Death certification: an audit of practice entering the 21st century.
OBJECTIVE
Death certification, a legal duty of doctors, continues to be poorly performed despite Royal College recommendations and increased education at an undergraduate level. Therefore, the current performance of certifying doctors was audited within a large teaching hospital entering the new century.


METHODS
A total of 1000 completed certificate counterfoils were examined retrospectively for appropriateness of completion and the ability to construct a logical cause of death cascade.


RESULTS
Only 55% of certificates were completed to a minimally accepted standard, and many of these failed to provide relevant information to allow adequate ICD-10 coding. Nearly 10% were completed to a poor standard, being illogical or inappropriately completed.


CONCLUSIONS
The results show no improvement in the state of certification. Possible interventions to improve outcomes are discussed; however, in light of a recent high profile legal case a current Home Office review of death certification may suggest the passing of statutory law to ensure accurate completion.
Swift
B
B
Department of Histopathology, Sandringham Building, Leicester Royal Infirmary, Infirmary Square, Leicester LE1 5WW, UK.
West
K
K
D002423:Cause of Death; D003644:Death Certificates / Q000331:legislation & jurisprudence*; D004739:England; D006784:Hospitals, Teaching / Q000592:standards; D006801:Humans; D008485:Medical Audit; D010820:Physicians / Q000592:standards*; D011361:Professional Competence; D012189:Retrospective Studies; D009626:Terminology as Topic