A Select Committee of the House of Commons, under the chairmanship of Sir Walter Foster, M.D., was appointed on March 27, 1893, to inquire into the subject of death-certification in the United Kingdom. Fourteen sittings were held, and thirty-two witnesses examined. All the witnesses practically agreed as to the serious defects in the law, and a number of recommendations were made. It was shown that in about four per cent. of the cases the cause of death was ill-defined and unspecified, many practitioners having forms specially printed for their own use, in which all mention of medical attendance is omitted, the object being to enable the doctor to give certificates in cases which he has never attended. Numerous deaths attended by unqualified practitioners were certified by qualified practitioners who had probably never seen the cases; and deaths were certified by medical practitioners who had not seen the patient for weeks or months prior to death, and who knew only by hearsay of the deaths having occurred. Deaths were also certified in which the true cause was suppressed in deference to the feelings of survivors; these last in particular are reported to be very numerous.
INADEQUATE RECOMMENDATIONS.
In Q. 2552-83, remarkable evidence was produced as to the reckless mode of death-certification. One medical witness testified that he saw a certificate of death, signed by a registered medical practitioner, giving both the fact and the cause of death of a man who was actually alive at the time, and who lived four days afterwards, with facts of even a more startling character described as “murder made easy.” It was pointed out that fraud and irregularity in giving false declarations of death are by no means infrequent. Various other matters are treated, and the following are some of their recommendations:—
1. That in no case should a death be registered without the production of a certificate of the cause of death by a registered medical practitioner, or by a coroner after inquest, or, in Scotland, by a procurator-fiscal.
2. That in each sanitary district a registered medical practitioner should be appointed as public medical certifier of the cause of death in cases in which a certificate from a medical practitioner in attendance was not forthcoming.
3. That a medical practitioner in attendance should be required, before giving a certificate of death, to personally inspect the body, but if, on the ground of distance, or for other sufficient reason, he is unable to make this inspection himself, he should obtain and attach to the certificate of the cause of death a certificate signed by two persons, neighbours, verifying the fact of death.
4. That medical practitioners be required to send certificates of death direct to the registrar instead of handing them to the relatives of the deceased.
5. That a form of certificate of death should be prescribed, and that medical practitioners should be required to use such form.
From the Times, May 23, 1896:—
DEATH-CERTIFICATION.