Protocol for writing cause-of-death statements for deaths due to natural causes

The purpose of this article is to describe a protocol that provides suggestions and guides the clinical practice of writing cause-of-death statements for death certificates, autopsy reports, and other medical documents. The 16 members of the Autopsy Committee of the College of American Pathologists (CAP), Northfield, Ill, were appointed by the CAP officers based on demonstrated interest and expertise in autopsy performance and reporting. The committee perceived a need for specific instructions aimed at promoting consistency, accuracy, and completeness when writing cause-of-death statements. Development of a protocol was supported by CAP after approval by the CAP board of governors. The framework for the protocol was based on recommendations of the National Center for Health Statistics, Hyattsville, Md, with additional concepts added by the autopsy committee. The protocol for writing cause-of-death statements for natural causes is expected to foster consistency, accuracy, and completeness in the writing of cause-of-death statements. The quality of individual death certificates, autopsy reports, and national mortality data may improve through protocol usage. Application of the protocol principles should impose no ongoing costs at any user level because no new products or personnel are required for its application.