In many legal
jurisdictions
Jurisdiction (from Latin 'law' + 'declaration') is the legal term for the legal authority granted to a legal entity to enact justice. In federations like the United States, areas of jurisdiction apply to local, state, and federal levels.
Jur ...
, the manner of death is a determination, typically made by the
coroner
A coroner is a government or judicial official who is empowered to conduct or order an inquest into Manner of death, the manner or cause of death, and to investigate or confirm the identity of an unknown person who has been found dead within th ...
,
medical examiner
The medical examiner is an appointed official in some American jurisdictions who is trained in pathology that investigates deaths that occur under unusual or suspicious circumstances, to perform post-mortem examinations, and in some jurisdictio ...
, police, or similar officials, and recorded as a
vital statistic. Within the United States and the United Kingdom, a distinction is made between the
cause of death
In law, medicine, and statistics, cause of death is an official determination of conditions resulting in a human's death, which may be recorded on a death certificate. A cause of death is determined by a medical examiner. The cause of death is ...
, which is a specific disease or injury, versus manner of death, which is primarily a legal determination versus the mechanism of death (also called the mode of death) which does not explain why the person died or the underlying cause of death and can include cardiac arrest or exsanguination. Different categories are used in different jurisdictions, but manner of death determinations include everything from very broad categories like "natural" and "homicide" to specific manners like "traffic accident" or "gunshot wound". In some cases an
autopsy
An autopsy (post-mortem examination, obduction, necropsy, or autopsia cadaverum) is a surgical procedure that consists of a thorough examination of a corpse by dissection to determine the cause, mode, and manner of death or to evaluate any di ...
is performed, either due to general legal requirements, because the medical cause of death is uncertain, upon the request of family members or guardians, or because the circumstances of death were suspicious.
International Classification of Disease
The International Classification of Diseases (ICD) is a globally used diagnostic tool for epidemiology, health management and clinical purposes. The ICD is maintained by the World Health Organization (WHO), which is the directing and coordinatin ...
(ICD) codes can be used to record manner and cause of death in a systematic way that makes it easy to compile statistics and more feasible to compare events across jurisdictions.
[National Center for Health Statistics â€]
Classification of Death and Injury Resulting from Terrorism – How are external cause of injury codes assigned?
Centers for Disease Control and Prevention
The Centers for Disease Control and Prevention (CDC) is the national public health agency of the United States. It is a United States federal agency, under the Department of Health and Human Services, and is headquartered in Atlanta, Georgi ...
. retrieved July 7 2019
Terminology
Death by natural causes
A death by natural causes results from an illness and its complications or an internal malfunction of the body not directly caused by external forces, other than
infectious disease
An infection is the invasion of tissues by pathogens, their multiplication, and the reaction of host tissues to the infectious agent and the toxins they produce. An infectious disease, also known as a transmissible disease or communicable dise ...
. For example, a person dying from complications from
pneumonia
Pneumonia is an inflammatory condition of the lung primarily affecting the small air sacs known as alveoli. Symptoms typically include some combination of productive or dry cough, chest pain, fever, and difficulty breathing. The severity ...
,
diarrheal disease or
HIV/AIDS
Human immunodeficiency virus infection and acquired immunodeficiency syndrome (HIV/AIDS) is a spectrum of conditions caused by infection with the human immunodeficiency virus (HIV), a retrovirus. Following initial infection an individual ...
(infections),
cancer
Cancer is a group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body. These contrast with benign tumors, which do not spread. Possible signs and symptoms include a lump, abnormal b ...
,
stroke
A stroke is a medical condition in which poor blood flow to the brain causes cell death. There are two main types of stroke: ischemic, due to lack of blood flow, and hemorrhagic, due to bleeding. Both cause parts of the brain to stop functionin ...
or
heart disease
Cardiovascular disease (CVD) is a class of diseases that involve the heart or blood vessels. CVD includes coronary artery diseases (CAD) such as angina and myocardial infarction (commonly known as a heart attack). Other CVDs include stroke, hea ...
