Email this article 
Risks in the Work of Doctors Pronouncing Death and Future Coroners: A Review of the Current Situation in Poland
Abstract
A physician’s work involves exposure to various harmful factors, mainly biological and psychosocial. Their source can be either living or deceased patients. In connection with the upcoming reform of the post-mortem procedure, it becomes important to present the risks affecting doctors involved in the determination of death. The purpose of this paper was to emphasize the psychological burden associated with constant dealing with death, which can reveal itself as a significant problem. The current legal regulations on the determination of death in Poland are contained in acts dating as far back as 1959 and 1961. Therefore, it is expected that the law will be amended to clarify the controversial aspects of the duty to declare death. Although the aspect of exposure to biological agents in the medical profession has been regulated by law, the psychological consequences of exposure, which revolve around post-traumatic stress syndrome and occupational burnout, are not covered by adequate prevention. Various forms of prevention of these phenomena through education and multidirectional self-therapy are currently under consideration. Determining death is an activity that requires not only knowledge but also appropriate emotional training. The dangers of contact with corpses are multifaceted, indicating the need for a thorough analysis of the occupational risks of coroners.
Keywords
Full Text:
PDF (Język Polski)References
LITERATURA
Alipour J., Karimi A., Haghighi M.H.H., Teshnizi S.H., Mehdipour Y., Death Certificate Errors in Three Teaching Hospitals of Zahedan, Southeast of Iran, “Death Studies” 2022, vol. 46(5), DOI: https://doi.org/10.1080/07481187.2020.1801893.
Alipour J., Payandeh A., Common Errors in Reporting Cause-of-Death Statement on Death Certificates: A Systematic Review and Meta-Analysis, “Journal of Forensic and Legal Medicine” 2021, vol. 82, DOI: https://doi.org/10.1016/j.jflm.2021.102220.
Andrews J.M., Sweeney E.S., Grey T.C., Wetzel T., The Biohazard Potential of Cyanide Poisoning during Postmortem Examination, “Journal of Forensic Sciences” 1989, vol. 34(5).
Brondolo E., Eftekharzadeh P., Clifton C., Schwartz J.E., Delahanty D., Work-Related Trauma, Alienation, and Posttraumatic and Depressive Symptoms in Medical Examiner Employees, “Psychological Trauma: Theory, Research, Practice, and Policy” 2018, vol. 10(6), DOI: https://doi.org/10.1037/tra0000323.
Brondolo E., Kaur A., Brondolo T.J., Schwartz J.E., Delahanty D.L., Development of a Web-Based Scalable Intervention to Reduce Mental Health Risks in Medical Examiner Personnel, “TPM – Testing, Psychometrics, Methodology in Applied Psychology” 2017, vol. 24(3), DOI: https://doi.org/10.4473/TPM24.3.7.
Brondolo E., Wellington R., Brondolo E., Brondolo T.J., Delahanty D., Work-Related Predictors of Psychological Distress among Medical Examiner and Coroner Personnel, “Academic Forensic Pathology” 2012, vol. 2(1), DOI: https://doi.org/10.23907/2012.011.
Carleton R.N., Afifi T.O., Taillieu T., Turner S., Krakauer R., Anderson G.S., MacPhee R.S., Ricciardelli R., Cramm H.A., Groll D., McCreary D.R., Exposures to Potentially Traumatic Events among Public Safety Personnel in Canada, “Canadian Journal of Behavioural Science” 2019, vol. 51(1), DOI: https://doi.org/10.1037/cbs0000115.
Chung S., Kim S.H., Park B.-J., Park S., Factors Associated with Major Errors on Death Certificates, “Healthcare” 2022, vol. 10(4), DOI: https://doi.org/10.3390/healthcare10040726.
Coleman J.A., Delahanty D.L., Schwartz J., Murani K., Brondolo E., The Moderating Impact of Interacting with Distressed Families of Decedents on Trauma Exposure in Medical Examiner Personnel, “Psychological Trauma: Theory, Research, Practice, and Policy” 2016, vol. 8(6), DOI: https://doi.org/10.1037/tra0000097.
Cumming M.F., The Vision of a Nurse-Coroner: A ‘Protector of the Living Through the Investigation of Death’, “Journal of Psychosocial Nursing and Mental Health Services” 1995, vol. 33(5), DOI: https://doi.org/10.3928/0279-3695-19950501-09.
