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Do nurses have the authority to pronounce death?

Wednesday August 12, 2009
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Dear Nancy,

Do nurses have the authority to pronounce death?


Nancy Brent replies:

Dear Larry,

The authority of a licensed RN (or advanced practice nurse) to pronounce death is based on state law(s). The nurse practice act and rules may contain this authority or the board of nursing may issue a statement that allows this role for RNs in the state. State law also governs the specific situation or situations in which an RN can pronounce death. For example, in a state that allows an RN to perform this role, the nurse may not be given the authority to do so if a coroner's inquest might be involved. Additionally, in states that do allow RNs to perform death pronouncements, the facility in which the RN works is often required to have policies and procedures to guide the RN employee.

It is also important to note that in states that allow RNs to pronounce death, the legislation or board statement clearly indicates that the RN cannot “certify” the death of the patient (e.g., sign the death certificate). The RN’s role is limited to the pronouncement of death after an assessment of the patient.

Maine, Texas, and New York are three states that allow the licensed RN the ability to pronounce death. Simply placing “pronouncement of death by RN” or something similar in the search bar of your search engine can identify other states. Keep in mind, however, that the specifics of the role need support from a legal resource, such as the hospital attorney or risk manager, or, if not an employee, through a consultation with a nurse attorney or attorney in your state.


Nancy J. Brent, RN, MS, JD, is an attorney in private practice in Wilmette, Ill. This information is for educational purposes only and is not intended as legal or any other advice. The reader is encouraged to seek the advice of an attorney or other professional when an opinion is needed.