Death notification: Breaking the bad news

     A suicide driver traveling at high speed crosses the center divide intentionally and rams head-on into an 18-wheeler in the pre-dawn hours of a Sunday on a rural highway.

     A 54-year-old pedestrian is run over and killed in a crosswalk returning from lunch early on a Tuesday afternoon in front of her urban office.

     A high school basketball player is stabbed to death outside a busy suburban pizza house on a Friday night after a game.

     All of these events have two things in common. Someone died violently and unexpectedly, and police officers will most likely be required to make the death notification to the next-of-kin. About 45,000 people are killed in automobile accidents in the United States every year, another 32,000 commit suicide and 17,000 more are victims of homicide.

     Death notification is considered by police officers to be the least desirable job they have. It is also the one for which they are the least trained.

     The Association for Death Education and Counseling, a 2,000-member organization composed of mental and medical health providers, educators, clergy and others, recently funded a University of Georgia study to evaluate the effectiveness of educating law enforcement officers in death notification.

     Principal investigator Brandon Register states he hopes results of the study will compel lawmakers and police departments to reevaluate the way in which death notifications are performed, which will aide both officers and the public.

     Performing death notifications is physically and emotionally exhausting.

     Officers are expected to express the right words, anticipate and understand family emotions, and respond with empathy. The delivery of a notification will likely remain etched in the family memory forever. It also stays with the officer; most can remember their first notification, in detail, years later.

     When done wrong, notifications leave families with the perception that police officers are callous, thoughtless and insensitive. A 2001 University of Florida study found that 41 percent of death notifiers had received neither classroom nor experiential training in death notification, although 70 percent had performed at least one notification.

     "Death notification is one of the toughest things to hand somebody in law enforcement, and a lot of officers are simply thrown into it," says Rick Tobin, CEO of TAO Emergency Management Consultants in Spring Branch, Texas. "They can cause a lot of harm when they do or say the wrong things."

     Notifications should be done in person, in time, in pairs, in plain language and with compassion.

     One of the biggest taboos committed in death notification is the use of the telephone, which is sometimes used to make notification if the victim's family resides outside the jurisdiction.

     "Using the phone to make death notification is cold-hearted and a sign of intellectual laziness," says Joseph Morgan, an assistant professor of criminal justice and forensics at North Georgia College and State University. "For all you know, the survivor might have a heart condition, be suicidal or eight months pregnant."

     Morgan trains students to arrange for in-person notification by the local police department or medical examiner if the survivor lives far away. If that proves impossible, he teaches them to at least arrange for them to be on standby while you talk to the family on the phone.

     Death notification is important for both practical and humanitarian reasons.

     "Humanitarian because this is the worst news any family will ever hear," says Laurence Miller, a clinical and forensic psychologist in Boca Raton, Florida. "Practical, because family members who feel they were treated fairly and sensitively by law enforcement during notification are more likely to be cooperative in any subsequent investigation or criminal proceedings."

     Negative perception of police resulting from a botched notification can be overcome with adequate training, but no formal national death notification standards exist. Most police departments are left to devise their own polices.

     The Texas Municipal Police Association, for instance, reports they do not have a protocol or training specific to death notifications. "Most departments develop policies internally," says executive director Chris Heaton.

     The International Association of Chiefs of Police (theiacp.org) does provide a model death notification policy, but does not track how many agencies have actually adopted it.

     Death notification practices vary depending on geographic location. The medical examiner or coroner's office may make notifications in larger urban areas, but there are far more officers than medical examiners so notifications often fall to police.

     If the officers are fortunate, the departments that employ them will have provided adequate death notification training. Training doesn't make notification any easier, but it might keep officers from making matters worse for themselves and the families of the victim.

     Too few police agencies, however, provide any formal death notification training. The focus of law enforcement is on solving crime. Not many police departments have a specific policy regarding notification of next of kin.

     "A lot of people in public safety, especially in higher ranking positions, give death notification lip service, but it really is the redheaded stepchild because it's the dirty job no one wants to do," Morgan says. Death notification is a large component of the death investigation course he teaches at North Georgia College and State University. He also teaches a death notification class twice a year at the Northeast Alabama Law Enforcement Academy of the Jacksonville University. Morgan's death notification course is one of what he estimates is fewer than 15 nationwide.

     Since so few death notification classes exist, too many officers are forced to learn death notification practices on the job, usually from older, more experienced officers who have been through the drill many times.

     "It may be better now, but when I was on the street we received little training on death notification," says Troutdale, Oregon, Chief of Police Dave Nelson. "Mostly, it was on-the-job training. We'd get the most experienced deputy we could to go with us and take two deputies and a member of the clergy to do the notification."

     Most police departments these days have police chaplains available to help make notifications. The International Conference of Police Chaplains (ICPC) estimates 65 to 70 percent of all departments, including all large urban agencies, now have chaplains assigned to them.

     "There is still some old guard out there who think their guys can suck up everything, but they're so far behind the curve of what's happening today it would be funny if it weren't so reckless," says the Rev. Chuck Lorraine, executive director of the ICPC.

