Usually it’s a euphemism for “this person had been sick for a long time, and we’re not going to perform an autopsy to figure out exactly what ailing bodily function finally failed first”
Usually you hear it more for people who die at an advanced age since nearly every system is limping along when you’re 95, but younger people who tortured their bodies with drugs and alcohol can end up in a similar “it’s all failing at once” state even if they’re currently clean.
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