Editor—Dyer reports that a new agency to catch underperforming or incompetent doctors has been set up.1 It was set up in the wake of an official report confirming that Harold Shipman, a British general practitioner serving life for killing 15 patients, was one of the most prolific serial murderers in history.
One of the diagnoses found to be unusually common on death certificates for deaths certified by Shipman was “old age.” The rules in the front of books of death certificates allow this diagnosis to be used for people aged over 70. But patients aged 70-75 are not classified as elderly today. Few doctors who work with elderly people are unable to give a specific cause of death, even for patients over 95. I use “old age” only for those few patients over 85 (no more than one a year) who make an active decision to fade away and in whom disease has been excluded by physical examination, blood tests, basic radiology, and psychiatric examination.
The time has come to restrict or even abolish use of this cause of death on certificates.
References
- 1.Dyer C. New agency set up to identify incompetent doctors. BMJ. 2001;322:67. . (13 January.) [PMC free article] [PubMed] [Google Scholar]