Determining the causes of pre-hospital cardiac arrest: Its relationship to the Korean legal system

Determining the cause of sudden cardiac deaths is an important medical task in terms of the health policy of emergency medical services and emergency medical service operations. At present, based on the Korean Medical Service Act, deciding the cause of death for certification can be done only by medical doctors. Because the office of coroner does not exist in South Korea, most deaths, excluding thosethat take place in hospital settings or which occur within 48 hours of discharge, are declared by emergency physicians in the emergency department (ED). This means that sudden deaths are in the majority recorded by emergency physicians. Basing a cause of death solely on clinical diagnosis in the ED has a high potential for error, which directly affects the reliability of statistical data about overall deaths. However, the Korean prevalence of autopsy cases is extremely low. In order to perform an autopsy on a patient with an unknown cause of death, autopsies must currently be performed only where they are permitted by regional legislation.