Denham A., Vasu T., Avendano P., Boslett A., Mendoza M., Hill E.L., Coroner County Systems Are Associated with a Higher Likelihood of Unclassified Drug Overdoses Compared to Medical Examiner County Systems, “The American Journal of Drug and Alcohol Abuse” 2022, vol. 48(5), DOI: https://doi.org/10.1080/00952990.2022.2072223.
Flannery R.B., Greenhalgh T., Coroners and PTSD: Treatment Implications, “Psychiatric Quarterly” 2018, vol. 89(4), DOI: https://doi.org/10.1007/s11126-018-9580-9.
Gamage U.S.H., Adair T., Mikkelsen L., Mahesh P.K.B., Hart J., Chowdhury H., Li H., Joshi R., Senevirathna W.M.C.K., Fernando H.D.N.L., McLaughlin D., Lopez A.D., The Impact of Errors in Medical Certification on the Accuracy of the Underlying Cause of Death, “PLoS ONE” 2021, vol. 16(11), DOI: https://doi.org/10.1371/journal.pone.0259667.
George B., Nicholls K., Pompeus S., Vasu V., Providing Effective Evidence for the Coroner, “Archives of Disease in Childhood – Education & Practice Edition” 2016, vol. 101(2), DOI: https://doi.org/10.1136/archdischild-2015-308584.
Gill J.R., Landi K., Putrefactive Rigor, “American Journal of Forensic Medicine & Pathology” 2011, vol. 32(3), DOI: https://doi.org/10.1097/PAF.0b013e3181dd17b9.
Hanzlick R., Nolte K., deJong J., The Medical Examiner/Coroner’s Guide for Contaminated Deceased Body Management, “American Journal of Forensic Medicine & Pathology” 2009, vol. 30(4), DOI: https://doi.org/10.1097/PAF.0b013e31819d208c.
Heinemann L.V., Heinemann T., Burnout Research: Emergence and Scientific Investigation of a Contested Diagnosis, “Sage Open” 2017, vol. 7(1), DOI: https://doi.org/10.1177/2158244017697154.
Iorga M., Soponaru C., Hanganu B., Ioan B.-G., The Burnout Syndrome of Forensic Pathologists: The Influences of Personality Traits, Job Satisfaction and Environmental Factors, “Romanian Journal of Legal Medicine” 2016, vol. 24(4), DOI: https://doi.org/10.4323/rjlm.2016.325.
Jones D.R., Secondary Disaster Victims: The Emotional Effects of Recovering and Identifying Human Remains, “American Journal of Psychiatry” 1985, vol. 142(3), DOI: https://doi.org/10.1176/ajp.142.3.303.
Levin A.P., Putney H., Crimmins D., McGrath J.G., Secondary Traumatic Stress, Burnout, Compassion Satisfaction, and Perceived Organizational Trauma Readiness in Forensic Science Professionals, “Journal of Forensic Sciences” 2021, vol. 66(5), DOI: https://doi.org/10.1111/1556-4029.14747.
McFarlane A.C., Williamson P., Barton C.A., The Impact of Traumatic Stressors in Civilian Occupational Settings, “Journal of Public Health Policy” 2009, vol. 30(3), DOI: https://doi.org/10.1057/jphp.2009.21.
Miner A.S., Markowitz D.M., Peterson B.L., Weston B.W., Examining the Examiners: How Medical Death Investigators Describe Suicidal, Homicidal, and Accidental Death, “Health Communication” 2022, vol. 37(4), DOI: https://doi.org/10.1080/10410236.2020.1851862.
Morgan A., Andrew T., Guerra S.M.A., Luna V., Davies L., Rees J.R., Provider Reported Challenges with Completing Death Certificates: A Focus Group Study Demonstrating Potential Sources of Error, “PLoS One” 2022, vol. 17(5), DOI: https://doi.org/10.1371/journal.pone.0268566.
Morii D., Miyagatani Y., Nakamae N., Murao M., Taniyama K., Japanese Experience of Hydrogen Sulfide: The Suicide Craze in 2008, “Journal of Occupational Medicine and Toxicology” 2010, vol. 5(1), DOI: https://doi.org/10.1186/1745-6673-5-28.
Ostrowski M., Pozytywne i negatywne następstwa zdrowotne pracy lekarza na więcej niż jednym etacie, „Polskie Forum Psychologiczne” 2009, vol. 14(1).
Park S., Kim S.H., Does the Application of International Classification of Disease Codes for the Cause of Death on Death Certificates Reduce Garbage Codes?, “INQUIRY: The Journal of Health Care Organization, Provision, and Financing” 2022, vol. 59, DOI: https://doi.org/10.1177/00469580221081433.
