Problems analysing intent

A temporary code (ICD10: Y33.9, ICD9: E988.8) can be used in England and Wales to register the underlying cause of death where an inquest has been adjourned pending legal proceedings. These deaths are included in the ‘undetermined’ cause of death count. A significant proportion of these codes will be subsequently re-coded to indicate the agreed underlying cause of death, while some will retain the original code to indicate an ‘open’ verdict. Re-coded records accounted for 52% of homicides in England in 2004. These amendments are not included in the standard releases of data from the Office for National Statistics.

The current analysis for England and Wales occurrences is unfortunately based on standard registration data so is likely to provide a particular undercount of homicides. It is suggested that organisations in England and Wales wishing to undertake analysis of homicide or combined suicide and undetermined deaths would benefit from acquiring ‘late’ data extracts containing code amendments as well as the standard more timely extracts. Alternatively, organisations will need to rely on an estimate of the true count. See also further comments

The ICE categories used in this analysis consider suicides and undetermined cause separately. However, it is often conventional to combine the two categories given the particular difficulties involved in determining intent. Countries may also differ in legal arrangements and attitudes regarding assigning deaths as suicide. In England and Wales, for example, all possible suicides are subject to a public inquest in a coroner’s court. The coroner will require proof ‘beyond all reasonable doubt’ before returning a verdict of suicide. Many possible suicides end up as ‘open’ verdicts and will be included in the ‘undetermined’ count. See also the note on drowning coding.