In most countries, the determination of death is within the competence of a medical doctor. In many cases, this task requires specific medical knowledge, training and experience. In the mountains, due to external conditions including objective dangers, the examination of a lifeless person can be particularly difficult or cannot initially be carried out by a doctor.
In addition to the absence of vital signs, the presence of definite signs of death is a prerequisite for the determination of death. Their detection can be a major challenge even for medical staff due to the time course of their occurrence, their variability and possible differential diagnoses. For this reason, only clear criteria (e.g. decapitation) should be used in special "mountain-typical" situations, such as the assessment of the death of a person from a distance or by a medical layperson.
The Medical Commission of the International Commission for Alpine Rescue (ICAR Medcom) has drawn up a recommendation that should help with this sometimes difficult diagnosis to enable accurate determination of death in mountain rescue (Schön CA et al. Determination of Death in Mountain Rescue : Recommendations of the International Commission for Mountain Emergency Medicine (ICAR MedCom). Wilderness Environ Med. 2020;31(4):506-20).