Chennai: Referring to the fact that death certificates serve the critical functions of providing documentation for legal/administrative purposes and vital statistics for epidemiologic/health policy purposes, the State Medical Council in Tamil Nadu has issued an advisory for the doctors in this regard.The Council has also reminded the registered medical practitioners in the State that...
Chennai: Referring to the fact that death certificates serve the critical functions of providing documentation for legal/administrative purposes and vital statistics for epidemiologic/health policy purposes, the State Medical Council in Tamil Nadu has issued an advisory for the doctors in this regard.
The Council has also reminded the registered medical practitioners in the State that issuing death certificates can have medico-legal implications and therefore, a doctor should only provide a Death Certificate if he/she has attended the deceased while alive, has attended the patient within 14 days before death, is satisfied with the reason of death.
"Death certificates serve the critical functions of providing documentation for legal/administrative purposes and vital statistics for epidemiologic/health policy purposes. Issuing a death certificate is one of the onerous duties of the RMP, which can have medico-legal implications. Hence, the RMP must verify all the relevant facts before issuing a death certificate," read the advisory dated 12.04.2022, issued by the Registrar of the Council, Dr. R. Shanmugam.
Also Read: Confusion at Work: Two doctors Suspended for preparing Death certificate of a living woman
The guidelines that the doctors need to follow as per the Tamil Nadu Medical Council advisory are as follows,
1) This is a Medical Certificate to be issued by a Registered Medical Practitioner (RMP), who:
a) has been the medical attendant of the deceased while he was alive.
b) has attended the patient within past 14 days prior to his death.
c) is satisfied as to the cause of death.
2) Depending on the place and time of death, the cause of death should be issued in Form No. 4 or Form No. 4 A.
- Form No. 4 has to be issued for death as inpatient in a hospital by the RMP who treated the patient.
- Form No. 4 A is issued by the RMP for non-institutional deaths, for the patients on treatment with the RMP.
- Form No. 4 A should not be used for still births.
3) The treatment given by the RMP should be for diseases of concern which can cause the death of the patient. The RMP treating the patient for minor illnesses cannot issue Death Certificate. The RMP must verify all the relevant facts before issuing a death certificate and should not issue a death certificate under any pressure.
4) The treating doctor should issue the Death Certificate only if he is sure that there is no suspicious cause of death.
5) Many a times domiciliary deaths are certified by the RMPs on request stating that they have already treated the patient earlier for various illnesses and for cremation purposes. This should be avoided, if the RMPs are not sure about the cause of death.
6) For domiciliary deaths, the Head of the house or household as the case may be, or in his absence, the nearest relative of the Head present in the house can report the death, if there is no suspicion in the cause of death.
7) The RMPs shall not issue the Certificate without treating the patient, for cremation purposes. If the cremation authorities demand a proof for natural cause of death, it means that there is some suspicion in the death. It is for the family members and the authorities to sort out the issue. The RMPs should not issue Medical Certificate on cause of death in Form No. 4 A in such cases.
8) A clear Xerox or soft copy of all certificates issued should be kept in safe custody by the RMP. 9) Form No. 4 and 4 A along with the guidelines for filling the same is given in the Annexure."
The advisory also includes a model form that the doctors need to fill up before issuing death certificate to a person. The form shall consist of all the details of the deceased including name of the hospital, name of the deceased, sex, age, cause of death, manner of death, name and signature of the medical attendant certifying the cause of death, among others.
Medical Dialogues had earlier reported that TNMC had previously warned the doctors to be cautious while issuing Life certificates to unknown people. Referring to the fact that fake life certificates are used for committing common crime including registration of properties, the Council had advised the doctors that Life Certificate can be issued using Identification marks/Signatures/LTI of a person, only if that particular person is known to the doctor.
The Council at that time had also pointed out that Life Certificate is an Identity Certificate for confirming if the person is alive (for pensioners and registration purposes, etc.) and on many occasions impersonators walk in with fake IDs.
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