Payne-James J., Parapanos L., Carpenter K., Lopez B., The Workload of a Medical Examiner Service at an Acute National Health Service Hospital during the COVID-19 Pandemic: The Norfolk & Norwich University Hospital Experience, “Medicine, Science and the Law” 2023, vol. 63(1), DOI: https://doi.org/10.1177/00258024221087005.
Ricciardelli R., Carleton R.N., Anschuetz B., Gravel S., McKay B., Testifying after an Investigation: Shaping the Mental Health of Public Safety Personnel, “International Journal of Environmental Research and Public Health” 2022, vol. 19(20), DOI: https://doi.org/10.3390/ijerph192013643.
Roberts I.S., Traill Z.C., Use of Post-Mortem Computed Tomography during the COVID-19 Pandemic, “Diagnostic Histopathology” 2021, vol. 27(10), DOI: https://doi.org/10.1016/j.mpdhp.2021.07.002.
Schraml F.V., Parr L.F., Ghurani S., Silverman E.D., Autopsy of a Cadaver Containing Strontium-89-Chloride, “Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine” 1997, vol. 38(3).
Sehsah R., Gaballah M.H., El-Gilany A.-H., Albadry A.A., Work Burnout and Coping Strategies among Egyptian Forensic Physicians: A National Study, “Egyptian Journal of Forensic Sciences” 2021, vol. 11(1), DOI: https://doi.org/10.1186/s41935-021-00230-w.
Singleton M., Start R.D., Tindale W., Richardson C., Conway M., The Radioactive Autopsy: Safe Working Practices, “Histopathology” 2007, vol. 51(3), DOI: https://doi.org/10.1111/j.1365-2559.2007.02768.x.
Smith F., Goldacre M.J., Lambert T.W., Adverse Effects on Health and Wellbeing of Working as a Doctor: Views of the UK Medical Graduates of 1974 and 1977 Surveyed in 2014, “Journal of the Royal Society of Medicine” 2017, vol. 110(5), DOI: https://doi.org/10.1177/0141076817697489.
Szleszkowski Ł., Kadej M., Thannhäuser A., Tarnawski D., Jurek T., Ecological Aspects of Unusual Findings of Animals Nesting Inside a Mummified Human Corpse in Natural Conditions, “Forensic Science International” 2018, vol. 289, DOI: https://doi.org/10.1016/j.forsciint.2018.06.002.
Tait G., Carpenter B., Quadrelli C., Barnes M., Decision-Making in a Death Investigation: Emotion, Families and the Coroner, “Journal of Law and Medicine” 2016, vol. 23(3).
Thomas M., Abtin F., Roth A., Yim C., Pahwa A., Paige J., Ukpo O., Postmortem CT in Decedents with SARS-CoV-2 Infection: A Single Institution Experience, “Forensic Sciences Research” 2022, vol. 7(2), DOI: https://doi.org/10.1080/20961790.2021.1977479.
Ursano R.J., McCarroll J.E., The Nature of a Traumatic Stressor: Handling Dead Bodies, “Journal of Nervous and Mental Disease” 1990, vol. 178(6), DOI: https://doi.org/10.1097/00005053-199006000-00010.
Wang M., Chu J., Wang Y., Li F., Liao M., Shi H., Zhang Y., Hu G., Wang J., Forensic Entomology Application in China: Four Case Reports, “Journal of Forensic and Legal Medicine” 2019, vol. 63, DOI: https://doi.org/10.1016/j.jflm.2019.03.001.
Wålinder R., Wieslander G., Norbäck D., Wessen B., Venge P., Nasal Lavage Biomarkers: Effects of Water Damage and Microbial Growth in an Office Building, “Archives of Environmental Health: An International Journal” 2001, vol. 56(1), DOI: https://doi.org/10.1080/00039890109604052.
ŹRÓDŁA INTERNETOWE
Canadian Institute for Public Safety Research and Treatment, Glossary of Terms: A Shared Understanding of the Common Terms Used to Describe Psychological Trauma (Version 2.1), https://www.cipsrt-icrtsp.ca/assets/glossary-of-terms-version-21-1.pdf (dostęp: 9.01.2023).
Coroner, https://dictionary.cambridge.org/dictionary/english/coroner (dostęp: 9.01.2023).
Courts and Tribunals Judiciary, Chief Coroner’s Guidance No. 32 Post-Mortem Examinations Including Second Post-Mortem Examinations, 23.10.2019, https://www.judiciary.uk/guidance-and-resources/chief-coroners-guidance-no-32-post-mortem-examinations-including-second-post-mortem-examinations1 (dostęp: 9.01.2023).
