Death certificate fill correctly...
To understand why these are disputes on cause of death one has to understand the death certificate first.
Let us take some examples. (see table )
A person has Diabetes . He also has high blood pressure . He dies of heart attack.
This person has died of heart attack. That is the immediate cause of death.
It is written in column ‘A ’of death certificate.
His high blood pressure put stress on his heart. So he got heart attack So high blood pressure is written in column ’b’ It is a condition that led to Heart attack.
He also had Diabetes
Diabetes is a significant illness that did not actually killed the patient but has complicated the matters. A diabetes is more likely to get high blood pressure & heart attack than a person without diabetes he might not have had high blood pressure or heart attack so diabetes is written in column ‘c’.
A person looking in totality will give 3 causes for his death. Heart attack, High blood pressure & diabetes. Or one notice only one & overlook others The doctors might do incomplete job, & commit the error of omission by not mentioning high blood pressure or diabetes on the death certificate . In such a case we never know as to how many people dying of Diabetes or high blood pressure
Death certificate gives cause of death in 3 columns
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A |
B |
C |
A |
Disease causing death |
Heart attack |
Diarrhoea |
Pneumonia |
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| B |
Significant disease leading to above condition. |
High Blood Pressure |
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Measles |
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| C |
Illness that did not directly kill the person but is responsible in making the patient worse & prone to death. |
Diabetes |
Aids |
Malnutrition |
Examples :
A&B,2 children get measles.Than they develop pneumonia. A is strong & healthy He survives the illness. B is Weak & malnourished . He dies . Death certificate has 3 columns A:B&C
1. Pneumonia Killed him. So word pneumonia is entered in column A giving immediate cause of death.
2. Measles caused pneumonia so measles is entered in column B, which describe the illness leading to immediate cause of death.
3. Malnutrition did not kill the child but had he not been malnourished he might not have died. Malnutrition complicated the illness & hence the child died. So malnutrition is entered in column ‘c’
If all death certificates are properly filled & if everyone understands the death certificate there will be no dispute on cause of death.
In present case those who want to overlook column ‘c’ where malnutrition will comes will only look at column ‘a’ Which always will carry pneumonia as cause of death.
If a person has aids. So he gets diarrhea & he dies.
In the death certificate Diarrhea is written in column A . It is the disease that actually killed the person.
Aids is written in column ‘c’ It did not kill the child itself but significantly contributed by reducing the fighting power of the person. Had he not had aids , he might not have died of diarrhea.
One who sees the whole death certificate will say that this person died of diarrhea & Aids. Person overlooking Aids will say he died of diarrhea.
Person overlooking diarrheas will say he died of Aids.
If doctors has not mentioning aids on the death certificate, there is no question of anyone knowing or noticing it. Then everyone will say he died of diarrhea OLONE . THE CASES OF aids will not be reported. Same is true of malnutrition .
Proper filling of death certificate & filling of column ‘c’ must be made compulsory.
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