By RON SHAWGO, ©1998 The (Fort Wayne) Journal Gazette
February 23, 1998
Vermillion County Hospital had seen more than 100 unexplained deaths, and the public wanted to know why.
For a year, even as a nurse became the prime suspect, the Terre Haute Tribune-Star pleaded with the Indiana Department of Health to release death certificates so that some public light could be shed on what happened.
The newspaper reasoned that the causes of death listed on the certificates could provide a piece of the puzzle. Only after the newspaper sued did the department release the records.
The irony is that in most of Indiana's counties, the death certificates would have been turned over immediately. But not in Vermillion County.
The problem stemmed from conflicting laws.
State law requires death certificates to be open to the public at county health departments, where they are recorded. But after local officials send certificates to the state Health Department, the state allows only limited disclosure.
Once the certificates are at the state Health Department, medical researchers, genealogists, reporters and anyone else interested in them come up empty-handed. Even some of the counties that keep local copies of death certificates maintain they are confidential and refuse to release them.
Why such a fuss over a piece of paper?
Those who oppose opening the records say a cause of death is a private matter that family members often don't want made public.
They also are concerned that insurance might be denied to survivors of someone who dies of AIDS, for instance.
Proponents say communities can use death certificates to follow health trends. People have a right to know about disease clusters in their neighborhoods, they say. And, they add, it's not a media-vs.-government issue.
"If I had a bunch of neighbors who died within a short period of time - if they were all cancer victims or heart attack victims - I think I would want to know about that," said Dave Cox, editor of the Tribune-Star. "I'd be concerned about the welfare of my family and my neighbors."
Officials at the state Department of Health can release death certificates only under limited circumstances.
The records can be released to settle property rights or to conduct research if the deceased is not identified. They also can be released to those "with a direct interest in the matter recorded" or in cases that have a "tangible and legitimate public interest," the argument the Tribune-Star used.
In 1975 the Indiana Court of Appeals ruled in favor of the Evansville Printing Corp. and against the Vanderburgh County Department of Health in finding that death certificates are open for public inspection.
Still, many county health departments refuse to issue the certificates, or they allow access to everything but the cause of death.
When representatives of Indiana newspapers asked for death certificates from all county health departments last summer, 18 refused to turn them over. In denying the records, many departments said the certificates either were not public or people had to have a good reason to see them.
Forty-nine of the newspaper representatives were required to give their names, 16 were asked who their employer was and 56 were asked why they wanted the certificates. State law does not require that that information be disclosed.
Opponents and proponents agree the laws are confusing.
"It sounds like the law needs to be changed or made more definite at both the state and county levels," said Dr. David Hadley, health officer for Hendricks County and president of the Indiana Association of Public Health Physicians. "My own feeling, based on the information I have, is that confidentiality should be protected as for cause of death."
Last year, the physicians group opposed a bill that would have opened death certificates at the state Department of Health.
Hadley said similar restrictions are needed on death certificates kept locally.
But Indiana Attorney General Jeff Modisett issued an opinion earlier this year affirming that death certificates are public records at the county level. The state health commissioner will be sending copies of that opinion to all county health departments.
Stephen Key, Hoosier State Press Association legal counsel, maintains that, even based on the 1975 court decision, county health officers are breaking the law if they don't release death certificates.
But even Key admitted that "you can't outlaw confusion."
The press association supported the bill that would have required the state Health Department to open death certificates. It also was supported by genealogists, Key said. Twice the measure has been unsuccessful in the Legislature.
Sen. Patricia Miller, R-Indianapolis, who heads the Senate committee where the measure has languished, said she has reservations about opening the records but will listen to both sides.
"There are some pretty profound ramifications for families out there," she said. "I just think we need to take some time and look at that." Ms. Miller did not call a similar measure for a vote.
But Cox said concerns surrounding the certificates' release are exaggerated.
Thirty or 40 years ago people were concerned about revealing that a death was the result of cancer or suicide, he said. Now, social changes have lessened those concerns.
Most people also don't realize that news organizations regularly have ethical discussions about what should be reported from the information they receive, he said.
Even after receiving death certificates from the state Department of Health, the Tribune-Star used very little of the information contained in them, Cox said.
Reporters interviewed about two dozen family members of people who died at Vermillion County Hospital, and the people were unanimous in their support of the newspaper's efforts to get the death certificates he said.
"My opinion," Cox said, "is there is a tendency to be overprotective - unnecessarily so."
© 1998 The E.W. Scripps Co.