Główny Urząd Statystyczny, Zgony według przyczyn określanych jako „garbage codes”, 11.03.2019, https://stat.gov.pl/obszary-tematyczne/ludnosc/statystyka-przyczyn-zgonow/zgony-wedlug-przyczyn-okreslanych-jako-garbage-codes,3,3.html (dostęp: 9.01.2023).
Koroner, https://encyklopedia.pwn.pl/haslo/koroner;3925892.html (dostęp: 9.01.2023).
Stawińska-Witoszyńska B., Gałęcki J., Wasilewski W., Poradnik szkoleniowy dla lekarzy orzekających o przyczynach zgonów i wystawiających kartę zgonu, 2019, https://stat.gov.pl/files/gfx/portalinformacyjny/pl/defaultaktualnosci/5746/7/1/1/poradnik_szkoleniowy_dla_lekarzy_orzekajacych_o_przyczynach_zgonow_pelny.pdf (dostęp: 9.01.2023).
AKTY PRAWNE
Rozporządzenie Ministra Zdrowia i Opieki Społecznej z dnia 3 sierpnia 1961 r. w sprawie stwierdzenia zgonu i jego przyczyny (Dz.U. 1961, nr 39, poz. 202).
Rozporządzenie Ministra Zdrowia z dnia 6 grudnia 2001 r. w sprawie wykazu chorób zakaźnych, w przypadku których stwierdzenie zgonu wymaga szczególnego postępowania ze zwłokami osób zmarłych na te choroby (Dz.U. 2001, nr 152, poz. 1742).
Rozporządzenie Ministra Zdrowia z dnia 7 grudnia 2001 r. w sprawie postępowania ze zwłokami i szczątkami ludzkimi (Dz.U. 2001, nr 153, poz. 1783).
Rozporządzenie Ministra Zdrowia z dnia 22 kwietnia 2005 r. w sprawie szkodliwych czynników biologicznych dla zdrowia w środowisku pracy oraz ochrony zdrowia pracowników zawodowo narażonych na te czynniki (Dz.U. 2005, nr 81, poz. 716).
Rozporządzenie Ministra Zdrowia z dnia 10 grudnia 2019 r. w sprawie zgłaszania podejrzeń i rozpoznań zakażeń, chorób zakaźnych oraz zgonów z ich powodu (Dz.U. 2019, poz. 2430).
Rozporządzenie Ministra Zdrowia z dnia 3 kwietnia 2020 r. zmieniające rozporządzenie w sprawie postępowania ze zwłokami i szczątkami ludzkimi (Dz.U. 2020, poz. 585).
Rozporządzenie Ministra Zdrowia z dnia 11 grudnia 2020 r. zmieniające rozporządzenie w sprawie szkodliwych czynników biologicznych dla zdrowia w środowisku pracy oraz ochrony zdrowia pracowników zawodowo narażonych na te czynniki (Dz.U. 2020, poz. 2234).
Ustawa z dnia 31 stycznia 1959 r. o cmentarzach i chowaniu zmarłych (Dz.U. 1959, nr 11, poz. 62).
Ustawa z dnia 8 września 2006 r. o Państwowym Ratownictwie Medycznym (Dz.U. 2006, nr 191, poz. 1410).
Ustawa z dnia 5 grudnia 2008 r. o zapobieganiu oraz zwalczaniu zakażeń i chorób zakaźnych u ludzi (Dz.U. 2008, nr 234, poz. 1570).
Ustawa z dnia 2 marca 2020 r. o szczególnych rozwiązaniach związanych z zapobieganiem, przeciwdziałaniem i zwalczaniem COVID-19, innych chorób zakaźnych oraz wywołanych nimi sytuacji kryzysowych (Dz.U. 2020, poz. 374).
Ustawa z dnia 1 grudnia 2022 r. o zawodzie ratownika medycznego oraz samorządzie ratowników medycznych (Dz.U. 2022, poz. 2705).
DOI: http://dx.doi.org/10.17951/g.2024.71.2.7-25
Date of publication: 2024-10-04 19:21:03
Date of submission: 2023-06-13 22:04:19
Statistics
Indicators
Refbacks
- There are currently no refbacks.
Copyright (c) 2024 Karolina Dębek, Maciej Kalinowski, Sylwia Mroszczyk
This work is licensed under a Creative Commons Attribution 4.0 International License.