@alangeh Actually, there are a number of issues with death miscodings! There are anecdotal reports that it's to spare parents feelings, but I don't know that the specific motivation has ever been studied. This
paper in Pediatrics conducted a survey of medical examiners with different scenarios to identify how they would categorize an infant death. The results highlight the significant variability in how MEs categorize infant deaths. In scenarios that highlighted potential airway obstructions, MEs categorized those deaths as suffocation/strangulation related between 60 and 77% of the time, meaning 1/4 to 1/3 of the time, those deaths were coded as something else. That is a pretty substantial variability.
There are a number of other issues around coding highlighted in the study but the takeaway is, in effect, that medical examiners vary in their categorization practices, which isn't surprising because the profession isn't necessarily standardized. In some areas its elected, in others it's appointed, in some areas it requires medical credentials, in some areas, it requires forensic credentials—variability isn't that surprising. And of course, I suspect it leads to some level of inequity—for instance, I wouldn't be at all surprised to see that white, upper/middle class families are more likely to receive codings of SIDS and wraparound victim support services, while Black and Hispanic parents are more likely to receive codings of suffocation and even face legal penalties (being super clear here—I haven't seen that study. I just wouldn't be surprised if a judgment-based profession reproduced inequity that already exists in society).
That variability in death coding part of the reason that the CDC reports SUID figures (R95, R96 and W75), not SIDS risk. However, a lot of
research papers look at SIDS (deaths coded R95), and explicitly exclude deaths coded R96 (unexplained) and deaths coded W75 (suffocation/strangulation in bed). That means research papers are often only looking at ~1/3 of infant deaths.
This is fairly well reported and the AAP actually
called for more standardization around coding in their most recent safe sleep update.