Legal registration of death before a body may be buried or cremated has been required since 1837 in England and Wales and is virtually complete. Doctors have been required to certify the cause of death for patients under their care since 1841, except for certain categories of death which are referred to the coroner for investigation.
The format of the medical certificate of cause of death was laid down in 1927, and forms the basis for subsequent international recommendations up to the present time. The certifying doctor is required to enter the conditions which led directly to death in part I of the certificate, so that the disease or condition which started the sequence is in the lowest used line. Any other significant conditions which may have contributed to the death are put in part II. The cause section of coroners' certificates has had the same basic format since 1993, although other details are different.
These certificates are used to code the cause of death to codes from the International Classification of Diseases.