AIDS on the death certificate: the final stigma.

AIDS has joined suicide as a barrier to the accurate certification of death as required by law in Great Britain and the U.S. Despite acknowledging the importance of accurate records for medical, epidemiological, and insurance purposes, and because registers of death are public records, sympathetic physicians may substitute other causes of death or omit stating the underlying diagnosis of HIV infection in order to spare families of the deceased the added psychological stress caused by stigmatization. Many physicians believe that informing public health authorities is sufficient. To preserve privacy and the confidentiality of medical information a British government paper has suggested that, with reference to sensitive causes of death, recent records be available only to those who have a legitimate reason for wanting them. In the U.S., the adoption of a two-part death certificate has been proposed, one for immediate legal purposes and the other for medical certification.