Physicians Resources

Physicians Responsibilities


How to Properly complete Certification of Death

Acceptable / Non Acceptable Cause of Death

Certifier of Death (Physician, Medical Examiner, or Coroner)

Completes the cause-of-death section of the death certificate and signs certificate

Completes information on decedent name (in margin) as well as date, time, and place of death

Forwards signed certificate to the funeral director


If death will not be certified by a medical examiner or coroner, it is the responsibility of the attending physician to complete the cause – of – death section of the death certificate. In some states, failure to do so may be violation of state law or vital records code. Regardless of whether state law requires it, attending physician has the professional responsibility of completing the death certificate and should not shirk that duty. Completion of death certificate may be considered as part of the patient’s end -of- life.

Some states allow ready access to copies of death certificates, while most do not. Regardless of whether death certificates are regarded as open or closed records, the certifier of death should report the cause of death as objectively, completely, and accurately as possible based on information available at the time.

Physicians also need to be aware of:

State and local regulations regarding deaths that must be reported to the medical examiner or coroner.

How to complete the relevant portions of the death certificate (topic of this book)

How to make the signed death certificate available to the funeral director for filing

How to assist local or state registrars by promptly responding to queries or other inquiries

State or local laws that require a death certificate to be filed within a specified number of days following death (usually 2 to 10 days)

How to file supplemental report or amendment of the cause of death if autopsy or other information shows the cause of death to be significantly different from what was originally reported on the death certificate.

Ways to write cause – of -death statements that communicate the same essential information as a concise clinical history would, while telling the story of the patient’s death in a logical, clear, and medically sound sequence (topic of this book)

Applicable state laws regarding death certificates, medical examiners, and coroners

Terminal Events, Nonspecific Processes, and Mechanisms of Death

Terminal events are final common pathways to death and include such conditions as:

Cardiac arrest

Respiratory arrest

Cardiopulmonary arrest


Ventricular fibrillation

Electromechanical dissociation

These terminal events do not provide useful information and should not be included in cause - of - death statements.

A nonspecific anatomic process is a complication or sequel of underlying causes of death and may be a macroscopic or microscopic alteration that may have functional consequences and more than one possible cause. A typical example is cirrhosis, which can be the end result of more than one disease.

A nonspecific physiologic derangement (may also be referred to as a mechanism of death) is a nonspecific functional disturbance that is a complication of an underlying cause of death and that may have more than one cause. A typical example is hemorrhage.

It is appropriate to include important nonspecific processes and derangements in cause-of-death statements as an immediate or intermediary cause of death, but the underlying cause of death also needs to be reported.

The following list includes just some of the nonspecific processes and derangements that do not stand on their own as an underlying cause of death. If such conditions are reported on the death certificate, a specific underlying cause of death should also be reported, when possible.


Proper Certification of Death Guidance

Death Certificate: A Final Service to Your Patient

Physicians Frequently Asked Questions (FAQ)

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Delaware County, presently consisting of over 184 square miles divided into forty-nine municipalities is the oldest settled section of Pennsylvania.

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