Rapid Responses to:

LETTERS: Gordon Pledger Medical examiners employed by health authorities should audit death certificates BMJ 1999; 318: 1559c [Full text]

Rapid Responses: Submit a response to this article

Rapid Responses published:

Cremation forms and death certificates - fact or fiction?

Liz Stevenson   (8 June 1999)

Cremation forms and death certificates - fact or fiction? 8 June 1999
Liz Stevenson Send response to journal: Re: Cremation forms and death certificates - fact or fiction?	Editor- There is another perspective to add to the debate on current cremation procedure - that of the relatives of the deceased. As someone whose husband's death certificate was incorrectly completed (it gave no underlying cause for his cardiac arrest), and who has spent the years since his death in a vain attempt to find out why he died, I can only agree that the present system is ineffective, and that the notion that cremation forms provide a means of medical audit, or act as a safeguard, is highly questionable. Having been repeatedly told by my husband's doctors, for over two years, that a cause of death had never been established, I telephoned the crematorium and asked what cause they had on record. It transpired that the cause that they had as 'definitely ascertained' was unverified and incorrect; it was also entirely different from the cause given to the General Register Office after the death certificate had been queried - another fact that I uncovered purely by chance. There was no evidence to support either of these official causes, and my husband's death should undoubtedly have been investigated, yet there was neither a post mortem nor a report to the procurator fiscal. It is apparent that the current system provides no guarantee whatever that correct procedure will be followed. My husband's cremation form B, like his death certificate, gave no underlying cause, yet the medical referee failed to query it. If, as my experience indicates, the cremation forms are merely regarded as a rubber-stamping exercise, and if deaths with an unknown or uncertain cause are not investigated, we have to question the efficacy of such a procedure. If my husband, at the age of 39, could be cremated with an incorrect cause of death, we can only wonder how often such failures occur. Abandon the present system by all means, and find a better method of monitoring and audit. Medical examiners checking death certificates prior to registering deaths, as Dr. Pledger recommmends, would be a a way forward, and would also prove a great deal more helpful to relatives in a similar position to mine. Whether such a system would actually ensure greater accuracy of reported causes of death, however, is another matter entirely. Liz Stevenson 29 Comiston Drive, Edinburgh, EH10 5QR.