Determining cause of death

As one ages, it is common for some to at least scan, if not read, local obituaries.

The older one gets, the more likely they may know someone who has died recently. Curiously, cause of death is often confused with manner of death. Sometimes, there is no mention of the reason for death at all.

Similarly, in veterinary medicine, it is common for grief-stricken people suffering the loss of a pet, including horses, to call or email wanting to know why their animal died. Too often, the animal has been dead for days to years and people will call and ask if a post-mortem examination to determine cause of death can be performed.

In gentlest terms, we have to ask them about their animal and eventually break through the profound grief they are experiencing. In most cases, there is virtually no chance for determining cause of death with some exceptions. But people suffering like this need all due respect and empathy first, before you can discuss realities.

Cause of death is an official determination of the conditions resulting in a death. In humans, that is what is recorded on the death certificate. Typically, this is a specific disease or injury. Examples might include pneumonia or exsanguination, meaning bled to death.

Manner of death is limited to a small number of categories such as natural, accident, suicide or homicide. All of these have different legal implications in different jurisdictions, and by degree, especially when considering wildly differing laws in other countries, too.

Both cause of death and manner of death should follow the International Classification of Diseases and Related Health Problems, or ICD. Maintained by the World Health Organization and using a system of uniform diagnostic codes, the ICD is used worldwide as a diagnostic tool for epidemiology, health management, and for clinical purposes.

Obituaries represent another facet of this issue, too. Nowadays, obits often are written by the family or funeral service providers and submitted to local newspapers. In the past, news reporters typically wrote them for the newspapers and they were edited for accuracy and consistency.

Currently, it is common to hear wildly varying reasons for a person’s death that may or may not represent what happened or why. An example would be, “ … was called home to Jesus.” Sometimes, such wording is used to mask the actual cause or manner of death for personal or political reasons.

It is also becoming more common to read pet obituaries since newspapers charge for the space now. Pets are said to “cross the rainbow bridge.” Basically, one can write what they want about the decedent and with few exceptions, it gets ink.

One area where this has changed a lot, and for the better, is in the reporting of suicides. Thankfully, journalism has created a new standard that uses softer wording for the surviving family and friends after a suicidal act and those who might be triggered by harshly worded notices.

Increasingly too, medicine is using molecular genetics to help determine cause of death, manner of death and contributing factors.

In a paper recently published in the Journal of Veterinary Medical Science, the authors provide a report about the death of a 10-day-old, Chinese spot-billed duck. To determine cause of death, they interviewed witnesses, examined the body externally, performed a necropsy, and they did genetic analysis of the wounds observed.

While the duck was hit by a car and died as a result of the trauma, molecular tests revealed the bite wounds had come from raccoons. The authors argue that today, molecular analysis is an additional step that should be used to clarify animals’ cause of death, especially in wildlife. Only the cost is in question.

Powell is the public information officer for the Washington State University College of Veterinary Medicine, which provides this column as a community service. For questions or concerns about animals you’d like to read about, email cpowell@vetmed.wsu.edu.