"Dead" Patients Coming Alive: A Case for a Foolproof Death Pronouncement in India

It is not a rare occurrence where a patient who has been declared dead in the hospital comes alive either during transport back home or while performing the last rites. But in recent times we are witnessing a steady rise in such incidences.^1-4 Though it is a global phenomenon, in our country it has brought a lot of negativity and adverse publicity against medical professionals and hospitals. These incidences are casting serious doubt in the minds of the public about the ability and knowledge of medical professionals in declaring someone dead and have eroded the public trust in doctors. On many occasions it is being perceived as serious negligence or total irresponsibility on the part of a medical professional. A patient who has been declared dead but comes alive could put medical professionals under serious mental stress with long-lasting emotional trauma as well. Beyond the medical realm, such cases raise legal and ethical dilemmas. Families go through unnecessary mental trauma, funeral services are disrupted, and, in some cases, patients wake up in morgues or coffins-an unimaginable horror. In India we have neither any data on such occurrences nor a well-accepted protocol or guidelines for the determination and declaration of death. While cases of the "dead" coming back to life remain rare, they highlight the gaps in medical practices that need urgent attention, and there is a pressing need for a foolproof protocol for pronouncement of death that is acceptable legally and medically and with a pan-India application.