Medical certificates: sick leave, death and medico-legal reports
- Topic
A medical certificate attests to a person's health, birth or death; it must be truthful and issued by an authorised professional.
What it is
A medical certificate is a document that attests to a person's birth, state of health, prescribed treatment or death. Issuing one carries legal and moral responsibility for the doctor. The most common are the certificate of health status (for example, to support sick leave), the live-birth certificate and the death certificate. In addition, the doctor acts as an assistant to justice when a judge or prosecutor asks for an expert opinion, or when treating injuries or violent deaths, which go to the National Institute of Legal Medicine.
Key facts
- Law 23 of 1981, art. 50: the certificate attests to birth, health status, treatment or death, and carries legal and moral responsibility.
- Law 23, art. 51: its text is clear, precise, truthful and states its purpose; art. 52: issuing a false certificate is serious misconduct.
- Decree 780 of 2016, art. 2.7.2.2.1.3.4: minimum content: place and date, addressee, health status or medical act, patient identification, purpose, and the doctor's name, registration number and signature.
- Decree 780, art. 2.7.2.2.1.3.6: the death certificate has parts for general data, fetal and infant deaths, deaths of women during or after pregnancy, violent deaths and causes of death.
- Decree 780, art. 2.7.2.2.1.3.7: a doctor signs it (including one doing compulsory social service); where there is none, a nurse may, and in hard-to-reach areas trained auxiliaries or health promoters.
- Violent deaths or deaths of undetermined cause: the certificate records how and where it happened when the case goes for an opinion of the National Institute of Legal Medicine and Forensic Sciences.
Step by step
- Examine the patient or the body before certifying; never certify from someone else's account.
- Identify the person correctly with their identity document.
- Write only verified facts, in clear language, and the purpose of the certificate.
- On a death certificate, record the direct cause, the underlying causes and other significant conditions, in order.
- If the death is violent or doubtful, do not certify a natural cause: inform the authority so Legal Medicine can act.
- Sign with full name and registration number, and keep a copy or note in the medical record.
In clinical practice
- Sick leave issued without examining the patient, or for more days than the condition justifies, does not keep to the truth (Law 23, art. 51).
- Faced with an injury from violence, the doctor treats first, records the injuries in detail and preserves evidence for the expert opinion.
- The death certificate feeds vital statistics: a poorly written cause (for example, «cardiorespiratory arrest») does not explain why the person died.
Legal framework in Colombia
- Law 23 of 1981, arts. 1 (no. 6), 50, 51 and 52: the doctor as assistant to justice and the rules of the medical certificate.
- Decree 780 of 2016, arts. 2.7.2.2.1.3.1 to 2.7.2.2.1.3.7 (compiling Decree 1171 of 1997): certificates of health status, live birth and death, and who signs them.
- Law 1146 of 2007, art. 9: in sexual abuse of minors, evidence is preserved under chain of custody and forensic tests are done at once.
- This page does not summarise the rules on recognition and payment of sick leave; check the rule in force.
Test yourself
Think of the answer, then tap the question to see it.
What does Law 23 of 1981 say about a doctor who issues a false certificate?
That it is serious ethical misconduct, without prejudice to legal action (art. 52).
Who may sign a death certificate where there is no doctor?
A registered nurse and, in hard-to-reach areas with no doctor or nurse, trained and registered nursing auxiliaries or health promoters (Decree 780 of 2016, art. 2.7.2.2.1.3.7).
What does the doctor do with a violent death or one of doubtful cause?
Does not certify a natural cause: records how and where it happened and leaves the case to the authority for an opinion from Legal Medicine.
What is the minimum content of a certificate of health status?
Place and date, addressee, health status or medical act, patient identification, object and purpose, and the doctor's name, registration number and signature.
Connections
Educational content on ethics and health law; not legal advice. Laws and case law change: each page links the official text and says when it was last checked. For a real case, read the text in force and ask a lawyer or the medical ethics tribunal.
Sources: Ley 23 de 1981, arts. 50 a 52: certificado médico (Función Pública, Gestor Normativo, 1981); Decreto 780 de 2016, Book 2, Part 7, Title 2: medical certificate (compiles Decree 1171 of 1997) (Ministerio de Salud y Protección Social, 2016); Ley 1146 de 2007, prevention of sexual violence and comprehensive care of children and adolescents (Función Pública, Gestor Normativo, 2007).
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Representative model, for educational purposes only.