You may have heard of celebrities or people in your community dying of “natural causes,” but have you ever wondered what exactly that means? If there are natural causes of death, are there also unnatural causes of death? Is the term only used if people die at an old age? It turns out, it’s a bit complicated. Here’s how experts explained the term to Health.
It’s important to point out upfront that “dying of natural causes” isn’t a medical term, Sarah Reuss, MD, a pathologist at The Ohio State University Wexner Medical Center, told Health.
“It’s more of a term used to communicate with people outside the medical field,” Dr. Reuss said. “A lot of times, what we use to talk to each other [in the medical field] doesn’t make sense to people outside the field, so we have a lot of terms to help people outside the medical field better understand us.”
Usually, dying from natural causes is interpreted as “nothing acute happened,” Dr. Reuss explained. And by acute, Dr. Reuss means that nothing sudden or severe happened.
A death certificate will state more than whether a death was natural or not. The certificate will indicate the immediate, or final, cause of death and any underlying causes or conditions that led to the death.
While there isn’t necessarily a set definition for what constitutes “natural causes,” Erin McNeely, MD, an internal medicine physician at Spectrum Health in Michigan, told Health that physicians can generally agree on what it means. “‘Natural causes’ is a really wide, wide term that can be anything that wasn’t an accident or affected by a force,” Dr. McNeely said. “We don’t pin a death from natural causes on one thing like a heart attack or stroke. Things just sort of stop.”
There is some nuance here, and technically, things like heart attack, cancer, and infections could be considered “natural” given that they happen to people without any outside force, Lewis Nelson, MD, chair of emergency medicine at Rutgers New Jersey Medical School, told Health. “It basically means that the death was not due to a ‘non-natural’ event, such as suicide or homicide,” Dr. Nelson said.
However, end-of-life researcher Christopher Kerr, MD, PhD, chief medical officer, and chief executive officer for Hospice & Palliative Care Buffalo, told Health that the term is usually used when someone dies of old age. “There’s usually an absence of overriding disease,” Dr. Kerr said. “There isn’t a driving catabolic state—it’s really dying in totality, and a general progression of loss of functional strength, energy, and appetite over time.”
Dr. McNeely compared dying of natural causes to a car shutting down after years of use. “The car rusts out, the engine stops, and things stop working over time,” Dr. McNeely said. “Your body eventually just slows down and stops. Your pancreas, heart, and lungs stop working. It’s essentially multi-organ failure.”
When “natural causes” shows up on a death certificate, it usually means that the person wasn’t diagnosed with any one health condition, like heart failure, or didn’t die in an accident, Dr. McNeely explained. Coroners typically come to this conclusion in the absence of an autopsy or known cause of death, Dr. Nelson said.
But “when there are questions about the cause or manner of death, an autopsy along with other testing provides the needed information to help improve the determination of the cause and manner of death,” Dr. Nelson said. Still, as Dr. McNeely pointed out, “we usually don’t do autopsies on significantly older people.”
Based on the explanations provided by these medical experts, dying of natural causes isn’t clear cut. It can mean that there wasn’t any one health condition that caused death, but a combination of factors. As such, a natural cause of death is more likely to be listed as the cause of death for older adults whose organs have slowly worn down and come to a stop.
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