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Medical Certification of Death

A report of death under ORS 432.133 requires a medical certification to be completed by the decedent’s primary or attending physician, physician associate, or nurse practitioner who was in charge of the care of the patient for the illness or condition that resulted in death.


General Guidance for Completing Medical Certifications of Death

The certification of death must be completed and signed by the physician, PA, or nurse practitioner in charge of the care of the patient for the illness or condition that resulted in death. Delaying the completion or refusing to sign a death certificate makes an already difficult time for surviving loved ones and may result in unnecessary complications with funeral arrangements, estate proceedings, and other legal and personal matters.


The Board recognizes that you may not be comfortable with uncertainty, however, a licensee should not decline to complete medical certification of death simply because the exact anatomic or physiologic cause of death is uncertain. Licensees are not expected or required to establish beyond a doubt the specific cause of death but should exercise their best judgment under the circumstances using available information.


Review of the patient’s medical history should provide adequate information to state a reasonable or likely cause of death. A licensee’s determination of the cause of death is a medical opinion and is based on the best available medical evidence, which may include the cumulative effects of multiple risk factors or a previously known disease. Use of standard nomenclature without abbreviations and legible writing is encouraged.


The Board will not pursue disciplinary action against licensees who complete a medical certification of death in good faith and to the best of their ability in accord with the information available. The licensee completing the medical certification provides a cause of death to the best of their knowledge, not to a medical certainty (which is not possible in many instances).


The Board also recognizes that licensees may believe, for a variety of reasons, they were not “in charge of the care of the patient for the illness or condition that resulted in death.” This is often because death has occurred weeks or months after the last contact with the patient. The Board encourages licensees to undertake completion of medical certification for patients under these circumstances as a professional and public health responsibility. Licensees should perform this final aspect of patient care promptly and with consideration for the decedent and their loved ones.


Medical Certification of Death

Oregon statute allows a physician, PA, or nurse practitioner licensed under the laws of Oregon or under the laws of Washington, Idaho, or California who has treated a decedent within the 12 months preceding death to complete the medical certification of death.1


A medical certification must be completed within 48 hours after having access to the report of death. The person completing the cause of death attests to its accuracy either by signature or by electronic signature. In most situations, the funeral service practitioner will obtain the medical certification from the appropriate physician, PA, or nurse practitioner.


Completed by an AssociateIn the absence or inability of the primary or attending health care provider, the report of death may be completed by their associate, the chief medical officer of the institution where death occurred, or the physician who performed an autopsy upon the decedent, if the person is given access to the medical history of the case and death is due to natural causes.


Completed by a Medical Examiner: When the death involves a criminal inquiry, the medical examiner in the jurisdiction where death occurred or the body was found must determine the cause and manner of death and will complete and sign the medical certification.2


Autopsy Results: Upon receipt of autopsy results or other information that would change the information related to the cause or manner of death, an amendment to the record of death must be submitted within five calendar days to the Center for Health Statistics.


Additional Resources