Death certificates are important because morbidity and mortality statistics often come from death-certification data. These statistics are vital in developing approaches to disease treatment and strategies for increasing longevity. It is often the primary care physician who is responsible for completing the death certificate, for explaining the cause of death to the family and, if appropriate, for referring some cases to the medical examiner. The primary care physician should have an explicit understanding of how to determine the cause and manner of death and should use succinct, clear language in completing the death certificate. When doubt exists or an external cause of death is a possibility, the coroner or the medical examiner is the appropriate public health official to contact.