The cause of Queen Elizabeth II's death has been confirmed as 'old age'. It is very unusual for this to be given as a sole official cause of death, but there are some circumstances where it is acceptable.
The death certificate, which has been released by the National Records of Scotland, records the Queen died at 3.10pm on September 8 in Balmoral Castle, at the age of 96. Douglas Glass, the Queen's doctor in Scotland, certified the death.
From a medical perspective, old age alone does not cause death. But complications arising from conditions that come with aging are often fatal. Doctors do not always know the exact cause of death in an elderly person, because they may have conditions that subtly overlap.
Read next: King Charles' female relative who was born 150 years ago and looks remarkably like him
When it comes to writing death certificates in the UK, there is strict government guidance that says doctors should avoid giving old age — or even 'senility' or 'frailty of old age' — as the sole cause of death. There are, however, "very limited circumstances" where this is acceptable. These are when a doctor has:
• personally cared for the deceased over a long period (years or many months);
• observed a gradual decline in the patient's general health and functioning;
• not been aware of any identifiable disease or injury that contributed to the death;
• been certain that there is no reason that the death should be reported to the coroner.
The guidance says doctors may mention old age or frailty as a contributing cause, especially if it explains the severe effect of a condition that is not usually fatal. It continues: "You should bear in mind that coroners, crematorium referees, registrars and organisations that regulate standards in health and social care, may ask you to support your statement with information from the patient's medical records and any investigations that might have a bearing on the cause of death. You should also be aware that the patient’s family may not regard old age as an adequate explanation for their relative’s death and may request further investigation."
It goes on: "While there is no statutory age limit or restriction on referring to ‘old age’, a death certified as due to old age or senility alone will usually be referred to the coroner, unless the deceased was 80 or older, all the conditions listed above are fulfilled and there is no other reason that the death should be referred. Similar terms, such as ‘frailty of old age’, will be treated in the same way."
On the Queen's death certificate Princess Anne is recorded as the person providing information about her death. The 3.10pm timing of the death gives an insight into what happened during September 8, when reports of her ill health circulated for hours before Buckingham Palace formally announced death at 6.30pm. According to the BBC there were some reports that the Prime Minister Liz Truss had been privately notified at 4.30pm.
The Palace had confirmed in a statement at 12.32pm that there were health concerns but that the Queen was "comfortable" and "under medical supervision". King Charles — then Prince Charles — and his sister Anne had already been in Scotland, but other members of the Royal Family travelled by air that afternoon. After travelling by car from Aberdeen airport, Prince William, Prince Andrew, and Prince Edward and his wife Sophie arrived at Balmoral at about 5pm.
You can read more about what it means to die in old age here. And you can find more news on the royal family here.
READ MORE:
- 'Adored' nurse made tragic call to girlfriend before fatal mountain fall
Prince William issues emotional 'life without Grannie' statement as he mourns Queen's death
Queen's exact time of death shows which royals didn't make it in time
- Beloved restaurant announces 'gut-wrenching' closure as energy prices soar
