Uncertainties in death certification

摘要

Death is one of life’s few certainties, and most GPs will inevitably preside over a few patient deaths each year. Indeed, the apotheosis of the ‘good death’ could be the patient who dies at home, dignified and pain-free following well-coordinated interdisciplinary palliative care.1 Given that around three-quarters of people express a wish to die at home2 yet only a quarter manage to do so,3 that sentiment appears to have wide public support. Nonetheless, in common with many aspects of clinical medicine, death is riddled with uncertainty, especially when it occurs unexpectedly, these being relative rather than absolute terms.