Differences in the determination of manner of death for death certificates by physicians in South Korea: questionnaire survey

In South Korea, the manner and cause of death are determined by physicians. The present study aimed to investigate the differences in decisions made by physicians when completing death certificates and the factors that lead to these differences in South Korea. Questionnaires were used to survey 210 physicians who routinely complete death certificates, and demographic data along with information on their decisions regarding the manner and cause of death as well as natural and unnatural contributory causes were ascertained for eight representative cases. The study sample comprised 149 (71.0%) and 61 (29.0%) male and female physicians, respectively, and the mean age in this sample was 36.93 ± 4.51 years. We found that 64.7%, 61.4%, 7.6%, 4.3%, 4.3%, 65.7%, 84.3% and 53.3% of the physicians considered cases 1, 2, 3, 4, 5, 6, 7 and 8 as unnatural deaths, respectively, while 27.6%, 32.0%, 91.9%, 95%, 8.5%, 26.6%, 6.7% and 38.1% considered them to be natural deaths, respectively. In Case 5, 81.7% considered death to be due to an indeterminate cause. We found that differences may exist in how physicians select the manner of death when completing a death certificate and that this decision is influenced by several factors.