There are three types of death defined in the document: somatic, molecular, and legal death. Legal death in India means the permanent disappearance of all signs of life after birth according to the Registration of Births and Deaths Act. The Transplantation of Human Organs Act further defines brain-stem death. A doctor is required to issue a death certificate listing the immediate cause of death and any significant contributing conditions based on their examination or information from relatives if no examination was possible. The certificate must be filed within 7 days without fee.

1. Certification of death
Definition
Total stoppage of circulation of the blood & consequent thereupon cessation of the
animal and vital functions.
Somatic death : complete loss of sensivity and the ability to move and there is
complete cessation of the functions of the heart, the brain and the lungs.
Molecular death : death of the tissue and the cells individually.
Legal definition
 Death means the permanent disappearance of all evidence of life at any time
after live-birth has taken place (The Registration of Births and Deaths Act, 1969 )
 “Deceased person” means a person in whom permanent disappearance of
all evidence of life occurs, by reason of brain-stem death or in a cardio-
pulmonary sense, at any time after live birth has taken place.
 Brain-stem death” means the stage at which all functions of the brain stem
have permanently and irreversibly ceased.(the transplantation of human
organs act, 1994)
Gordon`s classification of deaths Medico-legal deaths : the cessation of the
vital functions depends upon tissue anoxia which is brought about in the following
four different ways
1. Defective oxygenation of the blood in the lung. (anoxic anoxia)
2. Reduced O2 carrying capacity of blood.
3. Depression of oxidative process in tissue.
4. Inefficient circulation through the tissue.

2. Post mortem findings should be divided in two groups
1. The basic pathological change of circulatory failure.
2. The special pathological changes depending upon the particular type of death.

3. Circulation stoppage tests
 Magnus test
 Diaphanous test
 Icard test Application & withdrawal of pressure
 Application of heat
 Cutting a small artery

4.  ECG tracing
 Respiration stoppage test –
Feather or cotton fibers in front of open mouth and nostrils.
Death certificate
Part I :-
records (a) immediate cause and (b) the morbid condition, if any, giving rise to the
immediate cause
Part II :- records any other significant condition ( if important ) contributing to death
but not related to the immediate cause of death.
Duty of the doctor
 Who attended the person in last 7 days.
 Fill the prescribe format form 4.
 No refusal / no delay.
 No fee.

5.  Forward to the registering authority.
 Symptomatology or modes of death should not be recorded as cause of death
without mentioning the underlying pathological cause.
 In any of the domiciliary deaths not attended by a medical person before
death, a statement from the relatives of the deceased should be obtained in
writing to that effect, clearly mentioning the morbidity condition with sign and
symptoms prevailed preceding death, with duration of such illness so that the
most possible cause of death could be entered.