I have signed literally hundreds if not thousands of death certificates. Your cause of death options are natural, accident, suicide, homicide, undetermined, and pending. The vast majority are natural causes. People die from vital organ failure. For example breast cancer doesn’t hurt you until it gets into a vital organ like the liver or lung and causes it to fail. In that case I would sign the death certificate natural causes, #1 cause liver failure secondary to #2 cause breast cancer.
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