Certification process of a persons death by a doctor: FOI release

Information request and response under the Freedom of Information (Scotland) Act 2002.

Information requested

You asked how the difference between influenza and Covid on a death certificate is arrived at by the certifying doctor and/or pathologist carrying out the investigation.


The certification of a person’s death is a matter that falls within the clinical responsibility of medical practitioners, who require to be satisfied, on the balance of probabilities, as to the likely cause of death. Medical practitioners are aware that the Medical Certificate of Cause of Death (MCCD) is a legal document and information included in such a document must be to the best of their knowledge and belief.

We recognise the importance of high-quality, accurate completion of the MCCD and we have issued comprehensive Guidance for Doctors Completing Medical Certificates of Cause of Death (MCCD) and its Quality Assurance. Also available to doctors is a wide range of educational resources.

Scotland's Chief Medical Officer (CMO), jointly with Police Scotland, Crown Office and Procurator Fiscal Service (COPFS) and National Records of Scotland (NRS) also issued guidance to doctors for death certification during the COVID-19 pandemic.

When doctors complete a MCCD they are advised to consider a range of factors in order to determine whether, on balance, “COVID-19 Disease” or “presumed COVID-19 disease” can legitimately be recorded as the cause of death. These factors include, but are not limited to: 

  • Presence of COVID-19 symptoms
  • Reports of symptoms from family and friends
  • The wider facts and circumstances surrounding the death such as: that COVID-19 pandemic had struck in the locality; or evidence of medication suitable for treating the symptoms of a COVID-19 found in or near the deceased’s possessions.

Whether a certifying doctor records influenza or COVID-19 on a MCCD, is a matter of clinical judgement.

A person who has questions or concerns about the content of the MCCD, after speaking to the doctor, can consider applying to the Death Certification Review Service (DCRS) for an ‘Interested Person Review’. More information on what an Interested Person Review is and who can apply is available here.

About FOI

The Scottish Government is committed to publishing all information released in response to Freedom of Information requests. View all FOI responses at http://www.gov.scot/foi-responses.


Please quote the FOI reference
Central Enquiry Unit
Email: ceu@gov.scot
Phone: 0300 244 4000

The Scottish Government
St Andrews House
Regent Road

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