DEATH CERTIFICATES

From American Medical Association

Manner vs. cause
In signing death certificates, physicians need to be aware of the difference between the “manner of death” and “cause of death” entries, Dr. McDonald said. He often sees certificates where physicians have mistakenly filled out the manner of death portion of a certificate.
In most states, the manner of death would be either natural, suicide, homicide, accident or undetermined. In many states, such as Pennsylvania, only a medical examiner or coroner can answer that question on the form. Errors can have serious consequences, Dr. McDonald said.
In one instance, a person died of a seizure, and the physician thought it was a natural death. It turned out that the seizure occurred as a result of injuries from an assault, making it a murder.
“In that case the homicide was almost missed, and a murderer almost went free,” Dr. McDonald said.
For the cause of death, it’s important that physicians list a disease and not a mechanism, said Yul Ejnes, MD, immediate past chair of the ACP’s Board of Regents. For example, one would list “pneumonia” and not “respiratory arrest,” he said.