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The County of DuPage
Wheaton, Illinois
 

Signing Death Certificates

The last service and care that the attending physician can offer to the deceased patient, and especially, the remaining family and descendants is a proper and most accurate completion of the Death Certificate. The purpose of the Death Certificate is to create a permanent record of the cause and manner of death. If there is no suspicion or questionable death then our goal is to record the most valuation information available for the personal and public good.

You, as the treating Physician, are helping create a document for posterity to help future generations. This cause of death can best be determined by a thorough examination, autopsy toxicology etc.. The coroner's office is charged with doing this when there is suspicion and other mandated situations. However, when these situations do not exist the coroner is not mandated to do further examination. The hospital pathologists may perform and autopsy or the family may request private autopsy.

When an autopsy is not done the patient's personal physician has the best knowledge and is best able to document the vital information regarding the patient's final illness and death. 

This information is considered so important to the Public Good (well being of society) that the Illinois Legislature has obligated the attending physician with the duty to certify the death certificate of patients under their care.

TREATING PHYSICIAN'S OBLIGATION:

The following is the pertinent section of the Vital Records Act which mandates that the treating physician must sign the death certificate for patients under their care:

    (410 ILCS 535/18) (from Ch. 111 1/2, par. 73-18) 

    Sec. 18. 

    (2) The medical certification shall be completed and signed within 48 hours after death by the physician in charge of the patient's care for the illness or condition which resulted in death, except when death is subject to the coroner's or medical examiner's investigation. In the absence of the physician or with his approval, the medical certificate may be completed and signed by his associate physician, the chief medical officer of the institution in which death occurred or by the physician who performed an autopsy upon the decedent. 

This statutes states that the physician attending the patient for the condition which caused his or her death SHALL complete the Death Certificate within 48 hrs of the death. There is no time frame as to when the patient was last seen or cared for in this statute, only the question of whether the death is subject to a Coroner's investigation or not. 

Please consider the value that you as the treating Physician can pass to the remaining family and generations to come by putting your most educated and thoughtful diagnosis on this important document. If you do not feel that you can provide this data then consult with the Coroner or Deputy Coroner and assist them. The Death Certificate will then be completed by the Coroner's Office with as much information as possible.  

Physician Liability from Signing Death Certificate:

Physicians are reasonably concerned about liability and repercussions for their actions.

Later, in this statute, it is stated that you are committing a  Class A misdemeanor only if you knowingly make a false statement and at the same time are committing a Class A misdemeanor if you do not perform the duties of this act.

In summary you are not liable while making a good faith effort to provide the present and future generations with the best educated and knowledgeable conclusions about the death of your patient. If you do not provide such documentation you are in breach of the law. Please work with the patients family and the Coroner's Office to c the most beneficial Death Certificate to file. 

(410 ILCS 535/27) (from Ch. 111 1/2, par. 73-27) 

Sec. 27. (1) (a) Any person who willfully and knowingly makes any false statement in a report, record, or certificate required to be filed under this Act, or in an application for an amendment thereof, or who willfully and knowingly supplies false information intending that such information be used in the preparation of any such report, record, or certificate, or amendment thereof  

(2)(b) Any person who refuses to provide information required by this Act; or 

    (c) Any person who willfully neglects or violates any of the provisions of this Act or refuses to perform any of the duties imposed upon him or her by this Act is guilty of a Class A misdemeanor. 

Death Certificate Tutorial:

The Department of Public Health has created a tutorial for Physicians to help them understand the proper and best way to fill out Death Certificates; Below is that link:

http://www.netsmartu.com/ivrs/cod/player.html 

Death certificates in which mechanisms of death (sepsis, shock, cardiac arrest, multiorgan failure, etc) are listed as the underlying cause are often reported to our office by Vital Records. Listing a mechanism of death rather than an etiologically specific underlying cause will generate follow up from the Vital Records office or involvement by our office. Please remember that mechanism is not a cause of death for official purposes on a death certificate.