(internal body malfunctions), or sudden organ failure would most likely be listed as having died from natural causes. "Death by natural causes" is sometimes used as a euphemism for "dying of old age", which is considered problematic as a cause of death (as opposed to a specific
age-related disease
An aging-associated disease (commonly termed age-related disease, ARD) is a disease that is most often seen with increasing frequency with increasing senescence. They are essentially complications of senescence, distinguished from the aging proc ...
); there are also many non-age-related causes of "natural" death, for legal manner-of-death purposes. (See )
Unnatural causes
An unnatural death results from an external cause, typically including homicides, suicides, accidents,
medical error
A medical error is a preventable adverse effect of care (" iatrogenesis"), whether or not it is evident or harmful to the patient. This might include an inaccurate or incomplete diagnosis or treatment of a disease, injury, syndrome, behavior ...
s,
alcohol intoxication
Alcohol intoxication, also known as alcohol poisoning, commonly described as drunkenness or inebriation, is the negative behavior and physical effects caused by a recent consumption of alcohol. In addition to the toxicity of ethanol, the main p ...
s and
drug overdose
A drug overdose (overdose or OD) is the ingestion or application of a drug or other substance in quantities much greater than are recommended. s. Jurisdictions differ in how they categorize and report unnatural deaths, including level of detail and whether they are considered a single category with subcategories, or separate top-level categories.
There is no international standard on whether or how to classify a death as natural vs. unnatural.
"Mechanism of death" is sometimes used to refer to the
proximate cause
In law and insurance, a proximate cause is an event sufficiently related to an injury that the courts deem the event to be the cause of that injury. There are two types of causation in the law: cause-in-fact, and proximate (or legal) cause. Ca ...
of death, which might differ from the cause that is used to classify the manner of death. For example, the proximate cause or mechanism of death might be
brain ischemia
Brain ischemia is a condition in which there is insufficient bloodflow to the brain to meet metabolic demand. This leads to poor oxygen supply or cerebral hypoxia and thus leads to the death of brain tissue or cerebral infarction/ ischemic stroke ...
(lack of blood flow to the brain), caused by a malignant neoplasm (
cancer
Cancer is a group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body. These contrast with benign tumors, which do not spread. Possible signs and symptoms include a lump, abnormal b ...
), in turn caused by a dose of
ionizing radiation
Ionizing radiation (or ionising radiation), including nuclear radiation, consists of subatomic particles or electromagnetic waves that have sufficient energy to ionize atoms or molecules by detaching electrons from them. Some particles can travel ...
administered by a person with intent to kill or injure, leading to certification of the manner of death as "homicide".
The manner of death can be recorded as "undetermined" if there is not enough evidence to reach a firm conclusion. For example, the discovery of a partial human skeleton indicates a death, but might not provide enough evidence to determine a cause.
Categories by jurisdiction
United States
In the
United States
The United States of America (U.S.A. or USA), commonly known as the United States (U.S. or US) or America, is a country primarily located in North America. It consists of 50 states, a federal district, five major unincorporated territorie ...
, a manner of death is expressed as belonging to one classification of a group of six possible:
[Snohomish County Government, Washingto]
Cause & Manner of Death
retrieved April 27, 2019
* Natural
*
Accident
An accident is an unintended, normally unwanted event that was not directly caused by humans. The term ''accident'' implies that nobody should be blamed, but the event may have been caused by unrecognized or unaddressed risks. Most researche ...
*
Suicide
Suicide is the act of intentionally causing one's own death. Mental disorders (including depression, bipolar disorder, schizophrenia, personality disorders, anxiety disorders), physical disorders (such as chronic fatigue syndrome), and s ...
*
Homicide
Homicide occurs when a person kills another person. A homicide requires only a volitional act or omission that causes the death of another, and thus a homicide may result from accidental, reckless, or negligent acts even if there is no inten ...
