The manner could be natural, homicide, accidental, etc. The cause will be the primary cause, such as heart failure. Then there are "other conditions contributing to death but not resulting in the underlying cause" which might include things like hypertension or diabetes.
I began thinking about people I know who have experienced spiritual death—those who used to sit on the same pews I do, but for some reason left, those who decided that living as a Christian was not worth the taunts or the sacrifice or the minuscule persecution we have to deal with in this country, or simply not worth giving up the pleasures of this world. Those causes of death are pretty obvious. But how about those who just weren't careful to live a "healthy" spiritual life, watching their diets and exercising their senses to discern good and evil (Heb 5:14)? I wondered what their death certificates might look like.
Manner of death: suicide
Cause of death: sin
Other contributing conditions: failure to assemble with the saints, no companionship with their spiritual family except at the meetinghouse, prayer and Bible study deficiency, failure to consider and counteract the materialism of our "too rich" culture, thoughtless acceptance of society's standards instead of determining whether those standards will help or hinder their spirituality and are truly part of a holy life.
I will keep a copy of my mother's death certificate in the file next to my father's. But this I know—it is only the certificate of their physical deaths. They never had, and now they never will have, a spiritual death certificate. I don't believe I could bear it if they had.
Do you have one?
Blessed and holy is the one who shares in the first resurrection! Over such the second death has no power, but they will be priests of God and of Christ, and they will reign with him for a thousand years. (Rev 20:6).