Under most state laws, birth and death certificates are a matter of public record. The advent of physician-assisted suicides in less than a handful of states (e.g., Oregon) created new concerns for the scope of doctor-patient confidentiality. Some states have addressed this issue by express legislation, e.g., permitting the registration of physician-assisted deaths directly to state offices rather than to local county offices of vital statistics. Others have permitted dual-systems that incorporate specific codes for “cause of death” on public records but more thorough explanations on private state records. Many doctors simply list innocuous language, such as “cardiac-respiratory failure,” on public records, and leave blank the secondary or underlying cause. Similar issues of limited disclosure often arise on birth records. In some circumstances, personal details such as paternity, marital status, or information regarding a newborn’s HIV status may warrant the filing of dual records (one requiring more disclosure than the other) for separate purposes and separate viewers, based on a “need to know” criterion.