What to do if a person dies in a hospital?

The death of a loved one in a hospital, as at home, is a profound shock. However, within a medical institution, many of the initial steps are taken by doctors and the administration. This can create a feeling of losing control at a time when it is especially needed.

This article outlines the general sequence of actions and typical procedures initiated in such a situation. This information may help to understand the logic of what is happening, navigate the sequence of events, and ask the right questions to the responsible persons.

Remember that each situation is unique, and specific steps, documents, and timelines depend on the country, region, and rules of the particular institution. In case of uncertainty, the most reliable source of information remains the official representatives of the medical facility.

Immediately after death

When a patient's death occurs within the walls of a medical institution, a standard administrative and medical protocol is set in motion. Your personal involvement at this stage is minimal, and understanding this can slightly reduce anxiety.

Typically, events unfold as follows:

• Pronouncement and documentation. A doctor or a team of doctors pronounces the death. They record the time and circumstances in the medical documentation. Unlike a death at home, you do not need to call an ambulance or the police yourself for this purpose — the procedure takes place without your participation.
• Notification of relatives. The duty to inform the next of kin about what happened lies with the institution's staff. Usually, the attending physician or the head nurse of the department does this. The call may not come immediately, but within a few hours, especially if the death occurred during the night.
• Transfer to the pathology department (morgue). The hospital independently organizes the transfer of the body to its own pathology department or to the city morgue. This is a standard procedure that usually occurs within a few hours after the death is pronounced.

What can be done during this time

In the period between receiving the call and being able to visit the morgue, it is often recommended to do the following to help structure the subsequent steps:

• Record contact details. Ask for the name and position of the person who contacted you, as well as the telephone number of the department or hospital. This may be useful for further inquiries.
• Designate a "coordinator". It is difficult to negotiate and remember details while in a state of shock. If possible, entrust the resolution of administrative matters to one trusted person from among the close relatives.
• Locate key documents. Prepare in advance your passport and the deceased's documents (passport, insurance policy), as they will be needed for paperwork.

The morgue and questions about autopsy

The body, as a rule, is located in the hospital's pathology department or the city morgue. This is the next key stage where the next of kin usually begin active interaction with the system.

Obtaining the medical certificate of death

You or your designated person will need to visit the morgue to complete the paperwork. Usually, a medical certificate of death (or a doctor's report) is issued, which states the fact of death and indicates its cause. To obtain it, your documents and the deceased's documents are required, so it is advisable to take all documents with you. The medical certificate of death is issued after the autopsy, if one was ordered. This is not the same as the official death certificate, but it serves as its basis.

The issue of a postmortem examination (autopsy)

This is one of the key topics that relatives face. Approaches vary in different countries, but the general principles are as follows:

• Purpose of an autopsy. Its primary goal is to accurately determine the cause of death, confirm or clarify the diagnosis, and evaluate the correctness and effectiveness of the treatment provided.
• Right to refuse. In many jurisdictions, close relatives have the right to refuse a routine postmortem examination if there are no special grounds for conducting it. The refusal is usually formalized by a written application addressed to the head of the department. Common reasons for refusal are the religious or personal beliefs of the family or the deceased themselves (if they expressed such a will during their lifetime).
• When an autopsy may be performed as mandatory. There are a number of circumstances where a refusal may not be accepted, and the examination will be ordered as mandatory. Such cases, depending on local legislation, usually include: suspicion of violent or unclear death; death shortly (for example, within 24 hours) after admission to the hospital; death during or immediately after a surgical operation or resuscitation; suspicion of a dangerous infectious disease; death of a pregnant or recently delivered woman; and cases where an accurate diagnosis was not established during the patient's lifetime.

Information about whether an autopsy was performed and what its results are is usually reflected in the final version of the medical certificate of death.

Obtaining the death certificate

This is the main document for all subsequent actions. The official death certificate is a state-issued document. It is issued by the authority that registers acts of civil status (e.g., ZAGS, Standesamt, Registry Office), based on the provided medical certificate of death.

To obtain it, one should apply to the registration authority at the last place of residence of the deceased or at the location of the hospital. In many countries, an application can be submitted through multifunctional administrative centers or official online portals. To complete the process, your passport, the deceased's passport, and the medical certificate from the morgue are required.

First, you obtain the medical certificate at the morgue, and then, based on it, the official certificate from the state registry.

Organizing the funeral and farewell

With the official death certificate, you can proceed to organize the ceremony. The decision on burial or cremation is made by the family. If religious rites are important, it is recommended to contact a representative of the respective denomination to coordinate the details.

Many people seek help from professional funeral services. When choosing such an assistant, it is recommended to verify their official status, conclude a detailed written contract with a clear list of services, and request all receipts. Caution is advised regarding intrusive offers of help.

