Poll: Doubts persist over accuracy of death certificates

A significant number of Americans distrust what's written on death certificates -- those official documents that report when, where, how and why people die.

A survey of 946 people by Scripps Howard News Service and Ohio University found that 26 percent doubt the accuracy of the official cause of death listed on the death certificate of someone they know personally.

Scripps reporters followed up with telephone calls to more than 50 of the survey participants and spoke in detail to more than 20. Many asked for anonymity because of the sensitive nature of the deaths of loved ones.

Several had suspicions about hospital malpractice and suspected an attempt to cover up the true cause of death for fear of legal action. Others suspected murder or foul play in deaths that were signed off as the result of natural causes.

Some, like Greta Adkins, 65, of Harlan, Ky., simply think the natural deaths of loved ones were not investigated as thoroughly as they should have been.

Adkins wishes she knew what caused her healthy 31-year-old son to die when he was home alone in February 2004. She thinks knowing the cause could prevent future illnesses for her twin grandsons, who were 2 years old when their father died.

"I've often wished that he had an autopsy," Adkins says. "There could be something hereditary that we need to be looking for in his kids."

The county coroner asked if the family wanted an autopsy, but Adkins' daughter-in-law decided against it. Adkins said she wishes there was legislation requiring an investigation of every unsupervised death.

"I'm under the impression that if someone dies at home and nobody's there, there should be an autopsy," Adkins says.

But no state has passed a mandatory autopsy law for unattended deaths.

Her son's death certificate lists "Heart arrhythmia secondary to seizure disorder" as the primary cause of death, but Adkins is skeptical.

"When people ask me how he died, I always say, 'It was speculated that he had a seizure and his heart went out of rhythm,'" Adkins says.

Ruth Cook of Fairburn, Ga., also questions the official declaration of coronary death of her mother, Mary Pruett, who died in 1990.

"The doctor said she's had a heart attack," she says. "I just couldn't believe that was the case -- she'd never had any heart problems."

Right before her death, Cook's mother had spent four days in Piedmont Hospital in Atlanta because of complications related to emphysema. Two days after she was released, she was rushed to another hospital with more breathing problems and fell into a coma.

Cook believes her mother's death is related to her emphysema.

"I think that if they would have done an autopsy, they would have found that she had stopped breathing and wasn't getting any oxygen," Cook says. "And there really wasn't any reason for that to happen in a hospital."

Cheryl Dippel of Medford, N.Y., on Long Island, has a different reason for disliking what was printed on a family member's death certificate.

Her father, George Dietz, was 91 when he died in September 2008, and Dippel was prepared for it. He had been in a local nursing home since July of that year, but Dippel said she had been wrestling with her father's doctor to get him moved to a hospice.

She knew he was nearing the end of his life.

The doctor agreed to move him, citing "failure to thrive" -- a term that describes a state of physical decline in the elderly, marked by depression, weight loss and functional impairments. Dippel said her father died the same day.

The first cause listed on his death certificate is "Failure to thrive."

The term is not listed in the most recent edition of the International Classification of Diseases, a list of the 14,500 causes of death recognized by the World Health Organization. Officially, at least, it is not considered a cause of death.

"We just felt that was very irresponsible," says Dippel, who believes it was a personal jab by the doctor in reference to their conflict about the hospice. "I feel like we were mistreated, and that the doctor didn't act professionally. How someone dies is a serious matter."

The doctor -- M. Hani Salam of Medford, N.Y. -- has declined to comment.

The survey found that 31 percent of women know someone who died from uncertain or disputed causes compared to 21 percent of men. Experts said the difference probably results from the roles women have within the family.

"Women are still sort of the executive secretaries in families. They're the ones who keep all the information in their heads about who dies, who had a baby, who has what disease, whose birthday is coming up," said Stephanie Coontz, director of research and public education for the Council on Contemporary Families and professor of history and family studies at Evergreen State College in Olympia, Wash.

"It's interesting because this role is the slowest to go. Men and women's roles have been changing so rapidly in the last 30 years. Men have tripled the amount of time they spend on child care, they've doubled the amount of housework they do. But when we look at who keeps track of what needs to be done, what's happening to who -- everything from the size of the kids' shoes to the illness that Aunt Mary has -- it's the women who do the majority of that."

The survey was conducted by telephone from Feb. 16 through March 11, 2009, at the Scripps Survey Research Center at Ohio University under a grant from the Scripps Howard Foundation. It has a margin of error of about 4 percentage points.

(Distributed by Scripps Howard News Service, http://www.scrippsnews.com)

DEAD WRONG - WHAT'S REALLY KILLING AMERICA
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