Why is the coroner calling me to complete the Medical Certificate of Death?

If a matter is reported to the coroner and the coroner determines that they will not investigate the death the coroner can authorize a physician to complete the Medical Certificate of Death. You can be well assured that if the coroner is calling you to complete the certificate, they have done a thorough analysis of the scene and body, have considered medical history including medications, have conducted interviews surrounding the circumstances, and have come to the conclusion that the death was due to natural causes.

Physicians completing the Medical Certificate of Death should carefully review the medical records or make the necessary inquiries to satisfy themselves that the information provided about the circumstances of death is correct. Physicians who are unsure whether or not a death constitutes a coroner’s case should consult directly with the coroner. A consult with the coroner does not automatically make it a coroner’s case.

Disagreements about who is the “last attending physician” in a particular situation can delay the timely completion of a Medical Certificate of Death. Given the ambiguity sometimes associated with this term, the following criteria should be used to determine who should complete it:

1. In general, the physician who has the most complete and recent knowledge of the decedent should complete the Medical Certificate of Death. This is often a family physician, or nurse practitioner but may also be a specialist who has a good knowledge of the decedent’s medical history.
2. Physicians covering for their colleagues are urged to make every effort to complete the Medical Certificate of Death. A chart review is often enough to establish a reasonable determination of the medical cause of death (College of Physicians and Surgeons Saskatchewan, 2019).

Some physicians are hesitant to certify death if they do not know an exact cause of death. Such hesitancy is usually unwarranted. Although the cause of death should ideally be accurate and specific, legally it is not a guarantee of accuracy. When the certifier indicates a cause of death and signs the death certificate,  the cause of death is based on available information and designates that the cause of death was determined to the best of the certifier’s knowledge.  Every effort should be made to base the cause of death on all information that is available from medical records, and any other individuals with knowledge regarding the death (Hanzlick, 2006). The certifier should select the causes that are suspected to have been involved and use words such as ‘‘probable’’ or ‘‘presumed’’ to indicate that the description provided is not completely certain. (Centers for Disease Control and Prevention, 2003).