INFORMATION FOR WORRIED CERTIFIERS

Reporting cause of death is a complex process. It is understandable that some certifiers may worry about what they report. Here is some information you may find reassuring.

CAUSE OF DEATH IS AN OPINION. If you are a coroner and sign Item 26a, your signature certifies that “On the basis of examination and/or investigation, in my opinion, death occurred at the time, date and place and due to the cause(s) and manner as stated.” If you are a physician or registered nurse at a hospice and you sign Item 26a, your signature certifies that “To the best of my knowledge, death occurred at the time, date, and place, and due to the causes(s) and manner as stated.” Both of these signature statements accommodate the difficulties often faced in determining what caused death.

CLINICAL DIAGNOSES ARE ACCEPTABLE. If your opinion or knowledge about what caused death is based on a clinical diagnosis, you may still report the condition on the death certificate as a cause of death. For example, if the patient more likely than not had pancreatic cancer, and you think that was the most likely underlying cause of death, you may report it on the death certificate even if no biopsy was done and there was no “proof” of the site.

QUALIFYING TERMS. Although cause of death information should be as accurate and complete as possible, sometimes it isn’t possible to be completely sure what caused or contributed to death. In these cases, you may use qualifying terms with the cause of death such as “probable”, “consistent with”, “most likely”, or “apparent.”

SIGNING A BLANK DEATH CERTIFICATE? If you are worried about signing a blank certificate so someone else can fill in the cause or manner of death for you later, YOU ARE RIGHT TO WORRY! This is like signing a blank check. We don’t recommend it. If someone other than the certifier fills in the cause or manner of death, the certifier should review the information before signing.

See also UNKNOWN AND UNCERTAIN CAUSES OF DEATH