* Undetermined
* Pending
In some jurisdictions, some more detailed manners may be reported in numbers broken out from the main four or five. For example:
* Legal intervention (e.g.
capital punishment
Capital punishment, also known as the death penalty, is the state-sanctioned practice of deliberately killing a person as a punishment for an actual or supposed crime, usually following an authorized, rule-governed process to conclude that t ...
)
* Act of
war
War is an intense armed conflict between states, governments, societies, or paramilitary groups such as mercenaries, insurgents, and militias. It is generally characterized by extreme violence, destruction, and mortality, using regular o ...
* Automobile accidents
* Deaths of prison inmates by acute intoxication
United Kingdom
In the United Kingdom, when people die, either a doctor writes an acceptable natural cause of death
medical certificate
A medical certificate or doctor's certificate is a written statement from a physician or another medically qualified health care provider which attests to the result of a medical examination of a patient. It can serve as a sick note ( UK: fit no ...
, or a
coroner
A coroner is a government or judicial official who is empowered to conduct or order an inquest into Manner of death, the manner or cause of death, and to investigate or confirm the identity of an unknown person who has been found dead within th ...
(
procurator fiscal in Scotland) investigates the case.
Coroners are independent judicial officers who investigate deaths reported to them, and subsequently whatever inquiries are necessary to discover the cause of death, this includes ordering a post-mortem examination, obtaining witness statements and medical records, or holding an inquest. In the unified legal jurisdiction of
England and Wales
England and Wales () is one of the three legal jurisdictions of the United Kingdom. It covers the constituent countries England and Wales and was formed by the Laws in Wales Acts 1535 and 1542. The substantive law of the jurisdiction is Eng ...
, most deaths are certified by doctors without autopsy or coroner involvement. Almost all deaths certified by the coroner involve an
autopsy
An autopsy (post-mortem examination, obduction, necropsy, or autopsia cadaverum) is a surgical procedure that consists of a thorough examination of a corpse by dissection to determine the cause, mode, and manner of death or to evaluate any di ...
but most do not involve a formal
inquest
An inquest is a judicial inquiry in common law jurisdictions, particularly one held to determine the cause of a person's death. Conducted by a judge, jury, or government official, an inquest may or may not require an autopsy carried out by a coro ...
.
In England and Wales, a specific list of choices for verdicts is not mandated, and "narrative verdicts" are allowed, which are not specifically classified. The verdicts aggregated by the Ministry of Justice are:
[ – Table 6: Inquest verdicts returned, 1994-2008]
*
Homicide
Homicide occurs when a person kills another person. A homicide requires only a volitional act or omission that causes the death of another, and thus a homicide may result from accidental, reckless, or negligent acts even if there is no inten ...
**
Killed unlawfully
**
Killed lawfully
*
Suicide
Suicide is the act of intentionally causing one's own death. Mental disorders (including depression, bipolar disorder, schizophrenia, personality disorders, anxiety disorders), physical disorders (such as chronic fatigue syndrome), and s ...
* Attempted or self-induced
abortion
Abortion is the termination of a pregnancy by removal or expulsion of an embryo or fetus. An abortion that occurs without intervention is known as a miscarriage or "spontaneous abortion"; these occur in approximately 30% to 40% of pregn ...
* Cause of death aggravated by lack of care, or self-neglect
* Dependence on drugs
* Non-dependent abuse of drugs
* Want of attention at birth
* Death from
industrial disease
An occupational disease is any chronic ailment that occurs as a result of work or occupational activity. It is an aspect of occupational safety and health. An occupational disease is typically identified when it is shown that it is more prevalen ...
s
* Death by
accident
An accident is an unintended, normally unwanted event that was not directly caused by humans. The term ''accident'' implies that nobody should be blamed, but the event may have been caused by unrecognized or unaddressed risks. Most researche ...
or
misadventure
*
Stillborn
Stillbirth is typically defined as fetal death at or after 20 or 28 weeks of pregnancy, depending on the source. It results in a baby born without signs of life. A stillbirth can result in the feeling of guilt or grief in the mother. The ter ...
