how to complete a death certificate for cause of death

see also:

• death and the potentially dead
• how to verify death
• reportable and reviewable deaths - deaths which MUST be reported to the Coroner
• Western Health policies index for the deceased patient (intranet only)
  • Western Health's stillbirth and neonatal death procedure (pdf)
  • Western health's procedure for organ donation after cardiac death (pdf)
  • Western Health's post mortem request flow chart (pdf)

• as long as the patient does not fit the criteria for a reportable death, the treating doctor or patient's usual doctor will be required to complete a Medical Certificate of Cause of Death, AND cremation certification if a cremation is planned.

• this is a vital part of the notification process of a death to the Registrar of Births, Deaths and Marriages in the relevant state or territory in which the death occurred, and enables an authority to be provided to the funeral director to arrange disposal of the body.
• accurate cause of death information is important:
  • for legal purposes
    • the information may be relevant to the determination of the validity of a will, or life insurance payment
  • for statistical and public health purposes
    • the information recorded on death certificates is coded by the Australian Bureau of Statistics and is the major source of Australia’s mortality statistics, which enable the evaluation and development of measures to improve the health of Australians
  • for family members
    • to know what caused the death and to be aware of conditions that may occur in other family members.

• The medical practitioner who was either:
  • responsible for the deceased person’s medical care during their last illness or immediately before death, or,
  • who examined the body of the deceased person after death
• BUT ONLY if they are ‘comfortably satisfied’ as to the cause of the death and no other circumstances are present which require the death to be reported to the Coroner.
• when a deceased patient’s ‘treating’ GP is absent or unavailable, another GP in the practice can complete the death certificate provided they have sufficient information to do so.

• Victorian Online process:
  • Medical Practitioner online registration
  • http://www.bdm.vic.gov.au/home/medical+practitioners+online
  • you must complete the online form then PRINT and then SIGN it before the body can be released to the undertakers!
• manual process:
  • blank Medical Certificate of Cause of Death forms can be obtained from the Registry of Births, Deaths and Marriages.
  • once completed, the medical practitioner should forward the completed death certificate to the Registrar of Births, Deaths and Marriages (except in Western Australia where the responsibility for notifying the registrar of a death falls to the funeral director or other person who arranges for the disposal of the remains).
• in South Australia, Tasmania and Victoria, the legislation also requires the medical practitioner to provide the certificate to the funeral director or person disposing of the remains, as well as forwarding the certificate to the registrar.
• in Tasmania and Victoria manual certificates are in triplicate to enable this to occur, but in SA, certificates are in three parts which can then be torn apart (one part for the funeral director, one part for the registrar and one part for the doctor).¹⁾

• the causes of death section is divided into 2 parts:
  • Part 1:
    • sequential list of diseases or conditions leading directly to the cause of death
    • duration of each stated condition should not exceed the duration of condition further down the list
    • if conditions such as cardiac arrest, respiratory failure, chronic renal failure, pulmonary embolism, septicaemia, etc. are entered on line Ia always enter the underlying cause(s) on Ib, Ic etc. to indicate the sequence of events leading to death.
    • when a death is due to pneumonia, identify if the condition is primary hypostatic or due to aspiration. State the cause of any underlying condition that led to the pneumonia and identify the causative organism. If the pneumonia has been caused by debility or inactivity please state the condition leading to the inactivity or debility.
    • neoplasms should be classified according to histology and primary site. If the primary site is unknown, this should be recorded
    • the site and causative organism (if known) of an infection should be included
    • a condition should be regarded as being antecedent not only in an aetiological or pathological sense, but also where it is believed that this condition prepared the way for the direct cause by damage of tissues or impairment of function, even after a long interval.
  • Part 2:
    • list of other significant conditions contributing to the death but not directly causing it (eg. alcoholism, smoker, pregnancy, post-partum, emphysema, ischaemic heart disease)
• ensure it is legible - use block letters
• avoid abbreviations
• see also:
  • Aust. Bureau of Statistics - A BOOKLET FOR THE GUIDANCE OF MEDICAL PRACTITIONERS IN COMPLETING MEDICAL CERTIFICATES OF CAUSE OF DEATH 2001 (pdf)
  • Australian Family Physician Vol. 40, No. 6, JUNE 2011: How to complete a death certificate - A guide for GPs by Dr Sara Bird (pdf)

• cremation is generally less expensive than burials and avoids the process of memorialisation, but as it is irreversible (ie. no option for exhumation), it requires more legal requirements to be met and penalties for contravention are harsher.
• a cremation must generally be conducted in a public cemetery and only after all legal certificates are completed including permission to cremate form has been signed by an officer of the trustees of the cemetery, and an application to cremate (schedule Form 3) signed by the executor or nearest surviving relative, and the schedule Form 4 signed by the medical practitioner.
• a cremation can be performed outside of a cemetery but ONLY with the consent of the Secretary.
• Application for Cremation Authorisation (Cemeteries & Crematoria Act 2003; Cemeteries and Crematoria Regulations, 2005, Regulation 8, Schedule 3 (Form 3)).
• Certificate of Registered Medical Practitioner Authorising Cremation (Cemeteries & Crematoria Act 2003; Cemeteries and Crematoria Regulations, 2005, Regulation 9, Schedule 4 (Form 4)).
  • this form must not be completed by the same doctor who signed the notification of death form for the Births, Deaths and Marriages.