Table 1.

Expected versus sudden, unexpected deaths

Characteristic	Sudden, unexpected death	Expected death
Approach of death	Immediate or in a short time	Gradual
Nature of illness or injury	Acute process or acute worsening of a stable chronic illness	Chronic—usually an illness or combination of illnesses
Causes of death	Disease, suicide, homicide, accidental, disaster, or unknown cause	Usually disease or a result of aging processes
Age of decedent	Any age, commonly young or middle-aged adults, fetuses, and neonates	Usually elderly but can occur at any age
Place of death	Usually in public, emergency department intensive care unit, or at home or work	Usually home, hospital, or nursing home
When death occurs	At the time of or shortly after the acute event	Months to decades after diagnosis of chronic disease occurring in old age
Survivor reaction	Disbelief, shock, grief, dismay, disorganization, hostility, and fear	Grief
Survivor involvement	Usually not present at death; appear gradually at death scene or emergency department	Often present at death or aware of impending death
Site of last contact with medical personnel	Public space, home, or emergency department	Hospital, home, hospice, or nursing home
Resuscitation procedures	Often performed	Rarely performed; advance directives often available
Patient identity	Known or often, at least initially, unknown	Usually known
Autopsy	Frequent and done by medical examiner or coroner	Rare, and when done, usually by hospital pathologist
Family's immediate after-death rituals and requirements	Usually not prearranged	Often prearranged by dying person or family in anticipation of death