DuPage County IL – Coroner - Information for Hospitals & Physicians - Signing Death Certificates
As with any other delegated tasks, the supervising physician is ultimately responsible for ensuring that death certificates are properly filled out and filed. Clinicians may not decline to sign a certificate because they are uncertain of the exact cause of death.
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Clinicians are merely expected to exercise their best clinical judgment under the circumstances, just as they would in diagnosing treatment for a patient. Understand that, before the attending physician is contacted about signing the death certificate, an assessment of the circumstances has almost always been made by EMS, law enforcement, or the medical examiner. Natural deaths are referred to the medical examiner only in extremely limited circumstances.
Death certificate
Refusing to sign a death certificate and forcing the case to be accepted by the medical examiner: 1 Does NOT mean that an autopsy will be done. It probably will not be. As such, physicians are not required to establish a specific anatomical reason causing the death. If that were the case, postmortem studies autopsies would be necessary in all deaths.
Death Certificates
Obviously, performing autopsies on a routine basis would be unmanageable and beyond the resources of both the medical examiner and hospital-based pathologists. The requirement for death certification is a statement of the condition most likely responsible for death.
Clinicians may be uncertain about the exact cause of death, even if they have been treating the patient for one or more stable chronic conditions. The physician, PA or NP may feel that the death is unexplained and believe the decedent should be referred to the medical examiner to determine a specific anatomical diagnosis.
This is NOT the case. If a specific anatomic cause of death is desired a clinician may request permission for a private autopsy from the family after clearing the death with the medical examiner. Remember, the cause of death is a medical opinion and is based on the preponderance of medical evidence, which includes the cumulative effects of multiple risk factors for particular disease processes. Cause of death is the disease process that sets in motion the chain of events that lead to death.
For detailed guidance on completing death certificates, I recommend the U. The chance of facing investigation by the Board, or other adverse legal consequences, related to the completion of a death certificate in good faith is remote and should not deter a physician from performing this duty.
How quickly must death certificates be completed? Based on the calls and complaints the Board receives, this does not always happen. The reporting of vital events is an integral part of patient care. Adding a separate check box to indicate an unincorporated place will help avoid this problem. A listing of Michigan places and their incorporation status is enclosed and will be available through the state Web site to assist in clarifying this issue.
The format for reporting the decedent's education has been revised to require reporting years of school completed for less than high school and degrees earned for high school or higher levels of education. Entering the standard initials for a degree are appropriate, i. While national standards require the collection of Hispanic ethnicity, Michigan continues to prefer an open ancestry item.
Unfortunately, when the ancestry of the decedent is not known or is reported as American, their Hispanic status is lost. This item will compliment the ancestry item and eliminate the current "unknown" Hispanic problem. This item is intended to record the relationship of the informant to the decedent, as in husband, wife, son, daughter, etc.
This item compliments the item actual time of death, item 28a, which has been collected historically. A medical determination on whether tobacco use played a role in this death.
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This item was added to the national standard form to provide a better opportunity for documenting when a death is tobacco related. An item to insure better identification of all pregnancy related deaths as part of the ongoing national monitoring of maternal deaths.
An item to report the involvement of the decedent in a car or other vehicle crashes. Indicate whether a driver, a passenger, a pedestrian or the like. This item was added to the national standard form to enable more accurate US coding of vehicular deaths following new international guidelines. Tweets by MichiganHHS.
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Browsers that can not handle javascript will not be able to access some features of this site. Some functions of this site are disabled for browsers blocking jQuery. Effective January 1, The State of Michigan developed a revised death certificate to be used for all deaths that occur on or after January 1, Unincorporated Places Summary of Changes The following information provides a quick summary of nine key changes to this form. Item 5. Name at Birth or Other Name Used for Personal Business This field is intended to better identify the decedent to facilitate handling affairs after death and to create a better historical record.
Item 8c. Unincorporated Places With the current certificate listing an unincorporated place as the place of residence for the decedent can result in registration problems and can interfere with the families wishes for listing their residence at death.