The assessment of the manner of death by physicians is often a problem due to unclear regulations on this point. By means of a questionnaire we investigated how 40 nursing home physicians assess the manner of death in 14 different hypothetic cases and whether the physicians should report the case to the medical examiner if confronted with similar cases in practice. Some cases of unnatural death would not be reported. Especially in cases of death after a collum fracture the law and medical practice diverge. The reasons to report or not to the medical examiner were also investigated. Death fitting in the 'descending line of life' was most mentioned.