Some nurses can now sign death certificates

Volunteer nurses will be able, as part of an experiment, to issue death certificates, according to a decree published this Thursday in the Official Journal. Six regions are concerned: Auvergne-Rhône-Alpes, Centre-Val-de-Loire, Île-de-France, Hauts-de-France, Réunion and Occitanie. We must “give nurses the opportunity to sign [de] death certificates,” declared François Braun, former Minister of Health in Valenciennes on February 8, reported Europe 1. A measure which was taken up during the National Council for the Refoundation of Health last May. Until now, only a doctor could issue a certificate, necessary for organizing a funeral, but some families could sometimes wait several hours to obtain it. Doctors, in fact, lack time to carry out this procedure which is free. He is paid 100 euros in the evening and on weekends. Nurses will be paid 54 euros at night and weekends, and 42 euros during the day.

Nurses will therefore be able to relieve doctors of this act. The provision was included in the social security financing bill, adopted last year. “As an experiment, for a period of one year, the State may authorize nurses to sign death certificates. The costs relating to the examination necessary for the establishment of the death certificate and carried out at the patient's home are covered by the regional intervention fund,” it read. “At the latest three months after the end of the experiment, the Government sends Parliament an evaluation report, which decides in particular on the relevance of a generalization,” she predicted.

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The measure made some doctors jump. “The death certificate is a medico-legal act. As a doctor, I do not understand how we can entrust this task to someone who does not have the training,” regretted Jean-Philippe Platel, the president of the Council of the Order of Physicians of the North, at the microphone from Europe 1, after the announcement of the experiment.

“There are no longer many treating doctors and we are forced to call on outside doctors who will perform this procedure for free. Let’s pay a fee in relation to this act, and I believe that we will solve part of the problem,” he proposed. “We support our patients until the end, we have always done so and it is not the fact of completing the medico-legal document that will change the approach to nursing care. There is no financial interest for us, we do this to be of service,” judged, for his part, Thierry Amouroux, spokesperson for the National Union of Nursing Professionals, to Europe 1.

For a nurse to issue a death certificate, several conditions will be required. Firstly, the unavailability of the doctor to issue the death certificate “within a reasonable time”, specifies the decree. Then, the nurse will only be able to sign if the death is noted “at home or in an accommodation establishment for dependent elderly people, excluding situations where the violent nature of the death is obvious”. Nurses will also have to obtain the agreement of their employer, and follow twelve hours of training, face-to-face or online, around two modules: “epidemiology and clinical examination of the fatal process” and “administrative and legal”.

The departmental councils of the Order of Nurses must establish a list of “volunteers likely to be contacted in the event of death at home”. This list will then be shared with regional health agencies, emergency medical services, territorial professional health communities, regional unions of health professionals of liberal doctors, departmental fire and rescue services and emergency services. police and gendarmerie.

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Concretely, once the death is discovered, the nurse must inform the emergency medical aid service or the attending physician, so that he can prepare a death certificate. “If there is no doctor available within a reasonable time, the nurse can draw up the death certificate.” “When the nurse cannot establish the causes of death on his own, he calls upon the expertise of a doctor by any means, regardless of the mode and place of practice of the latter. For this purpose, he may call on a retired doctor,” the decree finally provides.