3.1Almost without exception, every person we consulted throughout the course of this review or who made submissions on Issues Paper 23 Final Words: Death and Cremation Certification in New Zealand considered that there were significant problems with the current death certification system. Funeral directors told us that the unavailability of doctors caused unnecessary and distressing delays in moving bodies from the family home or aged care facilities. On the other hand, doctors told us that they came under unreasonable pressure to complete documentation quickly. They also emphasised how difficult the documents were to complete and how little accompanying guidance there is. Coroners and government officials told us about the frequency of errors in the documents identifying the cause of death and whether or not a death should be referred to the coroner. Across the board, submissions were concerned about the current lack of oversight and checks on the system.
3.2The current legal requirements for documentation after death serve a number of purposes—some public and some private in nature. Those purposes, and the relevant importance of each, must be understood in order to also understand the problems with the current system and the solutions for the future.
3.3We consider that there are three primary purposes of death certification and a range of secondary purposes. The primary purposes are to:
3.4The secondary purposes of death certification include:
3.5It can be seen that the public purposes of death certification include health, justice and statistical purposes. Understanding these purposes is relevant to the discussion later about which government organisation should be responsible for the administration of the death certification system and how that system should be funded.
3.6We have identified a range of problems with the current system, both described by submitters and encountered in our other research, that undermine its effectiveness in meeting those purposes. These problems fall into the following categories.