Study on death certificates and postmortem examination certificates written by Korean emergency physicians

Introduction: Statistics on death are the basis of a country's health, safety, and welfare policies. Emergency physicians issue a postmortem examination certificate (PEC) for death outside the hospital as well as a death certificate (DC) for death in the hospital. This study investigated the actual conditions and criteria for writing a DC and PEC, writing environment, and doctor's experience. Material and methods: The physicians' DC and PEC writing experience and demographic data were analyzed. The questions focused on CPR, patient's medical certificate, time and place of death, difficulty in writing the PEC and DC, and education in certificate writing. Results: 229 emergency physicians were included. Physicians’ opinions differed for CPR patients in terms of time of death, location, and whether or not to issue DC/PEC. The causes of death were also different. Further, 76.9% of the doctors did not have enough time to write a medical certificate and about 45% of them wrote it within 30 min; 76% had DC-related complaints, and 7.0% faced legal problems due to the DC; 93.3% of the emergency physicians stated that a coroner system is needed in South Korea. Conclusion: Emergency physicians are responsible for writing DCs and PECs. The standards vary from physician to physician at the time of writing. Writing DCs and PECs is also burdensome. In South Korea, it is necessary to separate the DC and PEC, to develop national data management networks, and to introduce a postmortem examination system.