Although revered as the guiding star for science, clinical practice and legislation aimed to save lives, cause-of-death reporting does not meet any basic criteria of objective fact. Across continents, from 40 years ago to present day, death certificates, which provide the basis for our beliefs as to why we die, have been found to be erroneous in their causal conclusions 20-60% of the time according to the peer-reviewed literature.
The daily process of obtaining cause-of-death information, which I was an eyewitness to, is not a process of careful investigation, but rather a rushed and apathetic bureaucratic tumbling machine that incentivizes compliance over recording the complexity of truth.
In this piece I offer a personal account, a logical argument and the scientific evidence for the claim that mortality statistics derived from cause-of-death reporting on death certificates are an unstable material upon which to build actionable scientific or societal beliefs about risk. Then I provide an in-depth examination of the very particular situation of COVID death reporting manipulation that happened beginning in March of 2020, infused politicized bias into an already defunct system.
Lastly, you will find a call to action, with steps that we, the individuals affected by the inaccurate data capture, can take to hold the regulatory bodies responsible for this to account, as well as volunteer and support opportunities to help those who need to get erroneous death certificates officially amended.
Being a former death certificate clerk, and having spent nearly 7 years in the funeral home industry ushering thousands of death certificates from digital creation to final registration, I am appalled that death certificate data is codified for use as our national mortality statistics.
I was trained in the California Electronic Death Registration System (CA-EDRS) in 2013 while working in Los Angeles County for a high volume mortuary. Single-handedly, I would process nearly 1,200 death certificates a year as I was their only death certificate clerk. In 2015, I was hired by a smaller firm where I worked part time doing about ⅓ the case load. At either location I would work daily with doctors, medical examiner/coroner’s offices, and the local and state vital record registrars to accomplish the necessary death certificate registration process after a loved one passed away.