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Primary Care Provider Right to Sign Death Certificates


ORC Section 3705.16(C) states, when an individual dies under natural causes the attending physician is to sign the death certificate within forty-eight hours after the death. The funeral director or other person in charge of the final disposition of the remains shall present the death or fetal death certificate to the attending physician of the decedent, the coroner, or the medical examiner, as appropriate for certification of the cause of death.
               A physician other than the coroner in the county in which a death or fetal death occurs, or a deputy coroner, medical examiner, or deputy medical examiner serving in an equivalent capacity, may certify only those deaths that occur under natural circumstances. The medical certificate of death shall be completed and signed by the physician who attended the decedent or by the coroner or medical examiner, as appropriate.
  1. Physician means a person licensed pursuant to Chapter 4731 of the Revised Code to practice medicine and surgery or osteopathic medicine and surgery.
  2. Attending physician means the physician in charge of the patient’s care of the illness or condition that resulted in death.


A Death Certificate is a legal document, not a scientific document. Physicians are not required to establish a specific anatomical reason causing the death. The requirement for death certification is a statement of the condition most likely responsible for death.
               Clinicians may feel uncertain about the exact cause of death, even if they have been treating the patient for one or more stable chronic conditions and may feel the death is unexplained and believe the decedent should be referred to the coroner to determine a specific anatomical diagnosis. This is not the case and the patient’s medical history should provide adequate information to state a reasonable cause of death that meets legal requirements.


Ohio Law requires the County Coroner to investigate the circumstances and determine the cause and manner of death of all deaths that are: the result of violence or other trauma, Suspicious and unusual in nature or foul play is suspected, sudden and unexpected, when a person is in apparent good health, not under the care of a physician, and unlawful or due to criminal neglect.
               If these factors are not contributory, the responsibility of signing and determining cause and manner of death falls on the primary care provider or physician.


For detailed guidance on completing death certificates, visit the U.S. Centers for Disease Control and Prevention booklet, “The Physician’s Handbook of Medical Certification of Death”.
Under Box 32. Manner of Death, this should always be selected, “Natural”.


Ohio Revised Code 2705.16c states; When an individual dies under natural causes the attending physician is to sign the death certificate within forty-eight hours after death. Natural deaths do not fall under the Coroner’s jurisdiction.