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Medical Certification of Cause of Death

Rodrigues EJ, Sapeco SD, Ghodkirekar MG

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Causes of Death

I Immediate Cause: State the disease, injury or complication, which caused death, not the mode of dying such as heart failure asthenia etc.

Antecedent Cause: Morbid conditions, if any giving rise to the above cause, stating the underlying conditions last

II Other significant conditions if any giving rise to the above cause, stating the underlying conditions last.

Interval between onset and death approx

a) due to ( or a consequence of)

b) due to (or as a consequence of )

Besides the medical part the form also includes some minimum demographic and identification particulars about the deceased. The forms have a detachable portion separated by perforation mark containing information on fact of death. Separate forms exist for hospital (Form 8) and for non hospital events (Form 8A)

The top part of the Form 8 / 8 A (Medical part) is submitted to office of registrar through an informant along with Form 4 (Death Report) where as the bottom portion is detached and given to the relatives of deceased for carrying out the final rites of the dead body.

According to the recommendation of the Brodrick Committee, a doctor should not be allowed to issue medical certificate of cause of dearth unless he has attended the deceased at least once during the seven days preceding death. According to Registration of Births and Deaths Act, 1969, the doctor should issue certificate forthwith so that there is no delay in registration on this account.

Any medical practitioner or physician of allopathy, ayurvedic, homoeopathic or unani, can fill the medical part of the certificate. The act also incorporates a clause on confidentiality of the information on cause of death. It states that any person may obtain an extract from registrar relating to any birth or death provided that no extract relating to death, issued to nay person shall disclose the particulars regarding the particulars regarding cause of deaths as entered in the register (Form 10)

Doctor’s Role as Informant:

This act specifies certain categories of persons as informants in various places of occurrence of events. It is the duty of informant to report to the registrar the facts of the occurrence of a vital event together with certain of its characteristics in the prescribed form and only on the basis of his report the event may be registered.

The doctors becomes the informant specified by act as in charge in events in hospitals, health centres, nursing homes, or other like institutions or he can authorize any person to act as informant on his behalf.

The death report (Form 4) duly filled by the informant is to be submitted to the registrar irrespective of whether death is medically certified or not. In all medically certified deaths Form 4 is accompanied by Form 8 / 8A (Issued by the doctor)

In medico legal cases the hospital authorities or physician should inform the registrar details thereof for follow up action in obtaining the required certificates from the police authorities. The object is that on receipt of information the local registrar could register the event of death without completing the column of cause of death making a note in remarks column that the inquest report is awaited The cause of death could be filled in later, on receiving the inquest report or Postmortem report.

The Registration of Births and Deaths Act, 1969 has taken good care in safeguarding confidential nature of information by the physician.

The act specifies uniform reporting period of 14 days in case of births and seven days in case of deaths in both rural and urban areas.

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