In many legal jurisdictions, the manner of death is a determination, typically made by the coroner,

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 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 �
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 di ...

. 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 severi ...

, 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 or heart disease (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 intoxications and drug overdoses. 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 (

), in turn caused by a dose of ionizing radiation 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 territori ...

, 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 * Homicide * 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 ( 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 but most do not involve a formal inquest. 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 ** Killed unlawfully ** Killed lawfully * Suicide * 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 pre ...

* 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 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 th ...

or prosecutor 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

, 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 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 f ...

. Some insurance contracts, such as life insurance policies, have special rules for certain manners of death. Suicide, for example, may invalidate claims under terms of such a contract.

References

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