[The term 'cause of death': an international comparison]

'Cause of death' is an ambiguous concept. Terms such as 'immediate', 'underlying' or 'primary' cause of death are used, along with indications such as 'associated conditions' and 'contributing factors'. Furthermore, the terms 'mechanism', 'manner' and 'method' of death are used internationally. The Dutch classification of the manner of death with just two categories (natural and unnatural death) is not used in other countries. Belgium, Germany, England and the USA use more or other categories. It is recommended that the Netherlands consistently use these terms in accordance with the international codes for both the death certificate as well as the registration form for the cause of death statistics. The circumstances of death of which the medical examiner needs to be notified should be explicitly stated on the death certificate.