When could a South Carolina coroner record the death of a brain-dead patient kept on life support?

Plain-English summary

A Richland County coroner asked how to determine the time of death when a patient remained on life support after being declared brain dead. The Attorney General concluded in 2008 that a coroner could act at the time of brain death and use that time on appropriate paperwork in the circumstances covered by the opinion.

The opinion relied on a South Carolina statute defining death by either irreversible cessation of circulatory and respiratory functions or irreversible cessation of all functions of the entire brain, including the brain stem. It emphasized that a death determination had to follow accepted medical standards. The AG also pointed to coroner responsibilities involving cremation permits and rules governing disposal or transportation of human bodies.

Currency note

This opinion was issued in 2008. Subsequent statutory amendments, court decisions, or later AG opinions may have changed the analysis. Treat this page as historical context, not current legal advice. Verify current law before relying on any specific rule, deadline, or remedy mentioned here.

Common questions

Q: Did continued life support necessarily postpone the legal time of death? A: The AG said no under the 2008 statute it analyzed. Irreversible cessation of all functions of the entire brain, including the brain stem, was itself a statutory basis for death, subject to a determination under accepted medical standards.

Q: Could a coroner use the time of brain death on official paperwork? A: The AG said a coroner could do so in appropriate circumstances while carrying out official responsibilities under statutory and regulatory law.

Q: Did the opinion set a medical test for declaring brain death? A: No. It quoted the statutory requirement that the determination be made according to accepted medical standards, but did not specify a clinical protocol.

Background and statutory framework

The request concerned suspicious or unnatural deaths for which a coroner might investigate even though the patient was sustained on life support. The AG interpreted S.C. Code Ann.§ 44-43-460’s two statutory definitions of death and concluded that coroner jurisdiction could attach at brain death in appropriate circumstances.

Citations and references

Statutes: The opinion cited S.C. Code Ann.§ 44-43-460 and S.C. Code Ann.§ 17-5-600.

Source

• Landing page: https://www.scag.gov/opinions/opinions-archive/september-25-2008-2/
• Original PDF: https://www.scag.gov/wp-content/uploads/2011/05/watts-g-os-8653-9-25-08-time-of-death-determination.pdf

Original opinion text

H ENRY McMASTER
ATI'ORNEY GENERAi.

September 25, 2008

The Honorable Gary Watts
Coroner, Richland County
1725 Taylor Street
Columbia, South Carolina 29201
Dear Coroner Watts:
In a letter to this office you requested an opinion regarding the issue of determining the time of death of patients who are being sustained on life support after being declared brain dead. As referenced by you, S.C. Code Ann.§ 44-43-460 provides:

[a]n individual who has sustained irreversible cessation ofcirculatory and respiratory functions or irreversible cessation of all functions of the entire brain, including the brain stem, is dead. A determination of death must be made in accordance with accepted medical standards. You indicated that a coroner is sometimes called to investigate these cases if a death is suspicious or unnatural. When interpreting the meaning of a statute, certain basic principles must be observed. The cardinal rule of statutory interpretation is to ascertain and give effect to legislative intent. State v. Martin, 293 S.C. 46, 358 S.E.2d 697 ( 1987). Typically, legislative intent is determined by applying the words used by the General Assembly in their usual and ordinary significance. Martin v. Nationwide Mutual Tnsurance Company, 256 S.C. 577, 183 S.E.2d 451 (1971). Resort to subtle or forced construction for the purpose oflimiting or expanding the operation of a statute should not be undertaken. Walton v. Walton, 282 S.C. L65, 318 S.E.2d 14 (1984). Courts must apply the clear and unambiguous terms of a statute according to their literal meaning and statutes should be given a reasonable and practical construction which is consistent with the policy and pmpose expressed therei_n. State v. Blackmon, 304 S.C. 270, 403 S.E.2d 660 (199 1); Jones v. South Carolina State Highway Department, 247 S.C. 132, 146 S.E.2d 166 (1966). As set forth you have requested an opinion regarding the issue of determining the time of death of patients who are being sustained on life support after being declared brain dead. Section Rl:M llERT

c. D ENNIS B UILDING • POST OFFICE Box JJ 549 • COLUMBIA. SC 292 11 -1549 • T ELEPHONE 803-734-3970 • FACSIMILE 803-253-6283

The Honorable Gary Watts
Page2
September 25, 2008

44-43-460 clearly provides that an individual is considered dead when that individual "has sustained irreversible cessation of circulatory and respiratory functions or irreversible cessation of all functions of the entire brain, including the brain stem." Of course, as specified in the statute, the determination of death "must be made in accordance with accepted medical standards." In the opinion of this office, a coroner, in the appropriate circumstances, would have jurisdiction at the time ofbrain death in which to carry out his official responsibilities consistent with the mandates of statutory and regulatory law and use the time of brain death on all appropriate paperwork. See, e.g., S.C. Code Ann.§ 17-5-600 (permit required from coroner for cremation); DHEC Regulation 61-19, Section 23 (permit governing the disposal or transportation of dead human bodies). If there are any questions, please advise.

Sincerely,
Henry McMaster
Attorney General

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REVIEWED AND APPROVED BY:

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Deputy Attorney General

Charles H. Richardson
Senior Assistant Attorney General