Rights of relatives

A death in a medical institution often raises questions among loved ones about the quality of care provided and the details of what happened. It is important to know about your options in this situation.

The right to information about treatment and cause of death

Close relatives, as a rule, have the right to receive information about the deceased's state of health and the circumstances of their death.

• How to obtain information. To obtain detailed information (course of treatment, test results, medical records), it is usually necessary to submit an official written request addressed to the head of the medical institution. The response should be provided within the legally established timeframe.
• Review of medical documentation. In many jurisdictions, relatives have the right to review the original or obtain a certified copy of the deceased's medical record. This can be important both for clarifying the circumstances and for processing insurance claims.
• Expertise results. The final conclusions regarding the cause of death, made based on the results of the postmortem examination, are reflected in the medical certificate of death. If necessary, you can request a more detailed report.

Actions in case of suspicions of error or negligence

If you have serious grounds to believe that the death occurred due to inadequate medical care, the following steps can be taken (general algorithm):

• Official appeal to the medical facility's administration. The first step is recommended to be a written submission of your questions and claims to the chief doctor or a special internal investigation committee.
• Appeal to supervisory authorities. If a satisfactory response is not received, the next step may be to file a complaint with state bodies supervising the healthcare sector or with the insurance company (if the treatment was insured).
• Legal proceedings. To establish guilt and obtain compensation, it may be necessary to go to court. In such a situation, the assistance of a lawyer specializing in medical law is generally necessary, as is an independent forensic medical examination, which can be initiated at the request of the court or investigative authorities.

Making the decision to initiate such a procedure is a serious step, requiring effort, time, and often the involvement of experts.

Financial, legal, and organizational aspects

Once the main questions of organizing the farewell are resolved, it is time to address administrative and financial matters. To avoid overloading yourself in the most difficult days, it is often recommended to divide these tasks into urgent ones and those that can be resolved later.

Steps that can be taken in the first days

These actions are aimed at suspending the deceased's current obligations and obtaining initial support.

• Notifying the employer. Contacting the human resources department at the deceased's place of work helps to formally terminate employment relations and clarify issues related to final settlement, unused leave, or possible insurance payments and benefits from the company.
• Financial security. Since official actions with bank accounts require the official death certificate, in the first days one can focus on precautionary measures. These may include the physical retrieval of bank cards to prevent their loss or unauthorized use. If you had legal joint access to online banking, you can consider temporarily blocking the cards through the application, keeping in mind that this does not replace a subsequent official request to the bank.

Steps requiring the official death certificate

After the funeral, having the main legal document in hand, you can proceed to formal procedures.

• Compensation for burial expenses. In many countries, there is a state or insurance payment to compensate for part of the funeral expenses. To receive it, it is necessary to apply to the relevant social security authority, pension fund, or employer, providing the death certificate and documents confirming the expenses incurred.
• Insurance payments. If the deceased had life, health, or credit insurance contracts, it is necessary to notify the insurance companies, providing them with the death certificate to initiate the payment procedure.
• Inheritance proceedings. To formalize rights to the estate, the heirs must, within the period established by local law (which is often six months), apply to a notary or authorized lawyer at the last place of residence of the deceased. This process covers all aspects: from formalizing rights to real estate and accounts to settling existing debts.

Guiding principles for a difficult moment

When facing the death of a loved one in a hospital, remember a few basic principles that can help in this situation:

• Give yourself time. The initial reaction is often shock and confusion. This is natural. Try to focus on sequential, small steps.
• Trust the system but know your rights. In a medical institution, the key initial steps (pronouncement of death, transportation) are carried out by the staff. At the same time, you, as a close relative, have the right to receive information about the cause of death and the course of treatment, as well as the right to refuse a postmortem examination in cases where permitted by law. Your task is to obtain the information and then act further along the chain.
• Protect yourself from pressure. At this time, intrusive service offers may appear. Do not make decisions under pressure, do not hand over money or documents to strangers. Always conclude a written contract for any paid services.
• Do not stay alone. Handling organizational matters while grieving is a heavy burden. Do not hesitate to ask for help from relatives or friends to share duties or simply to be there for support.
• Act step by step. Do not try to solve everything at once. First, focus on obtaining the documents from the morgue, then on organizing the farewell, and only after that on the financial and legal aspects.
• Remember yourself. Taking care of your psychological state is not selfishness but a necessity. In the first days, talking to a loved one can help, and later, seeking help from a psychologist specializing in grief counseling.

This information outlines the general order of actions and is intended to help with orientation. Specific steps, document names, and deadlines always depend on the country, region, and rules of the particular institution. In case of uncertainty, the most reliable sources of information remain the official representatives of the medical facility and state authorities.