Module 2 Guidelines for Completing the Medical Certificate of Death
Module 2 Guidelines for Completing the Medical Certificate of Death
Cause of Death- Section 7
7. Ensure this section is completed as accurately and completely as possible.
Guidelines for Determining Cause of Death
This section contains two parts, Part I is designed to record the sequence of conditions causing death in an ascending casual order with one cause recorded per line, and Part II is designed to record any significant contributing conditions. The cause of death reported is to be the best opinion/reasonable determination of the individual completing it. Your duty is to indicate a cause of death as accurately as possible recognizing that medicine is not an exact science, and an exact cause of death is sometimes elusive. The cause must consist of a diagnostic entity which is a term used to describe a disease or other morbid condition (Office of the Registrar General, 2010). The cause of death must only meet the test of “being more likely than not” (Saskatchewan Coroners Service, nd). It is sometimes easiest to consider the conditions leading up to the death in a bottom to top fashion with the immediate cause being the top.
Important Definitions
Underlying Cause of Death (Part I)
The disease that initiated the chain of events that led directly to the death. This is considered to be what started it all, the first and oldest condition and must have caused all of the conditions on the lines above it (reported on line C in Part I of the Medical Certificate of Death).
Intermediate (Antecedent) Cause of Death (Part I)
For some deaths, the sequence of disease involves conditions that occur at a time between the underlying cause and immediate cause. This is considered to be an event older than the condition listed on line A and newer than the condition listed on line C (recorded on line B in Part I of the Medical Certificate of Death).
Immediate Cause of Death (Part I)
The final disease or complication resulting from the underlying cause of death that directly caused death. This is considered to be the most recent condition that caused the death (recorded on line A in Part I of the Medical Certificate of Death).
The terms cardiac arrhythmia, asystole, shock, exsanguination, respiratory failure, or cardiac arrest should never be used as an immediate cause of death (line A Part I) unless it is accompanied by a specific disease entity (line B or C Part I).
It is not necessary or always required to use all the lines in Part I. The underlying, intermediate, and immediate cause of death are linked in a cause-and-effect relationship from bottom to top.
Other Significant Conditions (Part II)
Pre-existing or co-existing disease(s) that contributed to death but did not result in the underlying cause of death (recorded in Part II of the Medical Certificate of Death).
Interval Between Onset and Death
This section is used to record the time interval between the presumed onset of the condition (not necessarily the date of diagnosis) and the date of death. Interval