Inadequacies of Death Certification: The Role of Forensic Pathologist.

Korean J Leg Med. 2002 Oct;26(2):72-79. Korean.

Department of Forensic Medicine, National Institute of Scientific Investigation, Korea. isyme@nisi.go.kr

Death certification is a public health surveillance tool and a valuable source of information at the national and local levels. Among activities that benefit from the availability of cause-of-death statistics obtained from death certificates are the monitoring of the health of populations, the setting of priorities and the targeting of intervention. Such statistics are also the keystone of much epidemiological study. So adequate writing cause-of-death statements for death is very important. The present study was undertaken to evaluate death certification in Seoul and Kyung-in area of Korea. The available 203 death certificates were obtained from the 1026 autopsy files of National Institute of Scientific Investigation(june, 2002-september, 2002). The summary of the results were: 1. Cases that writing the phenomenon such as cardiac or respiratory arrest, heart failure in the box of cause-of-death were 64 cases(31.5%). Cases that writing the immediate cause of death in the second or third line of box were 50 cases(24.6%). Cases that writing two or more immediate cause-of-death in one line of box were 36 cases(17.7%). 2. Cases that the statement of cause-of-death not correlated with the statement of manner-of-death were 18 cases(8.4%). 3. Cases that the immediate cause-of-death and manner-of-death is changed after autopsy were 179 cases(88.2%). The results of this study showed inadequacies of death certification in Seoul, Kyung-in area of Korea. We thought the reasons for this inadequacies of death certification were mainly insufficient education and campaign for physicians about accurate understanding of cause of death, manner of death. The forensic pathologists certified a number of deaths and have responsibility for education about cause of death, manner of death. So we emphasized need for forensic pathologists to be involved in works related with death certification forms and policies.

Key Words : Death certificates, Cause of death, Manner of death, Forensic pathologists