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Last Updated April 16, 2020

The outbreak of COVID 19 is causing changes to the process for pronouncing and certifying deaths.

Deaths in Long-Term Care (LTC): Legislation currently states that all deaths occurring in LTC will be certified by the Coroner. All other necessary paperwork will be completed by a staff member at the LTC facility. Family physicians will help by providing information about the cause of death/antecedent cause of death, which can be done by phone. One of the reasons for this change is to expedite the transfer of bodies to the funeral home. Family physicians must be available to provide this information within three hours of the time of death. This may involve a 3:00 am phone call, but it is a safer alternative to going to the facility. Please see the documents below for further information.

Deaths in the community: When a death occurs in the community, the physician may have the choice of asking that the body be moved to the funeral home instead of attending in-person to fill in the death certificate at the scene. The death certificate can then be dropped at the funeral home within 24 hours. This choice is dependent on having another health professional pronounce the death (police, nurse, EMS). This alternative to attending a death in person to certify is supported by the Medical Director for EMS for the City of Hamilton, the Regional Coroner, Hamilton Police, and the Deputy Regional Coroner for the province. All have agreed that this is a reasonable alternative to attending the death in person, and some have suggested that this is already a standard of care in our city.

The exception to the above is if the family physician is called directly by the family, pronouncement must occur before the body is moved. If the family physician is comfortable and feels safe to do so (ie has the necessary PPE), they may go in to the home to do the pronouncement. If there are unexpected circumstances, or they do not feel safe going to the home, the coroner or the police may be called upon to do the pronouncement.

Also, attending a death in person also remains as a choice in general for physicians.

If there are any concerns or questions at any time, the 24 hour dispatch line for the coroner on call is 1-855-299-4100 or 1-416-314-4100.

OMA guidelines on virtual pronouncements for expected deaths in the home

Prepared by Dr Monica De Benedetti