title: Death certification: an audit of practice entering the 21st century.
abstract: 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.
authors.affiliation: Department of Histopathology, Sandringham Building, Leicester Royal Infirmary, Infirmary Square, Leicester LE1 5WW, UK.
authors.forename: B
authors.initials: B
authors.lastname: Swift
authors.forename: K
authors.initials: K
authors.lastname: West
mesh_terms: 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