Experts Explain What Dying by Natural Causes Means

The nuance of the dying by natural causes statement.

When Betty White died just a few weeks shy of her 100th birthday, rumors quickly surfaced that The Golden Girls star died from complications of a COVID-19 booster shot—but her agent tried to quash those rumors. White's agent and friend, Jeff Witjas, said "Betty died peacefully in her sleep at her home." Witjas told PEOPLE the actress didn't get her booster shot just before her death. "People are saying her death was related to getting a booster shot three days earlier but that is not true. She died of natural causes. Her death should not be politicized — that is not the life she lived."

The Fake Report of the COVID-19 Booster Shot

Social media posts claimed that White had received a COVID-19 vaccine booster on December 28, 2021, with a fabricated quote that read, "'Eat healthy and get all your vaccines. I just got boosted today.' - Betty White, Dec. 28th, 2021." The "quote" turned up on Facebook and Twitter, according to reports from the Associated Press, and it led people to think that her death might be related to the shot.

Witjas also directly addressed the fake quote, saying, "She never said that regarding the booster. Betty died of natural causes. She did not have the booster three days before she died."

So the booster rumors are false. But you still might be wondering about the "died of natural causes" part of Witjas's statement. The term is used a lot when people die at an old age, but what does it mean, exactly? Here's how experts explained it—not for White's death, in particular, but for the term in general.

What Does Dying of Natural Causes Mean?

It's important to point out upfront that "dying of natural causes" isn't a medical term, Sarah Reuss, MD, a pathologist at The Ohio State University Wexner Medical Center, told Health. "It's more of a term used to communicate with people outside the medical field," she said. "A lot of times, what we use to talk to each other [in the medical field] doesn't make sense to people outside the field, so we have a lot of terms to help people outside the medical field better understand us." Usually, dying from natural causes is interpreted as "nothing acute happened," Dr. Reuss explained.

While there isn't necessarily a set definition for what constitutes "natural causes," Erin McNeely, MD, an internal medicine physician at Spectrum Health in Michigan, told Health that physicians can generally agree on what it means. "'Natural causes' is a really wide, wide term that can be anything that wasn't an accident or affected by a force," she said. "We don't pin a death from natural causes on one thing like a heart attack or stroke. Things just sort of stop."

Determining What Is Considered a Natural Death

There is some nuance here, and technically, things like heart attacks, cancer, and infections could be considered "natural" given that they do happen to people without any outside force, Lewis Nelson, MD, chair of emergency medicine at Rutgers New Jersey Medical School, told Health. "It basically means that the death was not due to a 'non-natural' event, such as suicide or homicide," Dr. Nelson said.

However, end-of-life researcher Christopher Kerr, MD, PhD, chief medical officer, and chief executive officer for Hospice & Palliative Care Buffalo, told Health that the term is usually used when someone dies of old age. "There's usually an absence of overriding disease," Dr. Kerr said. "There isn't a driving catabolic state—it's really dying in totality, and a general progression of loss of functional strength, energy, and appetite over time."

Dr. McNeely compared dying of natural causes to a car shutting down after years of use. "The car rusts out, the engine stops, and things stop working over time," she said. "Your body eventually just slows down and stops. Your pancreas, heart, and lungs stop working. It's essentially multi-organ failure."

When "natural causes" shows up on a death certificate, it usually means that the person wasn't diagnosed with any one health condition, like heart failure, or didn't die in an accident, Dr. McNeely explained. Coroners typically come to this conclusion in the absence of an autopsy or known cause of death, Dr. Nelson said. But "when there are questions about the cause or manner of death, an autopsy along with other testing provides the needed information to help improve the determination of the cause and manner of death," Dr. Nelson said. Still, as Dr. McNeely pointed out, "we usually don't do autopsies on significantly older people."

The Bottom Line

Based on the explanations provided by these medical experts, dying of natural causes isn't clear cut, but is more likely to be listed as the cause of death for older adults whose organs have slowly worn down and come to a stop.

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