to as the certifier. The certifier may or may not be the same person who was responsible for the care of the patient (the attending physician) or who pronounced the person dead (the pronouncing physician). The cer¬tifier is responsible for completing only a few items on the death certificate-the most important items being the cause(s) and circumstances of death. After this information was determined, it was my responsibility to record these medical terms on the accepted certificate.
             Some physicians are hesitant to certify death if they do not know an exact cause of death. Such hesitancy is usually unwarranted. Although the cause of death should, ideally, be accurate and specific, legally it is not a guarantee of accuracy. When the certifier indicates a cause of death and signs the death certificate, the certifier bases the cause of death on available information and des¬ignates that the cause of death was due to the stated causes to the best of the certifier's knowledge. In essence, the cause of death as stated is the best opinion of the certifier. It is the certifier's duty to indicate a cause of death as accurately and as specifically as possible. Every effort should be made to base the cause of death on all information that is available from medical records, the attending and pronouncing physicians (if other than the certifier), and other sources (such as an autopsy report), if necessary. The death certificate format allows for uncertainty, qualification, or probability when a cause of death is indicated, recognizing that medicine is not an exact science and an exact cause of death is sometimes elusive.
             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. The death of a patient is often perceived as a failure of medical science, the physician, the patient, or society...