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Approach to identifying and certifying cause of death 29/30

The following flow diagram summarises the approach to identifying and certifying the cause of death.  Firstly, ask yourself, “What initiated the chain of events that led to death?”  This will give you the underlying cause of death.  Then ask yourself if the underlying cause of death is: 

- Natural, due to disease 

- or Unnatural?  In other words, are there physical or chemical influences on the body, sudden unexpected death, procedure-related death or omission or commission?  If the cause of death is “Natural”, then think about the causal sequence

– that is the intermediate and immediate cause of death, as well as the contributing causes.  This will help you to determine the underlying cause of death.

Check that you:

•Do not mention mechanisms of dying

•Avoid ill-defined terms 

•Avoid abbreviations, and 

•that you have been as specific as possible, particularly for the site of cancer or infection.

If the death is as a result of Unnatural causes you should NOT complete a Death Notification Form, but refer the case to forensic pathology with a detailed referral letter explaining the, nature of the injury, circumstances of the death, manner of death and place of occurrence. They will then conduct a postmortem investigation which will determine whether the death was a homicide, suicide, accidental, natural or undetermined.