Uses of Death Certificates
Death certificates have multiple purposes. They serve as a permanent record of death and typically the deceased’s estate requires them for the burial and settlement. They provide documentation of an opinion regarding the cause, circumstances, and manner of death. Public health purposes are also a common reason behind the distribution of death certificates. These purposes include evaluating the general health of the population, as well as determining the prevalence of medical conditions among certain cohorts of the population. Death certificates provide data to triage medical research needs and help determine the appropriation of resources regarding health service grants.
State statutes govern Death certificates. Certification and completion of the certificate is typically the responsibility of the attending physician, or the physician in charge of the patient’s care, at the time of death. Effective January 1, 2022, in Illinois, an advanced practice registered nurse may complete and sign a death certificate. According to 410 ILCS 535/ Vital Records Act, the completed and signed by the provider within 48 hours after death, except when the death is subject to the coroner’s or medical examiner’s investigation. Also, each death that occurs in Illinois shall be registered by filing a death certificate with the local registrar of the district in which the death occurred, or the body was found, within seven days after such death and before cremation or removal of the body from the State with the same exception for coroner’s or medical examiner’s cases.
Components of the Document
Regarding the medical section of the document itself, there are two components: the cause of death and contributing conditions. The cause of death is based on the medical opinion of the provider. When there is not 100% certainty as to the cause of death, it is appropriate for the provider to document “unknown” or “probable”. The cause of death includes three sections: mechanism, immediate cause, and underlying cause of death. As an example, a patient’s immediate cause of death could be acute respiratory distress syndrome, due to pneumonia, due to COVID-19. Contributing conditions could include diabetes and obesity as both increases the risk of morbidity and mortality from COVID-19.
The National Center for Health Statistics also collects data from death certificates about risk factors. Death certificates inquire as to whether tobacco contributed to the death. In addition, one section asks if the deceased was pregnant within the year or if the death was work-related.
Deaths that fall under the jurisdiction of the medical examiner or coroner vary by region. The statutes and regulations of local health codes publish reporting requirements. As a general rule, reportable deaths include accidents, suicides, homicides, poisoning, drug intoxication, a disease with potential public health threat, deaths resulting from employment, deaths related to medical or surgical complications, suspicious deaths, deaths of individuals in police custody, and unattended deaths.
Thus, what seems like a simple document, has a large reach in terms of public health. To complete the document comprehensively and accurately, it is imperative to have inclusive medical records. At Hospice of Southern Illinois, we strive to complete death certificates for our families timely and accurately.