In many legal jurisdictions, the manner of death is a determination, typically made by the coroner, medical examiner, 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, 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 (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.[1]
A natural cause of death results from an illness and its complications and internal body malfunctions not directly caused by external forces, other than infectious diseases. For example, pneumonia, diarrheal diseases, HIV/AIDS infections, cancer, a stroke, a heart disease and a sudden organ failure would definitely be some of the natural death causes of some people.
As any form of life grows older, several health-related consequences form, in humans; such as skin tissue healing slower, the walls of blood vessels thicken, cells cannot fix error they caused as fast, and immune systems are not as effective. These health issues mean that if an elder falls down, they are more likely to have internal bleeding. If plaque builds up in an elder's arteries, you're more likely to have a heart attack. And if an elder gets a cold, it's more likely to developed into pneumonia.[2]
There is particular ambiguity around the classification of cardiac deaths, triggered by a traumatic incident such as in stress cardiomyopathy. Liability for a death classified as by natural causes may still be found if a proximate cause is established,[3] [4] as in the 1969 California case People v. Stamp.[5]
An unnatural cause of death results from an external cause, typically including homicides, suicides, accidents, medical errors, alcohol intoxications and drug overdoses.[6] [7] 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.[8]
"Mechanism of death" is sometimes used to refer to the proximate cause 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 (lack of blood flow to the brain), caused by a malignant neoplasm (cancer), 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.[9] For example, the discovery of a partial human skeleton indicates a death, but might not provide enough evidence to determine a cause.
In the United States, a manner of death is expressed as belonging to one classification of a group of six possible:[10] [11] [12]
In some jurisdictions, some more detailed manners may be reported in numbers broken out from the main four or five. For example:
In the United Kingdom, when people die, either a doctor writes an acceptable natural cause of death medical certificate, 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.[14] In the unified legal jurisdiction of England and Wales, 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.[15]
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:[16]
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":[17]
A death ruled as homicide or unlawful killing is typically referred to police or prosecutor or equivalent official for investigation and criminal charges if warranted. Deaths caused by capital punishment, 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.
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.