* Death from natural causes
* Open verdict
*
Disaster
A disaster is a serious problem occurring over a short or long period of time that causes widespread human, material, economic or environmental loss which exceeds the ability of the affected community or society to cope using its own resources ...
Other jurisdictions
Some jurisdictions place
deaths in absentia, such as deaths at sea and missing persons declared dead in a court of law, in the "Undetermined" category on the grounds that due to the fact-finder's lack of ability to examine the body, the examiner has no personal knowledge of the manner of (assumed) death; others classify such deaths in an additional category "Other," reserving "Undetermined" for deaths in which the fact-finder has access to the body, but the information provided by the body and examination of it is insufficient to provide sufficient grounds for a determination.
The
Norwegian Medical Association The Norwegian Medical Association ( no, Den norske lægeforening (1886–2008), spelled ''Den norske legeforening'' since 2008) is the main Norwegian medical association and trade union, and was founded in 1886. It has 32 555 members (as of 2016) o ...
classifies what other jurisdictions might call "undetermined" as "unnatural":
* Sudden and unexpected death of an unknown cause
* Deaths in prison or while in civilian or military detention
Legal implications
A death ruled as homicide or unlawful killing is typically referred to
police
The police are a constituted body of persons empowered by a state, with the aim to enforce the law, to ensure the safety, health and possessions of citizens, and to prevent crime and civil disorder. Their lawful powers include arrest and t ...
or
prosecutor
A prosecutor is a legal representative of the prosecution in states with either the common law adversarial system or the Civil law (legal system), civil law inquisitorial system. The prosecution is the legal party responsible for presenting the ...
or equivalent official for investigation and
criminal charge
A criminal charge is a formal accusation made by a governmental authority (usually a public prosecutor or the police) asserting that somebody has committed a crime. A charging document, which contains one or more criminal charges or counts, can ...
s if warranted. Deaths caused by
capital punishment
Capital punishment, also known as the death penalty, is the state-sanctioned practice of deliberately killing a person as a punishment for an actual or supposed crime, usually following an authorized, rule-governed process to conclude that t ...
, though homicides, are generally assumed to be lawful and are not prosecuted. Most deaths due to war are not prosecuted, unless there is evidence of a
war crime, in which case troops on foreign territory might be prosecuted by the
military justice
Military justice (also military law) is the legal system (bodies of law and procedure) that governs the conduct of the active-duty personnel of the armed forces of a country. In some nation-states, civil law and military law are distinct bodie ...
system, domestic law enforcement, or the
International Criminal Court
The International Criminal Court (ICC or ICCt) is an intergovernmental organization and international tribunal seated in The Hague, Netherlands. It is the first and only permanent international court with jurisdiction to prosecute individuals ...
.
Some insurance contracts, such as
life insurance policies, have special rules for certain manners of death.
Suicide
Suicide is the act of intentionally causing one's own death. Mental disorders (including depression, bipolar disorder, schizophrenia, personality disorders, anxiety disorders), physical disorders (such as chronic fatigue syndrome), and s ...
, for example, may invalidate claims under terms of such a contract.
See also
*
Inquests in England and Wales
Inquests in England and Wales are held into sudden or unexplained deaths and also into the circumstances of and discovery of a certain class of valuable artefacts known as "treasure trove". In England and Wales, inquests are the responsibility of ...
(conducted by coroners)
*
References
Further reading
*
External links
DEATH FROM NATURAL CAUSES – CERTIFICATE OF TREATING OR EXAMINING DOCTOR – Form 3 – Burial and Cremation Act 2013 (section 10)(Australia)
{{death
*
Medical terminology
Public health