Legal Issues for Medical Professionals

  CONFIDENTIALITY
 

Although the death certificate is a legal document, its use in certain court or legal procedings is restricted to providing proof of death.  The cause of death as indicated on the death certificate may not be admissible in legal proceedings as proof of the cause of death.  In fact, the death certificate is protected by statutes that preserve its confidentiality.  Access to the death certificate is restricted, for 25 years, to immediate family members. Both of these issues relate to the certifying physician's duty to accurately document the cause of death.  While certifiers should recognize the potential legal aspects of death certificates and the wording of the cause of death statement, certifiers should concentrate most on the medical and scientific content of the stated cause of death for reasons of accuracy.  The confidentiality statutes are intended to protect the privacy of the family or the dignity of the deceased; the certifying physician's primary duty is thus to report accurately the cause of death.   PROFESSIONAL RESPONSIBILITY In some states, attending physicians may not be legally required to certify the death of a patient, and, for a variety of reasons, some physicians prefer not to certify death certificates.  However, refusal to certify a death can cause delays for the family, funeral director (who cannot, at times, hold the funeral until the release of the death certificate), and other agencies.  Further, certification may ultimately be performed by another certifier who has less knowledge of the patient's history, clinical course, agonal events, and actual cause of death.  The attending physician should not abandon a patient's interests after the death of taht patient and, unless required otherewise by law, attending physicians should make every effort to ensure that the deaths of their patients are certified.   UNDUE DELAY OR FALSIFICATION OF DATA Knowingly falsifying data on the death certificate is a serious offense, punishable by a possible jail sentence of  2-10 years and  up to $10,000 in fines. While some physicians are hesitant to certify death if they do not know an exact cause of death, such hesitancy is usually unnecessary.  Although the cause of death should, ideally, be accurate and specific, the death certificate is not a legal guarantee of accuracy. The cause of death as stated must only be the best medical opinion of the certifier, to the best of the certifier's knowledge.  As explained elsewhere in this tutorial, the death certificate format allows for expression of uncertainty, qualification, and probability -- in recognition that medicine is not an exact science and that an exact cause of death is sometimes elusive. A physician should not cause undue delay in the completion of the death certificate.  Texas law calls on physicians to certify the death and release the death certificate within 5 days from the date of death of the deceased.  There are fines and penalties for delaying the processing of a death certificate by the physician who is taking an undue amount of time to complete the cause of death portion of the certificate.

 
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Last Revised: 5/3/99