Death certification: a primer. Part I--an introduction to the death certificate

Unlike the medical record, the death certificate is a public legal document that deserves the certifier's best intellectual effort to complete. The death certificate serves a variety of purposes, to include: A. Legal proof of death, usually necessary for a family to receive social security, health insurance, and other death benefits. B. A closure statement to the family from the physician documenting his or her final diagnosis. C. A family heirloom document that preserves a family history of causes of death (which may be invaluable in documenting hereditary diseases within a family). D. The death certificate is the backbone of national death statistics. Incorrect data from death certificates translates into incorrect state and national death rates for all causes. Cause of death assessment is inherently inaccurate (autopsy studies suggest that at least 10 percent of deaths have major unrecognized underlying disease processes that would have altered therapy had they been known). Even correct diagnostic assessments, however, can be lost to the system if they are improperly entered on to the death certificate.