Cause of Death

To the Editor.— We read with interest Kircher and Anderson's 1 article on proper certification of death. We routinely review death certificates filed in Utah and frequently see the common errors they described. Unfortunately, the effects of the educational process they recommend, such as lectures on death certificate completion to second-year medical students, will not be seen for many years. These effects are also diluted by the transfer of these individuals to postgraduate training programs out of the state. To improve the utility of the death certificate, instruction in its completion needs to be given not only to medical students and residents but also to practicing physicians through hospital staff meetings, regional medical societies, and specialty organizations. When the death certificate is used in court as evidence, the pathophysiological sequence in part I can cause confusion. A man who is shot in the neck and abdomen may die of pneumonia