Paramedics do not normally "pronounce" a patient as dead. That is the physicians job.
Paramedics in Kaleefornia can, and do, pronounce people dead.
Years ago the only people that could pronounce someone dead was a doctor or a CHP officer, unless it was compelling circumstances like the head ia here and the body is over there. But now not only paramedics, but an EMT as well can call a code.
True, but they are in direct contact with an ER doctor who can. That doctor frequently takes the verbal statements of the paramedics that would summarize, (example) "non-responsive, flatline, pupils fixed, dilated and non-reactive, no pulse, no respirations, do not believe this patient is viable" and will pronounce from the ER. An on scene physician can refuse to relinquish medical control, and it sounds like what happened here.
Medicine has become so specialized that frequently on scene paramedics will be significantly better than an MD at working with heart attack patients. They see and deal with it every day. This does not apply to ER doctors, cardiologists, and other MDs that work with cardiac patients on a regular basis. A dermatologist or other physician that specializes in a specific area may not keep up with the constantly changing methodologies of advanced trauma or cardiac work.
I don't know MJs doctor at all, but frequently, physicians who work with high dollar celebs become just part of their posse, and make decisions based on the personal desires of the celeb, rather than on sound medical criteria.
They also become emotionally involved (not suggesting romance, just that the doctor can become more of a friend, confidant, and yes, drug connection) than is healthy in a professional relationship.
Whether the doctor accidentally administered an overdose of Demerol, as has been suggested, and was desperately trying to cover his rear end, or whether he refused to accept the medical reality that MJ was dead because he was too emotionally involved, the indications of the story are that medically, he was dead, and that epinephrine, shocks, or whatever weren't going to bring him back.
I've been involved in these types of situations before, and we've continued to follow protocols to the best of our ability, transported, and let the inevitable declaration of death take place in the ER.
Paramedics may not usually, but they do call a lot of patients DOA. It’s very common for the meds to arrive, then call off any other units and request the coroner.
There are even scenarios where EMTs, rather than paramedics can say the patient is dead. Even if paramedics are working on the patient, the doctor at the hospital can call it over the radio.