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Misclassification of medically certified COD
22.
Even for hospital deaths where the cause of death was medically certified, physicians do not
always accurately identify the underlying cause of death, because they have not been properly trained
in certifying death according to the rules and guidelines of the International Statistical Classification
of Diseases and Related Health Conditions (ICD). According to this standard, it is the “underlying
cause of death”, meaning the disease or injury that initiated the train of morbid events that led to death
that should be reported and used for compiling statistics. From a public health standpoint, the most
important health objective is to prevent the precipitating cause to occur. ICD death certification
therefore is mainly focused on facilitating epidemiological research for prevention purposes, whilst
the “dead case conference”
3
aims to identify the organs that failed to function and led to death. In
addition, when certifying cause of death from an accident, the organs that were injured are frequently
chosen by the clinical specialist instead of what caused the accident.
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