How MDs complete death certificates and “old age” not a cause of death

Given our efforts with brain donation, we are often asked by families how they can get a certain “cause of death” listed on the death certificate (DC) and what that means.

Since a brain autopsy or body autopsy cannot be done in time for the death certificate, what is placed on the DC is largely up to the hospice MD, MD in the hospital, MD who most recently treated the patient, or coroner.  Of course families often can influence this.  And, once a brain autopsy report has been received, families can petition to have the DC modified to reflect the confirmed neurological diagnosis.  (There can be a fee associated with this.)

The topic of “cause of death” is raised in a recent blog post in the New York Times.  The author is frustrated that “old age” cannot be listed as a cause of death on a DC.  The author states:

Instead, every death must be attributed to a single disease, which is the immediate cause of death. A second disease may be cited as the intermediate cause, and a third as the underlying condition. Even in situations “when a number of conditions or multiple organ/system failure resulted in death,” the C.D.C. instructs that “the physician, medical examiner or coroner should choose…a clear and distinct etiological sequence,” a “chain of morbid events.”

The author believes that this “biomedical world view” distorts the reality that people do die of old age!

Here’s a link to the article:

The Immediate Cause of Death
New York Times
By Jane Gross
October 23, 2008 6:12 am