Correspondence (letter to the editor): Incorrect Causes of Death

Problems are repeatedly caused by pressure at the scene from the police or detectives who want the death certificate filled out on the spot. This does not allow one to have another look at a more detailed patient medical file, nor to refer to other colleagues who were involved in treatment either previously or concurrently. This alone, especially in cases where death occurs at an awkward time, must lead to incorrect statements of causes of death and chains of causality. In Schleswig-Holstein, the only permitted entries on the death certificate for manner of death are “yes” or “no” with reference to “indication to suspect unnatural event”—“unexplained” is not an option—so one has to commit oneself to an opinion. If you check the “unnatural” box, e.g., postoperatively or immediately after discharge from hospital, you are regularly put under strong pressure to reconsider this.