Public Health Law Map - Beta 5 - Medical and Public Health Law Site

The name on the birth certificate does not establish the child’s paternity. It may be
evidence of paternity, if the named father agreed to the use of his name, but it does
not affect the state’s legal procedures for establishing paternity. State restrictions on
choosing names on a child’s birth certificate do not prevent the parents or the child
from petitioning the court for a name change after the birth certificate proceeding.
3. Stillbirths
Some states use a separate form for filing a report of stillbirth. Other states require
the birth attendant to file both a birth certificate and a death certificate.
The gestational age that constitutes a stillbirth differs from state to state but is usually
around 20 weeks. In some cases, an induced abortion may require registration.
The stillbirth certificate may be the appropriate form even if the child is born alive.
Separate birth and death certificates are required usually only if the child is
potentially viable and lives for some period. If a fetus of any gestational age shows
signs of life such as heartbeat or respiratory effort, it is best to file the appropriate
certificates.
A reasonable attempt to determine the cause of death should be made for stillborn
infants. Prematurity is usually a result of some underlying medical condition, not the
cause itself. Prematurity is obviously not the cause of intrauterine death. Since some
causes of stillbirth, such as infection or uterine abnormality, are treatable, the
physician who does not establish the cause of a stillbirth may be liable for similar
problems in a subsequent pregnancy.
4. Death Certificates
The quality of death records in the United States is generally poor because physicians
are not well trained in filing these reports. Death certificates are problematic for
several reasons: unexpected deaths frequently occur outside the hospital; the cause of
death may not be immediately obvious; there may be no one to provide information
on the identity of the person who died; occasionally there may be a question of
criminal activity having been involved in the death.
The cause of death is the most important information on a death certificate and is
generally the most inadequate. Preferably the causes of death listed should be coded
from the International Classification of Disease. But for many certificates, the actual
cause of the death is not clear, let alone codable. “Cardiac arrest” is a result of death,
not a cause. A death certificate that lists cardiac arrest as the cause of death and
respiratory arrest following shock as the contributing causes may be for a patient
who died of a gunshot wound or a terminal cancer patient or a patient with
underlying heart disease. The cause of death should tell a reader what killed the
patient—not what the terminal events were.
It is important that the death certificate contain the information that a death was
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