About a third of death certificates issued in New York City have the wrong cause of death, the first study of its kind reveals, and many doctors say they knowingly do it for a variety of reasons.
Columbia University’s Barbara Wexelman surveyed 521 resident physicians in the city, about 175 of them writing out at least one a month.
“Only one-third of the respondents,” Wexelman and her team found, “believed the current system accurately documents correct cause of death.”
Nearly half — 48.6 percent — of respondents reported having identified a cause of death that did not actually represent what the person died from. Only 2.9 percent said they went back and updated a death certificate after learning new information about the patient’s circumstance.
Doctors write different cause of death mostly for bureaucratic reasons. Three-quarters said the system they use in New York City would not accept what they thought to be the real cause of death. So they put in something else instead. Other reasons included “My attending told me to put something else” and “I did not know why the patient died/I took my best guess.”
Death certificates are important to help epidemiologists understand leading causes of deaths and how people’s health habits are changing.