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ausdoc . com . au 14 JUNE 2024
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A death certificate haunting : case
Anonymous GP
Why I plan to be more circumspect and decline all requests for affidavits .
PUT your hand up if you got the memo that the date of dementia diagnosis was a good idea to include on a death certificate . You did ? Well done . Carry on . Keep up the good work . However , if , like me , you vagued-out during that particular PowerPoint presentation , read on : I am about to save you from getting involved in a shitshow shambles .
‘ Violet ’ came under my care in 2019 .
A resident of the dementia ward , she was clearly able to communicate her wishes and regularly — and forcefully — declined all offers of assistance from GPs , nurses , allied health staff and carers despite , on occasion , being demonstrably in need of some .
She passed away peacefully in her sleep four years later .
I duly completed her death and cremation certificates and entered the word ‘ dementia ’ under ‘ description of disease or condition ’ and the word ‘ years ’ under ‘ approximate duration
between onset and death ’.
Yes , I get it . The death certificate is a very important legal document : it informs the Registry of Births , Deaths and Marriages that a person has passed .
It triggers the funeral arrangements .
It states the reason for death for the family and for population studies .
That is why I always use my nice pen and neatest handwriting , and when I am unsure , I discuss the document with the friendly GP who vets them at the funeral home .
Which is why it was a surprise when the family reached out three months later . “ Could I please provide an affidavit confirming the date of Violet ’ s dementia diagnosis ,” they requested . Well , um , no . Violet had come to me with inadequate handover . It was clear from her MMSE on admission that dementia was present ,
I am about to save you from getting involved in a shitshow shambles .
but I had no idea when it had started .
“ It is just that her will was written in 2011 and the death certificate you have written has put its validity in doubt ,” they said . Easily solved ! The family just needed to reach out to the GP or specialist who had made the diagnosis .
“ But we tried that . The GP and specialists are retired and not responding to our requests . Can you please help ?”
Of course I could . How hard could it be ?
Cue the shitshow shambles .
The original practice had closed because all its GPs had retired but was attempting to reopen with rotating locums — none of whom wanted a bar of this .
The GP notes were eventually released with the 2020 specialist reports and diagnosis , but there was a 2012 GP note that Violet wanted a referral for “ memory issues ”.
There was a tussle over the 2012 specialist report , which was tagged with the comment , “ Not to be released to a third party without consent .”
But after two months of backand-forth phone calls and emails with the family , family lawyers , practice and my medical indemnity provider , we were finally able to put together an affidavit that said , well , not much .
I have generated an invoice to cover my time for this adventure , but in the end , I have discounted heavily and will chalk this one up to experience .
It is embarrassing to charge a sum of four figures for a medical report that says : “ I did not know Violet when she wrote her will , but there is a 2012 report that says she was fine . My best guess is that the will is valid .”
Okay , the report and attachments are more than 20 pages long , but that is the gist .
A quick review of my other aged care residents confirms that I have no idea when they all received their dementia diagnoses , let alone when they wrote their wills .
I will be more circumspect in my certification and will decline all future requests for affidavits .
Wish me luck !
AD _ UTM _ AU-18331-002301 BREZTRI _ 1-3 Page _ 260x133mm _ v2 _ 01 _ FA2-OL . indd 1 17 / 4 / 2024 3:47 PM