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Toma Kundrotė, family doctor and president of the Lithuanian Family Physicians Union, noted by her work practice that, in general, the relationship between people and death remains complicated.
“Everything is really very simple, as a person is born, then he dies. It will not be otherwise, the statistics in this regard are one hundred percent. And a death certificate is issued to all people. Only one thing, when a person dies unexpectedly, the cause of death is unclear because the person had no illnesses.
The second thing is when you probably already know what he died of. Although, of course, the cause of death can be quite different. Then the subtleties begin when, for example, a person who is ill for a long time lies down and his loved ones imagine that he cannot die at home, and they must necessarily take him to the hospital before dying. This is definitely not the case, a person can also die at home, he will feel better morally before dying at home, surrounded by loved ones than in an ambulance or elsewhere trying to resuscitate him hopelessly, “said T. Kundrotė.
The doctor says he understands that people are afraid and then calls an ambulance, sometimes, because he wants to be insured.
“Maybe sometimes there are some conflicts in the family, the relatives are wide and then all kinds of accusations begin that ‘you did not take care of yourself, you did not transport yourself.’ For everyone, death is a stressor and sometimes the worst qualities of family members are opened, ”said T. Kundrotė.
And then, according to the specialist, it turns out that the doctor is the one who must decide what the person died of.
“But we family doctors don’t do the autopsy. We can only predict the cause of death. If a person has had cancer and died from exhaustion, then it is not unexpected for loved ones, and he himself writes a diagnosis death cancer as the main, and all. While you can realistically choke your soup. You can never fully know, “said T. Kundrotė.
There are curious situations in reality.
One of the practical problems loved ones face if a person dies at home on the weekend is that, according to the doctor, without a death certificate, the funeral home cannot pick up and remove the body. It is based on the fact that “maybe there is murder.”
“But when a person is 82 years old and has many diagnoses: cancer or some kind of heart failure, after having four heart attacks, what is the difference, what exactly did he die from? The fact is that he died. To deliver it to the funeral home needs the fact of death, not the paper, the death certificate, not the diagnosis for which he died. There is no point in needing paper for that, “said T. Kundrotė.
That death certificate is the responsibility of the family doctor. In accordance with the legal regulations in force in Lithuania, its services must be available to patients 24 hours a day. per day / 7 days a week.
Actually, general practitioners have working hours, and to comply with this standard, polyclinics or various medical centers have contracts with other nearby treatment facilities to provide services to patients during their absence, or have a doctor on call in their office. office that would be responsible for is responsible. But there are all kinds of curious situations.
“After the patient’s death, the police walk out the windows for the third night because they don’t know if the family doctor will issue a death certificate. He goes home, wakes up the family doctor who sleeps over the weekend, and He asks, “Will you write a death certificate for such a specific patient?” When he sees a policeman in the morning at three in the morning and he may be scared. With good knowledge, they probably won’t walk at that time of day. it is that if a person’s health was not controlled intensively, they might not remember it so quickly, “said T. Kundrotė.
The family doctor regretted that the legal problems in this area were not completely resolved and were left in a “gray area”.
When a person’s condition worsens, an ambulance should be called
The specialist explained that if a patient dies at home, if family doctors work at that time, they must first look for him.
“But if a person in the house starts gargling, suffocating before dying, gets foam, then of course they should call an ambulance, because resuscitation may be necessary, and they can be saved.”
If a person has already died, ambulance personnel can determine the fact of death, and based on that documentation, I write a death certificate. Because I have access to the patient’s health data.
And the ambulance doctors, on the way to the patient’s house, have no information about him, as much as what they received from the phone call. This is a problem, “said T. Kundrote.
I don’t think allowing an ambulance to be issued is a good idea
Birutė Kavaliauskienė, Advisor to the Department of Personal Health of the Division of Primary Health Care and Nursing of the Ministry of Health, explained that according to current legal regulations, a family doctor or other doctor from the institution that has been admitted they issue a medical death certificate. Description of the procedure to issue a medical death certificate, approved by the Minister of Health in 1998. October 5 by order.
According to him, when issuing the document, the doctor relies on the available medical documents and records of the person who established the fact of death. The family doctor has the right to do so when the violence is not suspected and the cause of death is sufficiently clear and proven by medical examinations and no forensic examination of medical or pathological anatomy or a pathologist or medical examiner if a pathological examination has been carried out or forensic.
“It should be noted that it is prohibited to return human remains from a personal health care institution (ASPI) to a funeral person without preparing a Medical Death Certificate at the ESPBI IS or without issuing a Medical Death Certificate.
Under the current procedure, primary health care institutions must guarantee the provision of services 24 hours a day, 7 days a week. This is a much debated provision, but so far it has been, ”says a Delfi comment.
According to the SAM representative, it would be inappropriate to transfer the issuance of a medical death certificate to GMP due to the fact that these institutions see the person in an instant, so they generally cannot testify that the death was due to a chronic disease. known, but only to death.
“By issuing a medical certificate to a deceased person in a non-personal health institution, the family doctor assumes responsibility for the fact that the cause of death was a known chronic disease (ie non-violent death), not it is only a confirmation of the fact of death, “said B. Kavaliauskienė.
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