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To the Editor.—
The causes of death listed in three of the four cases cited in the editorial are all complications of the underlying disease entity or problem. Although the death certificates in almost all states say "due to, due to, due to," the physician is not obligated to fill in the cause of death in that manner. Many of us would issue case 1 as a type of hip fracture with complicating pulmonary embolism, and case 4 as intravenous narcotism or narcotic addiction with complicating endocarditis, etc. Dr. Hussey's premises for the "true cause of death" are the factors leading up to, or circumstances surrounding, the cause of death. These are stated in the death certificate under the item "How did injury occur?" Further, the circumstances surrounding death are an integral part of the opinion written for any medicolegal problems, including autopsy.The editorial should serve one purpose, namely,
Hofman WI. The Cause of Death. JAMA. 1974;229(14):1866. doi:10.1001/jama.1974.03230520014014