[Causes of death in patients with cerebral neoplasms]

The case records of 41 patients with cerebral cancer and their death certificates were reviewed with the object of investigating clinicians' causal reasoning. No really clear impression could be obtained. The case records did not contain any reflections about clinical or paraclinical conditions which might be related to conceptions of causality. The death certificates contained errors and deficits which were so serious in 44% of the cases that the death certificate presented an erroneous picture of the cause or causes of death. Minor errors were encountered in further 19% of the death certificates. These involved logically untenable statements of causes in 11 certificates (27%), statements about conditions which were not in agreement with the reports in 13 cases (32%) and errors in the statements about duration in ten cases (24%). These results scarcely express doctors' causal reasoning but rather that there is no uniform conception of how death certificates should be completed.