California Death Certificate Program: A Suggested Improvement

Abstract

California Death Certificate Program: A Suggested Improvement Robert A. Bitonte, MD, MA, JD, LLM, FCLM, City of Los Angeles Commission on Disability, Los Angeles, CA; Email rbitonte@aol.com Michelle Gutierrez Harris, MHS, San Diego, CA; Email michelleann.gutierrez@gmail.com Over the past several years much interest has been aroused by the number of opioid related deaths. In California this has led to the implementation and enforced usage of the CURES (California Controlled Substance Utilization Review and Evaluation System) database. The desire to curb opioid abuse has led to a recent initiation of the California Death Certificate Program. This program identifies physicians, dentists, and other providers who have prescribed opiates to an individual within 3 years of that person being identified as having died due to an opioid related overdose. The identified prescriber is then referred to that prescriber’s overseeing regulatory board, such a Medical Board of California or the Dental Board of California, for further investigation and possible disciplinary action. Any referral to a regulatory board necessitates an investigation. These investigations often are expensive, distracting, embarrassing, and potentially harmful to a professional’s reputation and practice. We propose that there be an intermediary process before these identified prescribers are referred to their respective regulatory boards for investigations. For example, implicated professional individuals could be referred to their County Medical Associations for review by their professional peers. If questionable, or unethical, behavior is determined to have occurred, then these professional individuals can then be referred to their respective regulatory bodies for investigation. 2020 American College of Legal Medicine JOURNAL OF LEGAL MEDICINE 2020, VOL. 40, NO. S1, 1 https://doi.org/10.1080/01947648.2020.1715717