
}}


If your deceased family member was not registered with the Organ Donor Registry, medical staff <span class="noglossary">will</span> ask you as next-of-kin, if you are willing to have organs donated. While you are not legally bound to do so, you may wish to make your <span class="noglossary">decision</span> based on what your family member would have wished.
===Who pays for an autopsy?===
If an autopsy is required by law, there is no charge to the family.


===What is the body donation program?===
If the family is requesting an autopsy, they can ask that a hospital do an autopsy on a person who died there. In some hospitals, there is no charge for this service.
If your family member donated his or her body for anatomy or medical studies, you need to make separate arrangements with the [http://cellphys.ubc.ca Department of Cellular and Physiological Sciences] at the University of British Columbia.  


For more details about the donation process and to receive the “A Unique Contribution” brochure and body donor consent form, <span class="noglossary">contact</span> the UBC Department of Cellular and Physiological Sciences:
Most health plans do not pay for autopsies. Make sure you understand the charges ahead of time.


:Lower Mainland: 604-822-2578 <br/>
===Can you get a copy of the autopsy report?===
:[mailto://anatomy@interchg.ubc.ca anatomy@interchg.ubc.ca] <br/>
No. The written autopsy report is a private document containing personal information about the deceased.
:[http://www.cellphys.ubc.ca www.cellphys.ubc.ca]


{{REVIEWED | reviewer = [[People's Law School]], 2012}}
===How can you get information about the cause of death?===
The medical certificate of death contains information about the cause of death. The death certificate does not contain this information. For a [https://www2.gov.bc.ca/gov/content/life-events/death/death-registration/certified-copies-and-certified-electronic-extracts-of-a-death-registration certified copy of the death registration] — which includes the medical certificate of death — you can apply to the BC Vital Statistics Agency. There is a $50 fee. If less than 20 years have passed since the date of death, only immediate family members and selected others can apply for this document.


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__NOGLOSSARY__

Latest revision as of 19:27, 13 December 2019

This information applies to British Columbia, Canada. Last reviewed for legal accuracy by Helen Low, QC and Nicco Bautista in January 2017.

When a loved one dies, it often catches us off guard, even if it was expected. During this difficult time, we deal with our grief along with some responsibilities.

Who to contact

Who to contact immediately after someone dies depends on whether the death was expected or not, and whether it happens at home or in the hospital.

If a loved one dies at home and their death was unexpected, call 911 immediately. You should also call your family doctor.

If a loved one dies at home and their death was expected, do not call 911, an ambulance or the police. Call family, friends and any spiritual advisor you would like to have present.

If a loved one dies in hospital, call family, friends and any spiritual advisor you would like to have present.

Say your goodbyes

Immediately after the death, you may choose to spend some time with your deceased loved one and participate in rituals that are in keeping with your spiritual beliefs.

If your loved one died in hospital, you can spend some time in the room with them. In general, the hospital will wait for family members to say their goodbyes.

The time spent with the body immediately after death can help people deal with the grief of a loved one’s passing.

Pronouncement of death

After someone has died, their death is “pronounced”. Pronouncing death means giving an opinion that life has ceased based on a physical assessment of the person. Under BC law, it is not required that a healthcare professional do this; a family member can do so by watching the person’s breathing and noting when breathing has stopped.

Even though not required under BC law, pronouncement of death by a healthcare professional is widely recognized as sound clinical and ethical practice for care providers. It can also provide assurance and support to family, and verify that this was an expected natural death.

As well, pronouncement of death by a healthcare professional is required before a funeral home will transport the body - unless the deceased’s doctor signed the form “Notification of Expected Death in the Home”.

If a healthcare professional is to pronounce the death, contact the family doctor, nurse practitioner or community nurse. You can take the time you need. If it is late at night, you may wait until morning before calling.

Organ and tissue donation

Your loved one may have made a decision to donate organs and tissue. They may have discussed those wishes with you. Or they may have left instructions in a will.

