Supreme Court Justice Scalia's Death

[freshstart]

if nothing suspicious was noted at the scene and there's nothing pointing to it being an unnatural death, I'm ok with backing the family's wishes regarding an autopsy. Having attended countless deaths during my 11 yrs in hospice, families have very strong opinions on autopsies. Some want them, they need the closure of knowing exactly how far the cancer had spread, etc but most families want nothing to do with an autopsy. The most common concerns being that the body has to go to the hospital instead of the funeral home, thus the loved one is alone in the morgue and the mutilation of the body, no matter that this can be totally hidden by the funeral home director. It's that gruesome thought of the body being desecrated at all. The family has to live with that unseen memory forever, I can't fault them for not wanting that.

[rodeosweetheart]

I think that[s a really good point, freshstart, that the wishes of the family might be very strongly held and that might be all that was going on. I think I would have the same reaction were a loved one to die--I would think, he already gave so much to his country, does he have to now sacrifice his dignity and autonomy even in death? Irrational, perhaps, but that word desecration really resonates for me.

[Williamsmith]

I understand the pressure to bend to the family wishes of such a politically powerful family. Certainly, overruling their insistence for closure would not be popular or the easiest route but it is the right one. It is not even feasible to visibly examine a body thoroughly at the scene let alone be assured that no pertinent evidence exists within the body that would change your opinion of cause and manner of death.

I had a female hanging victim that I allowed to be taken to the funeral home without an autopsy. I was called to the funeral home because there was reverse writing on her body that was not documented. An embarrassment but a learning experience. An autopsy confirmed suicide but the damage to my pride had already been done.

What would that dignity cost if it were at the price of a misplaced confidence in natural death without a sound basis? I never slept well at night without answers to questions that need to be provided. We have the ability to put to rest any suspicious thoughts and we should do it. The family can be explained these things with compassion and professionalism.

[iris lilies]

That softened me a bit toward him, too. That and the fact that I'm strangely attracted to crusty old Latins...

He wasnt crusty, he was charming and supprtive to all, and very well liked. Does that change your mind? Haha

But of course he is dead so he will be lionized.

[Teacher Terry]

At 79 with chronic health problems I don't think they did anything wrong. Just a few days ago a friend's family had a 40 yo die in her sleep. Turns out it was a heart attack and she didn't know she had any problems. At 79 it is not really that unusual. At one point I was going to college in Wis and because the class was on death & dying we got a tour of a funeral home. The director said that if you die in a car crash you can be pronounced dead at the scene and the coroner does not have to be a doctor. Then you go straight to the funeral home. He said that when he got a case like that the first thing he did was to make a small cut near the jugular vein to see if it was pulsating. If it was he called an ambulance. He had seen a few cases like this. Pretty scary stuff. Also of course the bags are air tight so you are lucky if you don't suffocate in it on your ride to the funeral home.

[iris lilies]

At 79 with chronic health problems I don't think they did anything wrong. Just a few days ago a friend's family had a 40 yo die in her sleep. Turns out it was a heart attack and she didn't know she had any problems. At 79 it is not really that unusual. At one point I was going to college in Wis and because the class was on death & dying we got a tour of a funeral home. The director said that if you die in a car crash you can be pronounced dead at the scene and the coroner does not have to be a doctor. Then you go straight to the funeral home. He said that when he got a case like that the first thing he did was to make a small cut near the jugular vein to see if it was pulsating. If it was he called an ambulance. He had seen a few cases like this. Pretty scary stuff. Also of course the bags are air tight so you are lucky if you don't suffocate in it on your ride to the funeral home.

that is cheerful news!


Yes the coronor in many rural counties is a funeral home director.

DH just came out of a long stint on grand jury and learned a few things. Here, there are set protocols --dont know if it is actual law, or internal rules. But things like: if somone of a young age dies outside of the hospital, the medical examiner always takes charge of the case and there may or may not be investigation including autopsy. If someone young dies in hospital the medical examiner MAY take charge, he may not necessarily accept a physician's report on cause of death.

on his visit to the city morque DH saw a dead body, covered, but with some identifyng characteristics that he now thinks was our neighbor who committed suicide.

my sister in law, an RN, worked for the medical examiners office in another state and she was taught that at any death scene, her office has precedence over police or any other agency on the scene.

