AN EXPLANATION OF DEATH CERTIFICATES
The cause of death may vary, depending on each observer's viewpoint of the situation. The trauma surgeon who is unsuccessful in controlling bleeding from a laceration in an auto crash victim might perceive hemorrhage as the cause of death. To the pathologist who conducts the autopsy, the cause of that person's death might be blunt force trauma. To an epidemiologist who studies mortality patterns, automobile accident might constitute the cause of death. Such varied viewpoints made it necessary for me to acquire knowledge in this area. The Coroner would formulate and put into words a cause of death for a death certificate, an autopsy report, or other medical documents using a format similar to the cause of death section on the death certificate and I transferred this information to the certificate.
To foster a viewpoint of the cause of death, the Coroner has to maintain concepts and certain terms in a manner that is clear to all readers. The emphasis on definitions seemed excessive, but it was important to provide clarity regarding causes of death.
Causes of death, whether appearing on death certificates or else¬where, are collected and used by governmental, public health,
When the certifier becomes aware that the cause of death (or associated information) is erroneous or incomplete, or if more specific information becomes available, the certifier should contact the registrar to initiate the amendment process. If it is unclear whether the death is reportable to the MEC, it is wise to report it. The attending physician should not abandon a patient's interests after the death of that patient and, unless required other wise by law, attending physicians should make every effort to ensure that the deaths of their patients are certified. Some general instructions might be helpful to those who face such cir cumstances: If an autopsy is to be performed, completion of the death certificate should be delayed (if practical) until sufficient autopsy findings are available. The term cause of death is used in the specific context of the death certificate format for indicating why a person has died, whether the cause of death is actually written or spoken. THEORY AND GENERALIZATION The Coroner, Medical Examiner, physician or pathologist serve as advocates of the patients, but this does not mean that the certifier should be untruthful or incomplete when stating a cause of death. When the Coroner indicated the cause of death on a death certifi cate and signed the certificate attesting to the cause of death he then became referred to as the certifier. 2) Evaluate whether there is a more appropriate certifier. Amendments must be made in writing by the original certifier and within a defined pe riod of time. It is best to certify the death in an accu rate and clear fashion on the first attempt. When a physician who did not certify the death becomes aware that information on a death certificate is not correct or is incomplete (as might occur after an autopsy or if the patient had more than one physician), that physician should con tact the original certifier and suggest that the death certificate be amended by the certifier, and perhaps, at the same time, offer some suggested wording as well. Hospitals have developed a policy for certifying the deaths of patients when their attending physicians are not available to certify a death that has come under their jurisdiction. Certifiers should concentrate most on the medical and scientific content of the stated cause of death for reasons of accuracy rather than legality. The death certificate is then passed on to and filed at the state level and, eventually, selected information is sent to the national level in electronic form for statistical purposes. Queries can consume the registrar's and certifier's valuable time.