Just because a decedent has a death certificate with the cause of death does not necessarily mean they died from that condition. While this may seem shocking to some, death certificates are not a good statistical data source for cause of death studies. For families, unless a competent medical autopsy is performed, knowing what really happened is a guess.
For instance, in my own experience, previously unidentified cancers can be found roughly 9% of the time. Cancer may be an incidental finding in an isolated organ but occasionally it is widespread and even the cause of death! A fall and an impact to the head can lead to massive and devastating intracranial bleeds. This is particularly a problem in individuals on blood thinners. A variety of stealthy traumas can happen to people that are completely invisible on the outside. I of course look for these and sometimes find them.
The point is that autopsies add value in most deaths. Even when you think you know why they died, an autopsy very often reveals a surprise. Even the most seemingly “obvious” cause of death such as traffic wrecks can in fact be natural deaths. I have seen many over the years.
It becomes even more problematic when issues such as pain and suffering are questioned after a traumatic death. If no autopsy occurs, you will never know. It is truly what is on the inside (correlated with history of course) that counts.