     How police utilize their chaplains varies from department to department.

     "I spent 25 years as a frontline chaplain in California and we were involved in all death notifications, but we still have places in this country where some desk sergeant makes notifications over the phone, which is ludicrous," Lorraine says.

     Police chaplains are trained in the proper way to perform death notification and are emotionally equipped to deal with it. The officers are there in an official capacity to answer questions.

     "There are resources to teach departments how to do death notification properly, but why have your officer involved notifications if you have a chaplain that can handle it for you?" Lorraine asks.

     There are situations, however, where police chaplains are less welcome by police detectives, particularly after violent crimes.

     "The problem with having chaplaincy involved in death notification after a homicide, for instance, is you are involving a third party less acquainted with investigative procedures in the investigation," Morgan says. Since many homicides involve spouses or family members, the danger is a chaplain is not trained to be sensitive to something the family might say or do during notification that could change the course of the investigation.

     "Suppose the family says something about the victim planning to visit someone," Morgan says. "That might not mean anything to the chaplain, but to the detective the entire case might hinge on that one piece of information — so it's essential that you try to handle notification within the bubble of people directly involved in the case."

     Police and hospital emergency departments in several states have begun using volunteers from an organization called the Trauma Intervention Program (TIP) to assist with notifications. TIP (www.tipnational.org) was founded in San Diego in 1985 by a mental health professional named Wayne Fortin to provide immediate support to citizens traumatized by personal tragedy. Twenty regional TIP chapters now exist in eight states (Arizona, California, Florida, Oregon, Maine, Massachusetts, Nevada and Washington), serving more than 250 communities.

     In these communities, TIP is dispatched on certain types of calls at the same time as fire and police. The volunteer meets the police officer, goes to the home with him or her, then the officer gives the notification and leaves. If it's safe, the volunteer stays with the family for the next several hours to provide emotional and practical support, something police have little time for.

     Susan Rutherford, RN, the executive director of the Arizona TIP chapter in Prescott Valley, says her chapter responded to 314 death-related calls in 2007. "Often, we end up giving notification to other arriving family members when it is too difficult for the family on the scene," she notes.

     While police usually do the notifications, some police departments are beginning to utilize TIP to make notifications because the volunteers have received specific death notification training whereas some police officers have not. Nelson, for instance, says his department has the officer go out with a TIP member and the TIP volunteer makes the notification.

     "TIP volunteers are trained in crisis intervention and work out of one of the Portland fire stations," he says. Volunteers receive 55 hours of training, part of which covers death notification.

     Several death notification assets are available to police departments interested in honing their death notification protocols.

     Mothers Against Drunk Driving (MADD) has developed a training curricula titled "Death Notification: Breaking the Bad News With Concern for the Professional and Compassion for the Survivor," available free of charge by calling the Office for Victims of Crime Resource Center at (800) 627-6872.

     This four-volume MADD series contains training curricula and planning steps for developing and conducting training seminars for those responsible for making death notification. The course is aimed at law enforcement personnel, medical professionals, crime victim advocates, members of the clergy, and funeral directors. Each volume includes suggestions for planning a seminar, tips for training adults, an annotated literature review, and copies of the training curriculums, overheads and handouts.

     Also, the ICPC has a training module available to anyone in law enforcement on how to make death notification. Typically, the existing department chaplain will use this material to teach notification techniques to officers, but the ICPC can also dispatch trainers if departments don't have their own chaplains.

     Death notification procedures are also documented on the California Department of Corrections and Rehabilitation Web site. Enter "OPVS (Office of Prevention and Victims Services) Bulletin — Death Notification Procedures" in any search engine for URL.

     Douglas Page writes about science, technology and medicine from Pine Mountain, California. He can be reached at [email protected].

     Next of kin are due the respect of having the death notification done by an official, and to be given the news straight, with kindness.

     Notification should be done:

• In person. Use of the telephone to make death notification is callous and insensitive. Ask yourself how you would like your family notified.
• In pairs. Death notification is best done by two people, at least one of whom should be in uniform. Do not arrive in a large group. Two vehicles are best, in the event medical transport may be necessary.
• In private. Present credentials. Ask to come inside. Do not make notification on the porch or in a public place.
• In plain language. Don't use medical jargon. Use simple, straightforward language to describe how, when and where the person died. Don't be afraid to use the "D" words — dead, died or death. Terms such as "expired," "passed on" or "lost" are words of denial. "Expired" can be used on a drivers license but not on a person — it's not respectful.
• In time. Make notification before the family sees it on the news. Then get to the point. Don't drag it out. People know when police arrive at their door at 4 a.m. it is not because they won the lottery. Say something like, "I'm sorry, your husband was in an auto accident tonight. He died while paramedics were attempting to revive him." Then give details as indicated.

     — Sources: Sue Rutherford, executive director of the Arizona Trauma Intervention Program and "In Person, In Time: Recommended Procedures for Death Notification."