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.
Centers for Disease Control and Prevention (2010) Standards to Facilitate Data Sharing and Use of Surveillance Data available at:
for Health Action.
See also: http://www.cdc.gov/nchhstp/programintegration/Data-Security-FAQ.htm
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.
Publication date: May 2018
Resource type: CRVS action 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
This document identifies barriers to accurate COD reporting by physicians and provides recommendations on how various actors can respond.
Author: University of Melbourne
Publication date: May 2018 (update)
Resource type: CRVS development series
Related resources: Action guide on reducing barriers to medical certification