Hostname: page-component-cd9895bd7-p9bg8 Total loading time: 0 Render date: 2024-12-26T17:28:59.379Z Has data issue: false hasContentIssue false
  • English
  • Français

‘I can't put that on paper.’ How medical professional values shape the content of death certificates

Published online by Cambridge University Press:  22 June 2016

Myles Leslie
Get access Rights & Permissions [Opens in a new window]

Abstract

This paper follows collegiality, demonstrating how, as a central value of medically trained coroners, it can shape the content of death investigations and certificates. Drawing on ethnographic evidence from a 16-month-long study of the Office of the Chief Coroner (OCC) of Ontario, Canada, I argue that collegiality is an instrument of trust that both affords investigators tremendous access to information, and severely limits the flow of that information into the public domain that the OCC serves. The paper focuses on in-care death investigations, which are those where the OCC's medically qualified coroners find themselves investigating the quality of care delivered by professional colleagues. I show how professional expertise, experience and collegial values often combine to see instances of poor or even incompetent care dealt with privately (rather than publicly) or referred up the medical (rather than public safety) hierarchy. The burden of my argument is that collegial deference to the autonomy and skills of other physicians tends to see coroners expurgate the death certificates they produce. These expurgations obscure competence issues from public view and reduce the accuracy of the certificates. I close with a discussion of the benefits and drawbacks of medically qualified death investigators, as well as potential adjustments to improve the accuracy of in-care death investigations and certifications.

