Forms for medical certificates of the cause of death under the Births and Deaths Registration Act, 1953 : prescribed by regulations made by the Registrar General with the approval of the Minister of Health under section 22 (1) of the Births and Deaths Registration Act, 1953 : these forms must be kept in safe custody, not to be used in cases of still-births (see page 1).

  • Great Britain. General Register Office
Date:
1962
Catalogue details

Licence: Public Domain Mark

Credit: Forms for medical certificates of the cause of death under the Births and Deaths Registration Act, 1953 : prescribed by regulations made by the Registrar General with the approval of the Minister of Health under section 22 (1) of the Births and Deaths Registration Act, 1953 : these forms must be kept in safe custody, not to be used in cases of still-births (see page 1). Source: Wellcome Collection.

    4/112 (page 3)
    STATEMENT OF CAUSE OF DEATH 1. The cause of death (excluding interval between onset and death) as certified by the practitioner in attendance during the last illness is entered by the registrar in the death register and forms part of that record. The entry in the death register and the certificate of cause of death itself are also utilised as material for the mortality statistics published by the Registrar General. The value of these statistics will be materially enhanced if certifying medical practitioners will:— (a) read and adopt, so far as possible, the suggestions printed below, remembering that the international classification of causes of death is based, not upon terminal clinical states but upon the antecedent and underlying pathological causes, of which the certifier is generally best qualified to form an opinion; (b) write the names of diseases (in full) in the certificates as legibly as possible, to avoid the risk of their being incorrectly transcribed into the death register. In view of the importance for many public purposes of the mortality statistics based upon these certificates, the Registrar General hopes that he may rely upon the co-operation of the medical profession in these matters. 2. It is desirable that medical practitioners should employ as far as possible only those terms recommended in the Nomenclature of the Royal College of Physicians of London or mentioned in the International Statistical Classification of Diseases, Injuries and Causes of Death. The use of vague and ill-defined terms is particularly to be avoided. An alphabetical list of commonly used incomplete causes is appended, with comments indicating in what respect the term is unsatisfactory and what further information as to the cause of death is required in each case for classification purposes. A few unobjectionable terms are included in the list for special reasons. 3. In cases where an indefinite term has to be employed because more definite information is lacking it would be well to indicate this fact in the certificate, e.g., by the words “ Cause Unknown ”. 4. The certificate is in the form recommended by the World Health Organization for international use from 1950 onwards. It differs in no essential particular from the form used by the Registrar General since 1927, except that space is given for the interval between reputed onset and death. (See 8.) 5. In a very large number of cases only one cause of death need be stated and in these the form of the certificate is of little importance. But where two or more causes must be entered it is of the utmost importance for purposes of classification that the arrangement of causes on the certificate should accurately represent the certifying practitioner’s opinion as to their order of occurrence if the causes were related one to another, or as to their relative importance if independent. 6. The present form of certificate is divided into two sections (I and II). In “ I ” should be entered the immediate cause of death and any morbid conditions which led up to it, if such there were, the latter being stated in order backwards from the immediate to the antecedent causes. In “ II ” should be entered conditions which are not in the chain of pathological events which have led to the immediate cause of death but which have none the less contributed to the fatal issue. The examples on page vii will make these points clear. 7. It is suggested that the practitioner should in each case first consider whether the essential features of the case cannot be epitomised by statement of a single cause (e.g., pulmonary tuberculosis) and that where entry of more than one cause is required he should next consider whether the con¬ ditions specified were or were not of independent origin, and indicate this by entry in the appropriate space. 8. When possible it should be stated in the certificate whether the condition was acute or chronic. In addition to such statement (and not as a substitute for it) the interval between date of onset, as nearly as it can be estimated, and date of death is asked for in the case of each condition entered. In many instances this can only be a rough guide to duration, but even so it will suffice to prevent errors in classification to the underlying cause. 9. In addition to the foregoing general considerations, the following points as to special causes of death call for attention:— (a) Cancer.—The primary site should be stated in all cases where it is known, even if the primary growth has been removed at previous operation. If it is not known, state the site of the secondary growths and add “ Primary not known ”. Primary growths in the liver, lung, or lymph nodes should be specified as primary. The following list shows the way in which the International Classification of Diseases classifies cancer of certain sites. If these requirements are borne in mind when completing medical certificates of cause of death, enquiries for additional information will be avoided. Lip upper, lower Tongue base, other parts Mouth floor, other parts Nose internal, external Pharynx tonsil, other mesopharynx, nasopharynx, hypopharynx Small intestine duodenum, other parts Large intestine ascending, transverse, descending, sygmoid Uterus cervix, corpus, other (including chorionepithelioma) Skin specified parts of face and neck, trunk, upper limb, lower limb Nervous system brain, spinal cord, meninges, peripheral, sympathetic (b) Childbirth.—Whenever parturition or pregnancy has been in any way a contributory cause of death, the nature of the abnormality, if any, should be mentioned on the certificate. If the delivery was an abortion (under 28 weeks gestation) or was premature, this should be stated. The word puerperal should not be applied to post-abortive conditions. Whatever the cause, state whether death occurred during pregnancy or after abortion or childbirth. (c) Prematurity.—State the weight at birth if known; if not, the estimated duration of gestation. (d) Congenital causes.—^If believed to have been congenital, state this. (e) Operations.—Mention tonsillectomy; mention Caesarean section or use of instruments in parturition. Always state the disease or condition for which the operation was performed. (/) Anaesthetics.—When death occurs during anaesthesia, or is in any degree attributable thereto, the nature of the anaesthetic(s) used and their sequence should be recorded.