Sorry For Your Loss: What working with the dead taught me about life by Kate Marshall

Author:Kate Marshall [Marshall, Kate]
Language: eng
Format: epub
Publisher: Mardle Books
Published: 2022-07-20T16:00:00+00:00

Chapter 7

November 2019

When the doctors offer a cause of death, we discuss it with the family so they are involved in the process and have some understanding of the medical terminology that may be used. We don’t want a situation where it’s six months later, they’re processing the grief, and think, Hang on, what did they mean systolic failure when he had cancer? That can happen. It’s hard to wade your way through complex information, at a time when you’re coming to terms with a loss. Often, people question things afterwards and, because the funeral has already taken place, will be embarrassed or hesitant about phoning up and asking questions. I have never minded at all. I would much rather have a chance to put someone’s mind at rest, if at all possible.

The Medical Examiner’s Service was implemented in the wake of the infamous Harold Shipman case and the failures in care that happened with the murders which went undiscovered for so long. That service was meant to give transparency for families and make them feel less excluded. Nowadays, the cause of death is always discussed in advance of the registration process so that families know what to expect. Doctors are now required to complete a brief summary of the events leading to the patient’s death and state what the proposed cause of death will be. A medical examiner then reviews and scrutinises the patient notes, to see if they reach the same conclusion. All examiners are experienced and impartial clinicians who must have been registered for a minimum of five years of practice. Currently, the service has a mix of examiners that include GPs, anaesthetists, consultants and clinical directors; a vastly experienced and dedicated team committed to improving the whole process for bereaved families.

Medical Examiner Officers are now able to call the family and explain, “This is what the doctors are offering at this stage. Does that fit in with your knowledge of events, does it sound accurate?” Not only does that give them vital input but it can also be invaluable in establishing some history for the patient. It can shed some light on whether there were falls, any lifestyle choices and their mental state, as well as giving the family an opportunity to raise any other concerns. The family can very often give you some helpful background information; if someone has died of, say, an out-of-hospital cardiac arrest after they’ve collapsed, it might appear it’s come from nowhere. But the families might say, “He hadn’t been well for a few weeks,” which adds more insight.

One of the most difficult issues to address with families is the reason for delays. When someone dies, the summary of death is meant to be received by the Medical Examiner’s Office by the end of the next working day. If it isn’t received by then, it gets escalated higher up the command chain. This isn’t an exact science. For a relatively new service that has only been implemented for a few years,

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