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Features: Medical certificates on cause of death in Scotland

27 November 2009

New guidance on completing medical certificates of the cause of death.

After a number of deaths had been wrongly categorised, the CMO in Scotland has published new guidance for doctors as Dr P Mishra, Senior Medical Officer for the Scottish Government, explains.

Medical practitioners play a vital role in the death certification process and are responsible for completing Medical Certificates of the Cause of Death (MCCDs) accurately. 

The death certification process in Scotland is key for a number of reasons:  it provides a permanent legal record of the fact of death; it allows for the disposal of the body and settlement of the deceased’s estate by the families; it provides statistical information of the cause of death so that the causes of death and the health of the population in Scotland can be monitored; it helps to recognise the priorities for healthcare services and medical research; it assists in the design and evaluation of public health interventions and healthcare services; and it facilitates the understanding of the health effects of exposure to a wide range of risk factors through the environment, work, medical and surgical care, and other sources.

MCCDs, provided on a prescribed form to the family by the medical practitioner, to the best of the medical practitioner’s knowledge and belief, is a statutory requirement. Recently, however, there have been some concerns expressed that some doctors do not appear to have a clear understanding of the appropriate reporting requirements in the form for MCCDs as a number of deaths have been categorised incorrectly. 

Aside from formal training, it is essential that doctors are provided with definitive written guidance to support them to report the deaths more accurately. For this reason the Scottish Government’s CMO has published revised guidance for doctors: The Guidance for Medical Staff Completing Medical Certificates of the Cause of Death.

The guidance provides help, support and advice to medical practitioners to enable them to complete MCCDs accurately and appropriately and will help deliver a consistent approach throughout Scotland. The new guidance is available from: www.sehd.scot.nhs.uk/cmo/CMO(2009)10.pdf