Stanford Report, January 9, 2008

Letter to the editor: Phrase ‘died of natural causes’ is problematic; autopsies illuminating

Louis Bergeron wrote an articulate and effective obituary of Edmund Chang in a recent issue of Stanford Report (Dec. 5, 2007). My only criticism is his writing that Chang "died of natural causes." The problem with that phrase is that no one dies of natural causes. There is always something that goes wrong with the function of a crucial organ, such as the heart, lungs or brain, that leads to death. No matter that it is a sudden death, perhaps at night while sleeping; it is not a "natural" death. I suppose that when one finally crosses that threshold at age 95 or so, it would be OK to call the cause "natural." But Edmund Chang was only 72. This "natural cause" euphemism is often used, I guess, when death is sudden and no autopsy is performed. The infrequency of asking and receiving an autopsy on a relative's death is a problem of recent years, particularly when it is possible, even probable, that examining the organs of the recently deceased would lead to a finding of significance for the family—an abnormality, accelerated and severe atherosclerosis, for example, that could lead to lipid testing and treatment, if necessary, for younger and asymptomatic children or grandchildren. Death happens, it often is welcomed, but something "unnatural" causes it.

Edward D. Harris Jr., M.D.

George Deforest Barnett Professor, Emeritus

Academic Secretary to the University, Emeritus

Executive Secretary, Alpha Omega Alpha Honor Medical Society, and Editor, The Pharos

Editor's Note: Dr. Harris is correct to assert that the phrase "natural causes" is an imprecise way of explaining the cause of death. Journalists, including Stanford Report writers, generally attempt to define the cause more narrowly when the information is readily available. When an individual's death is not the subject of a criminal investigation, reporters most often rely on the family for the diagnosis. In some cases, families prefer simply to describe a death that results from the nonviolent breakdown of the body as having occurred from "natural causes." (Of course, such deaths may have been precipitated by pre-existing conditions or unhealthy habits.) Although not explicit, the phrase is a useful way of informing readers that a death was not caused by a violent external factor, such as a traffic collision or gunshot wound.