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Contents Introduction The Messengers Law Enforcement Notifications Grief, Mourning and Bereavement Correct Notification Procedures Military Notifications Case History O.J. Simpson/Louis & Juditha Brown/ Ronald Goldman Medicolegal Death Investigator Notification Case History "I thought to myself, he's going to kill me!" Conclusions

It was 3 a.m. and the ringing of the doorbell combined with a loud pounding on the front door gave reason for the awakened homeowner to be frightened. "What the hell?" was the first thought that crossed his mind as he slipped into his robe and walked the few paces to the door to learn what interrupted his sleep. He called out through the closed door, "Who is it?" "Police department" responded a voice on the other side. He opened the door and observed two uniformed police officers facing him, each standing to the side of the doorway. The officers held long black flashlights tucked under one armpit and one of them held an aluminum report case in one hand. The taller of the two officers spoke and asked if he was Mr. John Smith. "Yes," he replied and the officer asked if they could step inside. Once inside the entryway Smith asked what this was all about. "Mr. Smith," the officer began, "I'm afraid I have some terrible news for you. Your daughter, Lisa, was involved in a traffic accident this evening on Old Route 11. I'm sorry to have to tell you this but she died as a result of her injuries."¹

Civil War death notification from Captain Parson to Sarah Brown

The scenario described above occurs frequently throughout the country. Almost daily, police arrive at someone's home to inform them of the death of a relative, either from a traffic accident, homicide, or some other unforeseen event. There can be no more devastating news than the unexpected death of a loved one.

Approximately 2.4 million people die in the United States every year and it is often the police who are relegated the task of making the death notification. (National Vital Statistics Report, 2002) Learning of the sudden and unexpected death of a family member leaves an indelible mark on the person receiving the news. The words or phrases used, the characteristics of the person delivering the news, the physical settings where the news is delivered all comprise painful memories of the loss that are never forgotten. (Stewart, 1999)

Other professionals, besides the police, are called upon to make death notifications. Who makes the notification may depend on circumstances and location. For example, many deaths occur in hospitals resulting from terminal illness, advanced age, surgical complications, trauma due to accidents, homicides, or any number of other causes. In all events, someone has to break the news to the next of kin or other family members. If family is present, it may fall upon the treating doctor, nurse, hospital chaplain or social worker to tell the family of the death. (Leash, 1994) If family is not present, efforts must be made to either bring them to the hospital, or send someone to the residence.

In studies conducted by R. Maroni Leash, when families were asked whom they preferred to provide the death notification, the unanimous first choice was the physician. However, another study on emergency room death situations discovered that families preferred the notifier to be a nurse because of the perception of nurses' compassionate nature. (Leash, 1994; Jones & Buttery, 1981)

When deaths occur in locations other than hospitals, the notification task is usually relegated to law enforcement officers. Some death notifications are mandated by state or local ordinance. In California, for example, a state statute requires that the responsibility for locating the next of kin and making the death notification belongs to the Medical Examiner/Coroner when a death comes under his or her jurisdiction. (California Government Code, Section 27471a) Some state laws mandate that law enforcement make a death notification regardless of the involvement of the Medical Examiner/Coroner. (e.g. Texas Code sections 49 and 49.25) If the death occurs at home and emergency medical response technicians or paramedics are summoned, they may have to make the death pronouncement and notification. However, there is no national standard on who delivers the devastating news of the passing of a loved one. (Leash, 1994)

Death notifications consequences, such as stress, grief, mourning, as well as economic and cultural differences are seldom considered when assigning personnel. Yet, all of these, and more, come into play. Personnel sent to inform someone of a death should have some understanding of the emotional turmoil that occurs, so their participation helps rather than hinders the process of dealing with such devastating news. According to Douglas Page, "Death notification is considered by police officers to be the least desirable job they have. It is also the one for which they are the least trained." (Page, 2008)

	Death notification role playing as part of physician training

Leash found that most families are reluctant to have law enforcement officers provide notification, stemming from a view of the police as "enforcers" and authority figures. Leash also found that police officers are seen as less sensitive to grief or need to suppress emotions to properly discharge their duties. They often deliver the news with "dispatch and professional detachment." He recommended other professionals, such as chaplains, social workers, family members or religious figures accompany the officers to help with the notification. (Leash, 1994) Alan Stewart (2001) reported on a survey of 245 death notifiers. The survey assessed the benefits the notifiers received by attending a death notification seminar developed by Mothers Against Drunk Driving. According to Stewart, forty one percent of the notifiers had received neither classroom training nor experiential training in death notification before the seminar. Respondents reported needs for education that included (1) specific detail on how to deliver a notification, (2) how to manage survivor reactions, and (3) how to manage their own emotional reactions. Stewart found that fifty-five percent (n=239) of police officers indicated they received no classroom training in death notification. Twenty-six percent reported minimal death notification training while eight percent stated they received other minor training on death notification following the initial academy training. In addition, forty-nine percent reported they received no prior experiential training in death notification while seventeen percent attended an in-service training session. A full forty-one percent reported receiving neither classroom nor experiential education in death notification. (Stewart A, 2001)

Stewart documented a few poorly delivered death notifications by law enforcement officers. In one such notification a police officer taped a yellow sticky note to the family's front door telling them to call the morgue because their daughter had been killed. Also cited were families who frequently received death notifications over the telephone. In one such telephone delivery, a father suffered a heart attack and subsequently died following the notification from a Medical examiner's employee seeking dental records for his son who had died in a vehicle fire. An Omaha, Nebraska Police officer was fired after leaving a death notification on a family's answering machine.

Researchers identify limited training and a lack of firm policy accounts for much of the difficulty faced by law enforcement officers when making death notifications. (Miller, 2008, 1995, Page, 2008, Stewart et al, 2001)

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