Dealing with Death & Dying in Medical Education and Practice
© 2001 Kirsti A. Dyer, MD, MS
AMSA Convention March 30, 2001
Death Pronouncement – Knowledge Assessment

True or False Questions:

1. In order to pronounce death, a physician should complete the following examination(s):

a. Listen for the absence of heart sounds
 True or False
b. Look and listen for the absence of spontaneous respirations
 True or False
c. Perform and document a complete neurological examination
 True or False
d. Ascertain that the patient is not responsive to painful maneuvers such as sternal pressure or nipple twisting
 True or False
2. The physician who pronounces death may only ask the patient’s next of kin if they are willing to consent for organ donation if the physician is a designated requestor for organ/tissue donation.
True or False
Choose the Single Best Answer:

3. Medical record documentation of the death pronouncement includes the following information:

a. Discussion with attending
b. Discussion with family
c. The date and time of death
d. The findings of physician examination
e. All of the above
4. In most states, which one of the following deaths must be reported to a coroner/medical examiner:
a. 80 y/o women living at home falls, breaks femur, is hospitalized, develops a Pulmonary Embolus three days post-op and dies.
b. A metastatic cancer patient dying from hypercalcemia, hospitalized for seven days.
c. A patient with alcoholic cirrhosis who is admitted with massive GI bleeding and dies in 48 hours.
d. A dementia patient on tube feeding aspirates, is hospitalized and dies of pneumonia after 5 days. 
Ready for Answers


1. a. and b. are true.
c. False.  It is not necessary to perform and document a complete neurological examination to pronounce death.
d. False.  Overtly painful maneuvers are never indicated in death pronouncement.

2. True.  Only designated requestors or organ procurement organization (OPO) staff may obtain consent for organ donation from next-of-kin.

3. e.  All of the above are true regarding documentation of death pronouncement.

4. a.  Of the four scenarios, only the death of a patient that occurs as a complication of a recent accident comes under the jurisdiction of the Medical Examiner in most states (check with your own state for applicable laws).

© November 2000 Charlotte Heidenreich, MD David E. Weissman, MD. Death Pronouncement and Death Notification: What the Resident Needs to Know.Available from: EPERC (End-of-Life Physician Education Resource Center)

Compilation of resources for this presentation and Website © 2001 Kirsti A. Dyer, MD, MS.
Journey of Hearts,
This information may be reproduced for educational purposes provided the Heidenriech and Weissman copyright is included.