Improving the certification of death and the usefulness of routine mortality statistics.

The conviction of Dr Harold Shipman for murdering 15 of his patients and the recent audit of his practice carried out by Professor Richard Baker, have raised many issues about the certification of death by doctors1. Inevitably, there have been calls for a radical overhaul of the system2. There are many problems with the certification and registration of death, and various proposals have been made to improve death certification and the accuracy and usefulness of routine mortality statistics. Current law enshrines the process of death certification and death registration in restrictive legislation, which prevents some such proposals from being implemented. However, the usefulness of death certificates and the quality of mortality statistics could be substantially improved if doctors simply completed certificates more accurately, without any additional changes in the legislation governing death certification.