To the Editor.
—The study by Drs Messite and Stellman1 emphasized the inaccuracies of death certification and attributes these partly to the lack of adequate training of physicians. However, a more serious flaw in the system was also evident in their study: the very format of the death certificate encourages physicians to list mechanisms of death instead of a cause of death.
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Wetli CV. Death Certificate Completion by Physicians. JAMA. 1996;276(4):279–280. doi:10.1001/jama.1996.03540040023014