RESUMEN
We have led a study about 2251 death which are declared during 1996 in the Great-Tunis. Results are following :The hospital deaths are as many betters certified that the physician is a specialist. The cause mention rate is about 88,6% for death observed by specialists against 28,5% for those observed by internists. Paradoxically, a precise cause mention is best for deaths that are observed outside hospitals and when the physician is an internist. Badly define morbid states represent 17,1% of outside hospitals mentioned causes against 30,8% in the Hospital. They represent 12% of causes mentioned by internist against 30,1% of those mentioned by specialists. Despite death medical certificate obligation, the strong proportion of badly defined morbid states characterizes death causes. We hope that this situation will be improved by the new model usage of the which will be introduced since 2000. This certificate mentions death causes distinguished in initial, immediate and associated. This certificate has be the object of the decree n° 99 - 1043 of 17 May 1999