The new authority for completing and signing an MCOD for RNs and the changes in NP authority come into effect on July 1, 2025; RNs and NPs must follow new requirements for
completing and signing an MCOD, as outlined in the Vital Statistics Act, 1990.
Nurses must consider the following before proceeding with the MCOD completion:
- whether the RN or NP has the knowledge, skill and judgement
- if the RN or NP is the most suitable person to carry this out
- whether the employer permits RNs and NPs to certify death
- Please note, there may be employer-specific policies that impact RNs’ or NPs’ authority.
- the cause of death and circumstances surrounding death and whether a coroner must be consulted
- The threshold for involving the coroner should be relatively low. The coroner may determine that investigation is not required in a specific circumstance, but this must be their decision to make. If in doubt, consult with the coroner. Please visit the Government of Ontario website for more information.
Apply this Decision Tree to determine if an RN is the most appropriate person to complete the Medical Certificate of Death (MCOD).
An NP with sufficient knowledge of the deceased’s last illness can complete the MCOD. NPs do not need to be the client’s primary care provider to certify death. If the NP does not have the knowledge, skill and judgement to complete the MCOD, they should not complete it and refer to another provider.