I never put “Old Age” as a cause on any of my Death Certificates. Like most physicians, I suspect, I am unaware of any rules about what you can and cannot put there. That is not to say they don’t exist.
The clearest Death Certificates give you a place to put the patient’s immediate (proximate) cause, followed by one or more underlying causes…
Joe Schmoe
Cause of Death: Pneumonia
Associated or underlying causes: Multiple trauma secondary to MVA
etc.
J. Robert Oppenheimer must have been quite ignorant when he called that device he exploded at Trinity, made with plutonium, an “atomic bomb”.
I’ll have to go back and look, but the author of The Okinawa Program contends that the centenarians the project focused on often died simply of old age–meaning that they died without previously being plagued with chronic heart disease, dementia, etc. They just eventually “wore out.”
Science isn’t a popularity contest and it isn’t decided by High Nabobs. I’ve explained my terminology. Can anyone offer a cogent explanation for calling a nuclear bomb an ‘atomic bomb’?
Because that is what J. Robert Oppenheimer, the director of the Manhattan Project, called it:
As far as I am concerned, if he said it, that is the correct usage. Any other interpretation is pedantry. If I have to choose between Oppenheimer and you, guess who carries more weight?
Besides, you have offered no other usage of ‘atomic bomb’ in reference to conventional explosives, It ain’t so just because it makes sense to you.
Are you just concerned that people use the term “Atomic Bomb” to refer to bombs that employ a nuclear reaction for their power even though all bombs contain molecules composed of “atoms”?
Are you hung up over that?
We call “nuclear fission bombs” atomic bombs, even though all bombs are composed of molecules that have atoms in them. When people say “Atomic Bomb” they mean a bomb that uses nuclear fission for its power.
The term might not be the most restrictive definition in the world, but that’s not how language works.
It refers to nuclear bombs because that’s what it refers to.
North Carolina death certificates specifically state that “cardiac arrest” is not to be used as the COD.
No, but language is. It’d be nice if the more scientifically-descriptive terminology had caught on, but I think this one is a lost cause.
I have put “general debility of old age” as a cause of death for an old person, with no known medical problems other than dementia who just didn’t wake up one morning.
They were 90-something and had been admitted to hospital because they were no longer coping at home, not because they were unwell. They were basically sitting on a ward waiting for a nursing home bed to become available. Bloods were normal, X-rays were normal, everything was A-OK, they were just very, very confused and not safe to be left at home because they weren’t eating or bathing properly and had a “wandering while in a state of undress” episode.
I discussed it with the coroner and we decided that this was the best cause of death to put on the certificate, so as to avoid a coroner’s autopsy and inquest, as the family didn’t want a post-mortem, and I couldn’t be sure whether the patient had died of a stroke, heart attack or pulmonary embolism (I’m 99% certain it was one of the three).
Picunurse I just love the pragmatic attitude most medical care people have towards life. “Air goes in and out, blood goes round and round, or it doesn’t.”
Beautifully put. And so true! 
On the off chance that anyone is still interested in the OP, and as someone who’s cared for hundreds of people who’ve died, I wish old age were still considered a cause of death.
Most of my hospitalized patients are over age 80, and many are over 90. Sure, they’ve been admitted with pneumonia or heart failure, but the truth is that a lot of them are just plain old. If it wasn’t pneumonia, it would be kidney failure. If it wasn’t heart failure, it would be a stroke. I mean, there’s just so much wrong with them as a result of being old, that something’s gotta give.
Here’s a typical example - 93 year-old man with advanced dementia, multiple previous strokes, congestive heart failure, Parkinson’s disease, and chronic renal insufficiency (i.e. chronic mild kidney malfunction). He has a fall, gets admitted to hospital, then gets totally delirious, then develops pneumonia, then experiences a worsening of his kidney function, then aspirates his breakfast, then gets worse kidney function, then seems to have had another stroke, then goes into worse heart failure, then gets a urine infection, then gets worse pneumonia, then dies. Not only is it arbitrary to choose a specific cause of death, or label him as dieing from pneumonia, it’s misleading. He died because he was decrepit. He was decrepit because he was old.
FWIW, the British Medical Journal (BMJ), in its obituaries of British physicians, often lists the cause of death as “old age”.
I’ve got the first series of QI on DVD and ‘death from old age’ isn’t mentioned anywhere in it.
Here’s a .pdf from the CDC on properly filling out a death certificate. There used to be a really nice tutorial about it online somewhere, and I can’t seem to find it.
As KarlGauss says, it’s often hard to nail down the specific sequence of events. It’s OK to hedge with “likely”, as in “likely pulmonary embolism”, and you often have to if no one is interested in an autopsy.
Lucky you. I can’t put “likely” anything!
If they die within 24 hours of admission, it’s a phone call to the coroner. If like my patient above, we only discover they are dead when they don’t wake up for the 6am observations, but they were alive and well for the 4am obs, it’s a phone call to the coroner.
I have filled out a cremation form for a 95 y/o who died from a pneumonia, caused by a blood clot to the lung, as a result of a DVT in her leg, caused by dehydration and immobility, in turn caused by diarrhoeal illness, caused because she ate something from her fridge at home that was well past eating.
I put COD as Pneumonia, secondary to pulmonary embolism, secondary to dehydration and immobility, secondary to diarrhoeal illnesss.
I still got a call from the registrar for deaths asking if I was sure the death wasn’t suspicious before they cremated the body.
My response?
“She was 95, her funeral was pre-paid and she spent yesterday choosing hymns for the service and giving away her jewelry to her grandchildren. I’m pretty sure no-one will be wanting an exhumation.”