Contents

Chapter 2
The current system of death certification

2.1Since the 1840s, New Zealand has considered it important to account for every death—that is, to record the fact of death and the cause of death in a central register. In New Zealand, registration of the fact of death began for Pākehā in 1847 (although it was not standardised or comprehensive until 1856) and for Māori in 1913. However, it was only in the later part of the 20th century that full descriptions of the cause of death were also included.11

2.2Death certification is significant for several reasons. For the family, it is a record of the precious life that is now gone, it records important information as to familial medical histories and it might determine whether a life insurance claim can be paid. For the doctor, it marks the final act in the professional care relationship. However, for society, it provides vital demographic data upon which policy decisions are based and large sums of money are spent. Therefore, it is somewhat surprising to discover, as we describe in Chapter 3, that error in death certification is so common, not only in New Zealand but around the world. Doctors receive little training in correct death certification practice, and this task is commonly afforded low priority in the context of busy medical practices.

2.3In 2011 we published Issues Paper 23 Final Words: Death and Cremation Certification in New Zealand.12 It asked for feedback on a range of proposals for reform in this area. We received 45 submissions, with a particularly strong representation from the medical community.13 Submitters were very clear that the death certification process requires substantial reform. Common complaints were that it was cumbersome, produced inconsistent and inaccurate results and lacked independence and sufficient checks and balances.

2.4In this part of the Report, we describe the current process of death certification, the problems we discovered through research and consultation and a range of proposals for reform of the system. In making proposals for reform, we are attempting to improve accuracy in the death certification process and create an efficient and cost-effective system.

11Ian Pool “Death rates and life expectancy: Recording births and deaths” (13 July 2012) Te Ara: The Encyclopedia of New Zealand <www.teara.govt.nz/en/death-rates-and-life-expectancy/page-1>.
12Law Commission, above n 7.
13The breakdown of submitters by type is as follows: 11 medical organisations; 11 medical professionals; 8 government organisations (central and regional); 3 submitters from the funeral industry; 3 legal professionals; 1 from the insurance industry; and 8 other individuals.