BC Transplant oversees all aspects of organ donation and transplantation in BC. They administer the BC Organ Donor Registry.

If your loved one died in hospital, the staff will look up whether they were registered as a donor in the Registry. If they were, the hospital staff will show you the deceased’s donation decision.

If your loved one was not registered, the hospital staff may ask the family if they wish to have the deceased’s organs and tissue donated. While not legally bound to do so, the family may wish to make this decision based on what their loved one would have wished.

If a donation takes place, the family has an opportunity to say their farewells before the organs are removed. A specialist trained in organ recovery will carefully remove organs and tissue. The body is then prepared for removal to the funeral home of choice.

Donation of organs and tissue should not cause a delay in the funeral arrangements and you will be able to have an open casket, if you wish.

Body donation

Your loved one may have donated his or her body for anatomical study and medical research. The Body Donation Program at the University of British Columbia medical school accepts bodies for teaching and research purposes.

If the deceased was registered in the program, their personal representative or a healthcare professional should contact the program as soon as possible after the death, by calling 604-822-2578. For more information see the Body Donation Program website.

Removal of the body

Whether the death took place at home or in hospital, arrangements must be made to remove the body. There are legal requirements as to who can remove the body, where it can be moved to, and who can authorize the removal.

Only licensed funeral homes or those issued a permit by Consumer Protection BC may move a body.

A body can be moved only to a place of cremation or burial, a place where a bereavement ceremony will be held, or a funeral home.

The removal must be authorized by a representative or relative of the deceased according to a priority order set out under BC law. The priority order begins with the personal representative named in the deceased’s will, followed by the deceased’s spouse, adult children (in age descending order), adult grandchildren and so on. If the person at the top of the priority order is unavailable or unwilling to give instructions, the right to give instructions passes to the person who is next in priority.

The authorization to remove the body can be made by telephone. However, the funeral home must not dispose of the body until it receives written authorization from the representative of the deceased.

Your loved one may have made arrangements

Your deceased loved one may have made arrangements with a funeral home, and may even have prepaid for services. They may have left instructions in a will.

If prior arrangements have not been made, contact a funeral home. For information on funeral homes in your area, contact the BC Funeral Association at www.bcfunerals.com or 1-800-665-3899.

If the death happened at home

If the death happened at home, call the funeral home when you are ready. It is not necessary to call immediately; take time to call the relatives and friends you want to be with you.

If the form "Notification of Expected Death in the Home" has been completed, authorizing the funeral home to transport the body without pronouncement of death by a healthcare professional, you need to wait at least one hour after the breathing has stopped before calling the funeral home to remove the body.

If the death happened in hospital

If the death happened in hospital, provide the hospital with the name of the funeral home that has been selected. The hospital may prefer to contact the funeral home, or ask that you call the funeral home. You may be asked to sign a form authorizing release of the body from the hospital.

Registering the death

When a person dies in British Columbia, the death must be registered with the BC Vital Statistics Agency. Registration creates a legal record of the death. It also results in the issuing of a death certificate, which survivors will need to apply for benefits and to settle the legal and business affairs of the deceased.

The funeral home typically handles the death registration, which consists of these steps:

  1. A medical certificate of death is completed. A doctor, nurse practitioner or coroner completes and signs a medical certificate of death within 48 hours after the death, and forwards it to the funeral home. The certificate states that the person has died and the cause of death. The funeral home will typically make arrangements to have the certificate completed.
  2. The funeral home obtains information about the deceased from a relative or friend. The information includes the deceased’s date and place of birth, date and place of death, name of spouse, full names and birthplaces of parents, the name of any personal representative named in their will, and the method of “disposition” of the body (burial or cremation).
  3. The funeral home registers the death. When the funeral home has the medical certificate of death and the necessary information about the deceased, the funeral home completes a death registration form with the Vital Statistics Agency.

After registering the death, the funeral home is provided with the requested number of original death certificates and a disposition permit.

