How accurate are death certificates?

 

At the time of the public inquiry into Harold Shipman, the South Manchester coroner, John Pollard, was highly critical about the way in which Dr Shipman had been able to register the cause of death on a patient's death certificate as "natural causes." The coroner said that the term "natural causes" was meaningless and was not a cause of death. He added, "It doesn't reveal the medical cause of death any more than putting murder." Yet, Harold Shipman, had been able to get the cremation certificate countersigned by another doctor and thus avoided a post mortem being carried out on the deceased. Harold Shipman was jailed for life for murdering 15 women patients and is believed to have killed more than 300 in his 30-year career.

The head of the public inquiry, Dame Janet Smith, had criticised the coroner for readily accepting a detective's account of a flawed investigation he'd carried out into the suspicious deaths of some Harold Shipman's patients. It was said that Mr. Pollard had "relied entirely on the probity of the police to look at matters properly." It was revealed during the inquiry that the detective who had carried out the flawed investigation, Detective Inspector, David Smith, had kept scant notes and had failed to check if Shipman had a criminal record. The investigation lasted only four weeks with Mr. Smith concluding that Shipman had done nothing improper and the case was dropped. Smith had told the public inquiry that he'd never been involved in such a case and had struggled to find information to support the allegations.

Death by "natural causes" continues to be recorded on deaths certificates and it's known that critical errors on death certificates are quite common. Questions have been raised about the accuracy of people having died of COVID during the COVID-19 pandemic. Many people who died of COVID already had underlying health problems like cancer. Only recently, it was reported that the BBC TV presenter, Dr. Michael Mosley, had died of "natural causes" when he was found dead on the Aegean Island of Symi. The actual causes of death is likely to have been heat exhaustion. Dr. Mosely had collapsed while out walking in very hot temperatures. When Queen Elizabeth II died in September 2022, the cause of death was given as “Old Age.”

Some years ago, I attended a meeting that was addressed by John Pollard. The coroner made it perfectly clear that there's always a reason why a person dies but that it's not always possible to ascertain the reason for a person's death. He pointed out that perfectly healthy young people who engage in sporting activities can suddenly drop dead and it isn't always easy to establish their cause of their death.