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Pediatric death certification

K A Bowen1, W N Marshall

  • 1Department of Pediatrics, University of Arizona College of Medicine and Steele Memorial Children's Research Center, Tucson, USA.

Archives of Pediatrics & Adolescent Medicine
|September 22, 1998
PubMed
Summary

Most child deaths are certified by medical examiners or neonatologists, not general pediatricians. Education on pediatric end-of-life care should target specialists most involved in critical events.

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Area of Science:

  • Pediatric Mortality Analysis
  • Death Certification Practices
  • Public Health Surveillance

Background:

  • Understanding the patterns of pediatric death certification is crucial for improving end-of-life care and support services.
  • Previous studies have not comprehensively detailed the physician certifiers, locations, and causes of death for children.

Purpose of the Study:

  • To identify the physician certifiers, the locations of death, and the manner of death for all pediatric fatalities.
  • To analyze the specialty of physicians certifying pediatric deaths and the circumstances surrounding these deaths.

Main Methods:

  • A descriptive study analyzing death certificate data for all children aged 0-17 years.
  • Data collected from an urban county covering the years 1995 and 1996.
  • Key metrics included physician certifier's specialty, location of death, and cause of death categorization.

Main Results:

  • The medical examiner certified 42.6% of 361 child deaths, followed by neonatologists (24.1%) and obstetricians (10.0%).
  • Trauma (64.5%) and sudden infant death syndrome (13.5%) were leading causes certified by medical examiners.
  • Most deaths occurred in hospitals, but 10.0% occurred at home and 4.4% on roads.

Conclusions:

  • General pediatricians are rarely the primary certifiers of pediatric deaths.
  • Specialized pediatric critical care and neonatology training should incorporate end-of-life care education.
  • Community-based support services are essential for families experiencing child loss.

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