The death certificate is a certified extract of the information provided on the death registration. The person looking after the estate of the deceased will need to produce the death certificate whenever they are required to provide proof of death - for example, to cancel a driver’s licence or to settle insurance policies. Some institutions will require the “original” death certificate or a notarized copy, while others will accept a regular copy. You may wish to order two originals, then have additional “certified true copies” prepared by a notary public or a lawyer if needed.

The disposition permit is a permit to dispose of human remains or cremated human remains. It is illegal in BC to bury or cremate a body unless you have a disposition permit.

Common questions

When might a coroner be involved?

If a loved one dies unexpectedly, whether at home or in hospital, a coroner may become involved. A coroner is an appointed official who investigates all unnatural, sudden or unexpected deaths in BC.

Anyone may report a death to the coroner, including doctors, hospitals, care homes, police, or funeral homes.

What does a coroner do?

The coroner will investigate to determine when, where, and how the death occurred.

The coroner’s investigation can end in one of three ways:

  • A determination of natural death: The coroner may conclude that the death was due to natural causes.
  • A coroner’s report: The results of the investigation may be released in a coroner’s report. This is a public document setting out the coroner’s findings, including a cause of death and whenever possible, recommendations to prevent future deaths.
  • A coroner’s inquest: The coroner may hold an inquest, which is a formal court proceeding with a jury, held to publicly review the circumstances of a death. The jury hears evidence from witnesses. The coroner helps the jury maintain a fact-finding role, not a fault-finding role. A written verdict is prepared, and includes recommendations to prevent future deaths.

How can you get a copy of a coroner’s report or an inquest verdict?

Coroner’s reports and inquest verdicts are public documents. For a copy of a coroner’s report, contact the regional coroner office in your area. For copies of jury findings and verdicts from coroner’ inquests, see the Coroners Service of BC website. See the “Where to Get Help” section for contact details.

What is an autopsy?

An autopsy is a thorough medical examination of a body after death. It may be done to find out how or why a person has died, or to learn about a disease or injury.

An autopsy is done by a doctor called a pathologist. This type of doctor is an expert in diagnosing diseases.

The autopsy is usually carried out within 48 hours of the death. Once it is completed, the body is released to the representative of the deceased. Funeral arrangements can then go ahead.

When is an autopsy done?

Family members may ask for an autopsy to be done after a loved one has died. This is called a requested autopsy.

Image via www.istockphoto.com

Sometimes an autopsy is required by law. This is called a required autopsy.

Family members may ask for an autopsy:

  • when the loved one died from a medical problem that had not been diagnosed before death
  • if there are questions about a sudden death that appears to be from natural causes
  • if there are concerns about genetic problems that family members may also be at risk for

Situations in which the law may require an autopsy include:

  • sudden or unexpected death, such as sudden infant death syndrome (SIDS)
  • death caused by an injury, including suicide, murder, an accident, drug overdose, or poisoning
  • deaths that are suspicious

Does the family have to consent to an autopsy being done?

If an autopsy is required by law, a coroner or doctor can legally have it done without the consent of the person’s family or personal representative. But if the autopsy is not required by law, the family or personal representative must give their consent. Most often, a consent form must be signed in front of a witness.

Who pays for an autopsy?

If an autopsy is required by law, there is no charge to the family.

If the family is requesting an autopsy, they can ask that a hospital do an autopsy on a person who died there. In some hospitals, there is no charge for this service.

Most health plans do not pay for autopsies. Make sure you understand the charges ahead of time.

Can you get a copy of the autopsy report?

No. The written autopsy report is a private document containing personal information about the deceased.

How can you get information about the cause of death?

The medical certificate of death contains information about the cause of death. The death certificate does not contain this information. For a certified copy of the death registration — which includes the medical certificate of death — you can apply to the BC Vital Statistics Agency. There is a $50 fee. If less than 20 years have passed since the date of death, only immediate family members and selected others can apply for this document.


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