The Social Network & Community JUST for Firefighters
Declaring Death
I have learned that the new chief of a small fire district near us has declared himself the only one legally authorized to declare deaths. This sounds suspicious. First, he is not certified in any EMS capacity; not an EMT, paramedic, nurse. Second, shortly before he made this procedural change in his district/department he demanded a raise, claiming that he was working many more hours than expected due to his responding to all EMS calls in his "command vehicle" (a pickup truck with logo, lights, siren but NO medical or firefighting equipment).
My question is: How can he get away with this? Can a non-medically trained Fire Chief give himself such power? I certainly don't want him checking me out and deciding whether I'm worth doing CPR on! Looking this up online, the only individuals I found who are legally authorized to declare death are medical doctors, or nurses caring for end of life patients in hospices.
My question is: How can he get away with this? Can a non-medically trained Fire Chief give himself such power? I certainly don't want him checking me out and deciding whether I'm worth doing CPR on! Looking this up online, the only individuals I found who are legally authorized to declare death are medical doctors, or nurses caring for end of life patients in hospices.
Replies to This Discussion
-
Permalink Reply by Ben Waller on
-
If the chief is just doing the runs to get overtime pay, then this issue can go away be the completely legal expedient of having the Fire Chief position declared FLSA "exempt" and making him a salaried employee who is not eligible for overtime pay.
The only thing that might prevent this is if the fire department has a contract that makes the chief an hourly employee.
-
-
That's why I posted the link to the Arizona laws on pronouncing death for Laura.
I don't know if the chief in question got himself appointed as a "death investigator" or not, but if I were in her shoes, I'd rule it out before I publically questioned whether or not he had the legal right to do so.
There are plenty of non-paramedic Assistant Coroners in many states. They don't have to be able to treat people, they just have to be able to determine if they are dead or not, and the method of death.
-
-
Medical directors usually don't have anything to do with it. In every state in the country, it is usually physicians that declare death, but in states that don't have an out-of-hospital medical examiner system, the coroner is the one who decides who can declare death.
-
-
" If he is doing this, he is practicing medicine without a license." Not necessarily.
Did you check the link to the AZ law I posted elsewhere? In AZ, nurse practicioners can declare death and sign the death certificate, and authorized "death investigators" also have some powers in this area.
Who can or cannot be a "death investigator" isn't made clear.
In many states (not AZ, but plenty of others) coroners also legally declare death. In my state, paramedics can declare death, but cannot sign the death certificate.
-
-
Laura, you are confusing two very different things.
I didn't say that your opinion isn't correct - it well may be. I did say that it is slanted, and it obviously is.
Everything you posted is slanted against the chief being in the right and against him possibly having the legal right to do what he is doing. You haven't posted anything to indicate that there is any other possibility. A non-slanted post would offer other options. You didn't do that.
You've apparently confused "slanted" with "incorrect". Those are two very, very different things.
-
-
"For us, if we respond to a PNB and it is obvious death..."
What do you do if it's a PNB & J? :-)
-
-
Exactly. The old "CPR until they're dead at the hospital" thing is on the way out for patients that either don't meet the Ustein Template criteria or for those who do and who have more 20 minutes of well-done but futile resuscitation in the field.
-
Permalink Reply by Laura McGaffey on
-
Hi M.J.,
Yes, tragic deaths and the subsequent lawsuits is exactly what we fear. But, even if the law says a non-medically trained chief can be authorized in some way to take over at the scenes of medical emergencies, the final authority for the SOPs of the district is the elected Fire Board which answers to the citizens. The Board needs to have the correct information as well as learn the wishes and concerns of the citizens.
Thank you for your response to my posting.
-
-
Hi Michael,
Thank you for responding to my post. I've been under the impression that the medical director at the hospital with which the ambulance service is associated is the one who sets policies and protocols. Including death declarations too? I'll have to give them a call.
-
Permalink Reply by Vic Silverfish on
-
John - I'm a city-boy, so it would be very unusual to stop CPR in the field as a hospital was always relatively close. I'll grant that you could phone in to the hospital or medical control to stop a code, but when you do that, you are working on the doctor's orders remotely, so the same rules apply.
When you say the ME or coroner also has authority to declare, aren't they usually MDs? I believe in Maryland they were. Here in Australia, the helicopters usually have a trauma doctor on board (yay, socialised medicine!) so it's easy.
I think we operated with a subtle difference. As a plain old EMT-B (or really anyone with any or no training) we could decide not to work a patient and phone it in as a "priority 4." All that means is the patient did not require transport (strangely, it was the same code for a patient that was healthy and didn't need anything). We did not "declare" them dead, but we refused to treat them and recorded the reasons. We did not call in the paramedics, or anyone else. Usually we left the scene with the police, as it is technically a crime scene. At some later point, the ME would show up to declare the person dead. This may happen several hours later.
-
-
Hi Michael,
Thanks for your comments. Here in our county, the Sheriff's dept. "stages" ambulances away from any potentially dangerous scene. But, I don't believe they declare death. I'm not even sure they take that authority upon themselves when rigor and livor have set in - just in case, you know. :)) (Unless, of course, one of them is a paramedic or EMT and is senior to the ambulance personnel.)
That's too bad about the EMTs who are fighting to keep their tickets. What were they supposed to do, take the cops' guns away and storm their way into the crime scene?
-
-
Hi John,
Back when I was an EMT in California in the 70's and 80's, coroners were not required to have any medical training. But, the ME, the one who did the autopsy, was a doctor. I always thought it funny that on TV, in small towns the funeral director was the coroner.
Although I haven't been an EMT since the early 80's I have always remembered that we were taught that as EMTs we could be sued for NOT getting involved and/or for NOT taking command if we were senior in medical training at a scene. We were taught that we had a legal obligation to stop at auto accidents, etc. Doctors and nurses could just drive or walk on by anyone needing medical care, but not EMS personnel. If we ignored someone in crisis we could be sued. In fact, if we handed over a patient to someone we assumed was senior to us but wasn't (like a veterinarian who said, "I'm a doctor, can I help?") we could be sued.
I'll have to check the Arizona Revised Statutes website to see if I can find the applicable Good Sam laws.
© 2024 Created by Firefighter Nation WebChief.
Powered by
