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Medical certification of cause of death

Legal and practical support to physicians

It is essential to implement strategies to ensure that certifying physicians have the legal protection and support for their COD certification activities. This should involve multiple entities, including the national civil registration and vital statistics (CRVS) committee, office of the registrar-general, the ministry of health, medical professional associations and national statistics agency. Key actions include:

  • Introduce and enforce legal and policy frameworks that protect physicians from undue pressure when assigning COD. 
  • Clearly communicate to physicians the legal and policy protections that are available to support accurate COD certification. 
  • Encourage physician peer support to address challenges associated with MCCOD.
  • Encourage physicians to seek guidance from a hospital or medical ethicist, ethics committee or legal advocate when responding to very challenging individual circumstances around certification of COD. 
  • Ensure that detailed information on individual causes of death is shared with national statistical agencies for aggregation and analysis when individual identities have been removed. 
  • Permit the sharing of individual COD information with health authorities only in cases of overriding health imperative to prevent the spread of notifiable diseases. 
  • Raise awareness through community education and advocacy campaigns around causes of death that are stigmatised or sensitive and the reasons why it is imperative to report these correctly.

Read more

Centers for Disease Control and Prevention (2010) Standards to Facilitate Data Sharing and Use of Surveillance Data available at: http://www.cdc.gov/nchhstp/programintegration/SC-Standards.htm#DATA-SHARING for Health Action.
See also: http://www.cdc.gov/nchhstp/programintegration/Data-Security-FAQ.htm


Action guide on reducing barriers to medical certification
Action guide on reducing barriers to medical certification

Describes five actions that can be taken to reduce barriers to accurate medical certification of cause of death, from legislative review to training and support.

Download resource (489KB)
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Publication date: May 2018

Resource type: CRVS technical guide

Related resources: Reducing barriers to the accurate medical certification of cause of death


Reducing barriers to the accurate medical certification of cause of death thumbnail
Reducing barriers to the accurate medical certification of cause of death

This document identifies barriers to accurate COD reporting by physicians and provides recommendations on how various actors can respond.

Download resource (600KB)
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Author: University of Melbourne

Publication date: May 2018 (update)

Resource type: CRVS best-practice and advocacy

Related resources: Action guide on reducing barriers to medical certification


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