London School of Hygiene & Tropical Medicine

Many doctors view the completion of death certificates as an 'irritation' or a 'necessary evil' rather than a vital aspect of their work, a letter in today's British Medical Journal reveals.

Dr Aileen Clark, Senior Lecturer and Dr Jean Gladwin, Research Fellow at the London School of Hygiene and Tropical Medicine's Health Services Research Unit, who carried out research in support of the Government's recently published 'Fundamental Review: Death Certification and Investigation in England, Wales and Northern Ireland', have written to the British Medical Journal today to encourage a rethink in attitudes to death certificates.

As part of this work they interviewed doctors about the processes and practice of death certification. They found that although doctors did not lack respect for the process, they often saw it as an interruption to their 'real' work, an 'irritation' or a 'necessary evil'.

'Completing an accurate death certification may be one of the last acts of good medical care a doctor can perform for one of his or her patients', explain the authors in the letter. 'It can allow the relatives and friends to understand more clearly what has happened to the person who died. And it can allow for the best use to be made of that person's death to improve the health of the living. The more accurate our mortality statistics, the better informed we will be to deliver best health care to the living'.

The authors call for ideas about a 'good death', and the acknowledgement of terminal and serious illness, death and dying to be built into the curriculum for trainee doctors and health specialists. 'It needs to be appreciated that dying and death are part of the 'real' work of health care and that best care of the living often involved acknowledgement of the possibility of death', they say.

To interview either of the authors, please call the London School of Hygiene & Tropical Medicine on 020 7927 2073.

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