[jp1]

I understand the pressure to bend to the family wishes of such a politically powerful family. Certainly, overruling their insistence for closure would not be popular or the easiest route but it is the right one. It is not even feasible to visibly examine a body thoroughly at the scene let alone be assured that no pertinent evidence exists within the body that would change your opinion of cause and manner of death.

I had a female hanging victim that I allowed to be taken to the funeral home without an autopsy. I was called to the funeral home because there was reverse writing on her body that was not documented. An embarrassment but a learning experience. An autopsy confirmed suicide but the damage to my pride had already been done.

What would that dignity cost if it were at the price of a misplaced confidence in natural death without a sound basis? I never slept well at night without answers to questions that need to be provided. We have the ability to put to rest any suspicious thoughts and we should do it. The family can be explained these things with compassion and professionalism.

I guess I see a difference between a hanging victim and an old, overweight smoker dying in bed with no indication of foul play.

[freshstart]

just for fun, I'll throw in my hat. I could not understand why I was made charge nurse on the evening shift just barely out of college. I quickly learned why, one nurse sent a DNR patient down to the morgue and called the family, having either ignored the protocol for assessment of death or was too stupid to identify it. The patient came back up but luckily truly, actually died before the family got there. Another nurse did that twice, only the patients both lived, one for a few days, the other eventually well enough to go home! And being in charge meant I had to tell those families we were wrong and that sucked.

Then I got to hospice and someone did that to one of my patients at night, they got a free ride home from the funeral home. I know sometimes determining death is tricky, especially with someone who has been dying for days and has stopped breathing 1.2 million times over those last few days, only to gasp and take in a large breath. It can be hard to hear the heartbeat if family is talking or see the chest rise in a dark room. But it takes an hour usually for the funeral home to come and you are just present with the family and patient. You bathe them, move the body around, that would give you some clues about whether they are still alive. I thought this problem was following me everywhere I went, lol. But seriously this kind of stuff haunts family. If you're not sure if a heart has stopped beating after 5 mins, you do another five, you put your hand on the chest to feel for breaths, check their pupils, etc. Do everything in your power to be as close to 100% sure of your assessment.

so I get it, williamsmith when you questioned yourself on that suicide, it's obvious from your posts that you are methodical and would want that to be the case with such an important person. Is your gut telling you foul play or something? My people were not a fan but I don't get any inkling someone wanted him gone so Obama could nominate someone. If they were gonna do that, they would've done it sooner to give Obama time to get past the Senate. Or is it the lack of protocol that bothers you?

[Teacher Terry]

IL: No the funeral home director was not the coroner and he did not think that someone that was not a doctor should be pronouncing people dead at the scene. The town had about 70,000 people but he was talking about not even being taken to a hospital. Ugh! That's why he was so careful before he started draining the blood.

[bae]

In my state, Washington, it is not legal for the coroner/ME to be a funeral director. My county's coroner is also our county prosecutor.

In my state/county, all sorts of qualified people (EMTs, paramedics, physicians, nurse practitioners, PAs, RNs, ...) can *pronounce* death, a smaller subset are able to *certify* death. The coroner/ME's office isn't even notified until the death is pronounced by someone.

Whether there is an inquest/autopsy or not is entirely in the hands of the coroner/ME's office. I responded to a call at 5am this morning for a medical emergency. ~90 year old fellow, he's on a dozen different meds, is on oxygen and in poor overall health. Living alone. We visit him on aid calls every week or so. We've med-evac'd him a dozen times. One of these calls will be the last one, and I don't think there will be an autopsy. And we don't treat his home like a crime scene every time we show up. On the other hand, we came across a very very dead person in a tent in the woods last year - he'd clearly been dead for months. We did an autopsy on that one, and treated the scene very carefully to preserve what evidence there was.

It's pretty obvious sometimes, when you go into someone's home for a welfare check because a neighbor hasn't seen them for a few days, and they are dead in their bed, and have clearly been dead for many many hours.