Type
Articles
Information
International Journal of Law in Context , Volume 12 , Issue 2: Frontiers in Coronial Justice – ushering in a new era of coronial research , June 2016 , pp. 178 - 194
Copyright
Copyright © Cambridge University Press 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Abbott, A. D. (1988) The System of Professions: An Essay on the Division of Expert Labor. Chicago, IL: University of Chicago Press.Google Scholar
Bayatrizi, Z. (2008) Life Sentences: The Modern Ordering of Mortality. Toronto, ON: University of Toronto Press.Google Scholar
Bloor, M. (1991) ‘A Minor Office: The Variable and Socially Constructed Character of Death Certification in a Scottish City’, Journal of Health and Social Behaviour 32: 273–287.Google Scholar
Boeije, Hennie (2002) ‘A Purposeful Approach to the Constant Comparative Method in the Analysis of Qualitative Interviews’, Quality & Quantity 36: 391–409.Google Scholar
Bosk, C. (2003 [1979]) Forgive and Remember, 2nd edn.Chicago, IL: University of Chicago Press.Google Scholar
Cambridge, B. and Cina, S. J. (2010) ‘The Accuracy of Death Certificate Completion in a Suburban Community.’ American Journal of Forensic Medicine and Pathology 31: 232–235.Google Scholar
Chen, K. (1996) ‘The Coroner's Necropsy: An Epidemiological Treasure Trove.’ Journal of Clinical Pathology 49: 698–699.Google Scholar
Dash, S. K., Behera, B. K. and Patro, S. (2014) ‘Accuracy in Certification of Cause of Death in a Tertiary Care Hospital – a Retrospective Analysis.’ Journal of Forensic and Legal Medicine 24: 33–36.Google Scholar
Ericson, Richard Victor (1993) Making Crime: A Study of Detective Work. Toronto/London: University of Toronto Press.Google Scholar
Eriksson, A., Stenlund, H., Ahlm, K., Boman, K., Bygren, L. O., Johansson, L. A., Olofsson, B. O., Wall, S. and Weinehall, L. (2013) ‘Accuracy of Death Certificates of Cardiovascular Disease in a Community Intervention in Sweden’, Scandinavian Journal of Public Health 41: 883–889.Google Scholar
Evans, R., Cardiff, K. and Sheps, S. (2006) ‘High Reliability versus High Autonomy: Dryden, Murphy, and Patient Safety’, Healthcare Policy 1: 12–20.Google Scholar
Freidson, E. (1988 [1970]). Profession of Medicine: A Study of the Sociology of Applied Knowledge. Chicago, IL: University of Chicago Press.Google Scholar
Freidson, E. and Rhea, B. (1963) ‘Processes of Control in the Company of Equals’, Social Problems 11: 119–131.Google Scholar
Glaser, Barney G. and Strauss, Anselm L. (1968) The Discovery of Grounded Theory: Strategies for Qualitative Research. New York: Aldine de Gruyter.Google Scholar
Goodin, Julia and Hanzlick, Randy (1997) ‘Mind Your Manners: Part II: General Results from the National Association of Medical Examiners Manner of Death Questionnaire, 1995’, American Journal of Forensic Medicine and Pathology 18: 224–227.Google Scholar
Goudge, S. (Commissioner) (2007) Inquiry into Pediatric Forensic Pathology in Ontario. Witness Testimony Dr. James Young. 29 November 2007, pp. 112–3.Google Scholar
Govindan, S., Shapiro, L., Langa, K. M. and Iwashyna, T. J. (2014) ‘Death Certificates Underestimate Infections as Proximal Causes of Death in the U.S.’ PLoS One 9: e97714.CrossRefGoogle ScholarPubMed
Hanzlick, Randy and Goodin, Julia (1997) ‘Mind Your Manners: Part III: Individual Scenario Results and Discussion of the National Association of Medical Examiners Manner of Death Questionnaire, 1995’, American Journal of Forensic Medicine and Pathology 18: 228–245.Google Scholar
Hunnisett, R. F. (1961) The Medieval Coroner (Cambridge Studies in English Legal History). Cambridge: Cambridge University Press.Google Scholar
Innes, Martin (2003) Investigating Murder: Detective Work and the Police Response to Criminal Homicide. Oxford: Clarendon Press.CrossRefGoogle Scholar
Jentzen, Jeffrey (2009) Death Investigation in America: Coroners, Medical Examiners, and the Pursuit of Medical Certainty. Cambridge, MA: Harvard University Press.Google Scholar
Johnson, C. J., Hahn, C. G., Fink, A. K. and German, R. R. (2012) ‘Variability in Cancer Death Certificate Accuracy by Characteristics of Death Certifiers’, American Journal of Forensic Medicine and Pathology 33: 137–142.Google Scholar
Johnson-McGrath, Julie (1995) ‘Speaking for the Dead: Forensic Pathologists and Criminal Justice in the United States’, Science, Technology & Human Values 20: 438–459.CrossRefGoogle Scholar
Landes, S. D. and Peek, C. W. (2013) ‘Death by Mental Retardation? The Influence of Ambiguity on Death Certificate Coding Error for Adults with Intellectual Disability’, Journal of Intellectual Disability Research 57: 1183–1190.CrossRefGoogle ScholarPubMed
Malthus, T. (1978 [1798]). An Essay on the Principles of Population. Cambridge: Cambridge University Press.Google Scholar
Mcnamara, P. and Mcculloch, S. (2010) Investigations, Resolutions and Hearings Department 2009 Annual Report. Toronto, ON: Ontario College of Physicians and Surgeons (OCPS).Google Scholar
Mertz, K. J., Janssen, J. K. and Williams, K. E. (2014) ‘Underrepresentation of Heroin Involvement in Unintentional Drug Overdose Deaths in Allegheny County, PA’, Journal of Forensic Sciences 59: 1583–1585.Google Scholar
Office of the Chief Coroner (2007) ‘About the Office.’ Online: <http://wayback.archive.org/web/20080708211202/http://www.mcscs.jus.gov.on.ca/english/pub_safety/office_coroner/about_coroner.html> (last accessed 24 April 2008).+(last+accessed+24+April+2008).>Google Scholar
Prior, Lindsay (1985a) ‘The Good, the Bad and the Unnatural: A Study of Coroners’ Decisions in Northern Ireland’, Sociological Review 331: 64–90.Google Scholar
Prior, Lindsay (1985b) ‘Making Sense of Mortality’, Sociology of Health and Illness 7: 167–190.Google Scholar
Prior, Lindsay (1989) The Social Organization of Death: Medical Discourse and Social Practices in Belfast. London: Macmillan.Google Scholar
Propublica (2011) ‘Post Mortem: The story so far.’ Online: <https://www.propublica.org/article/post-mortem-the-story-so-far> (last accessed 25 June 2015).+(last+accessed+25+June+2015).>Google Scholar
Reason, J. (1990) Human Error. Cambridge: Cambridge University Press.Google Scholar
Saucedo, M., Bouvier-Colle, M. H., Chantry, A. A., Lamarche-Vadel, A., Rey, G. and Deneux-Tharaux, C. (2014) ‘Pitfalls of National Routine Death Statistics for Maternal Mortality Study’, Paediatric and Perinatal Epidemiology 28: 479–488.CrossRefGoogle ScholarPubMed
Timmermans, S. (2005) ‘Suicide Determination and the Professional Authority of Medical Examiners.’ American Sociological Review 70: 311–333.Google Scholar
Timmermans, S. (2006) Postmortem: How Medical Examiners Explain Suspicious Deaths (Fieldwork Encounters and Discoveries). Chicago, IL: University of Chicago Press.Google Scholar
Watling, C., Driessen, E., Van Der Vleuten, C. P., Vanstone, M. and Lingard, L. (2013) ‘Beyond Individualism: Professional Culture and Its Influence on Feedback’, Medical Education 47: 585–594.Google Scholar
Wexelman, B. A., Eden, E. and Rose, K. M. (2013) ‘Survey of New York City Resident Physicians on Cause-of-death Reporting, 2010’, Preventing Chronic Disease 10:120288. Online: <http://dx.doi.org/10.5888/pcd10.120288>.CrossRefGoogle ScholarPubMed