The Forgotten, Unidentified, and Abandoned Dead

The largest ethical concern for identifying dead bodies is retaining the DNA because it is must be protected to ensure the right to privacy. Although it contains information about a person’s family and genetic predisposition to diseases, laws have been adopted for the protection of genetic data. An IRC workshop in 2002 examined national legislation and compiled a set of legal principles concerning the protection of personal and genetic data that must be respected in all circumstances. Some of these principles are as follows: biological samples left by the missing person, either as medical samples or other biological artifacts; the consent of the individual is required for the collection and use of personal data, except if required by a substantial public interest or for the protection of the vital interests of the person concerned; personal data may not be used, disclosed or transferred for purposes other than those for which they were collected without the consent of the person concerned, except if required by a substantial public interest or for the protection of the vital interests of the person concerned. These limitations on the deceased give them autonomy for the use of their DNA after their death, but unfortunately makes it harder to identify (ICRC, 39). The dead no longer make decisions when dead, so the need for consent from the a deceased person should not be a principle in retaining their DNA. They embody a distinct identity in the minds of living, making it even more of a valid reason to use their DNA or a loved one to identify the dead.

The problem with consent for using DNA of the deceased arose when DNA profiles were used to identify bodies in a particular battle from the World War.  250 sets of human remains were excavated from the site from the battle of Fromelles in 2009 and matched with their descendents and relatives who came forward with their DNA profiling (Scully, Woodward). The identification of the dead body unites the deceased with the living one again almost a century later. However, the issue of consent as the unidentified are unable to provide consent. This results in a paradox since they are technically still unidentified before the DNA matching so a relative cannot give consent either. Another issue is that it can create repercussions that could arise from the sharing of the DNA can inadvertently provide information about other members of the family that did not share consent such as traits associated with inherited disease and predispositions to said disease. However, the deceased deserve the dignity to be identified, so it raises ethical concerns on is DNA profiling is a necessary evil to identify the abandoned dead.

Another ethical concern is the problem of neurological emergency services in third world countries identifying bodies. Presented with a case study in India specifically, there is no data on unknown patients or systematic studies on their specific subgroup of unknown patients. In a study done by Umesh, Gowda, Kumar, etc, they investigated the clinical, socio-demographic, and investigational profile of these unknown patients in India. They identified a pattern of the common causes of the admission into neurology finding seizures, metabolic causes, and neuro-infections as the primary reasons. The main issues that come to light from this study is that India lacks an efficient emergency service system since they cannot properly identify the patients that may end up dying. The government must develop mobile emergency units to handle the unknown population as well as a protocol to handle the unknown persons that arrive. It is hard to for third world countries such as India to determine what to do with these unknown subjects since the countries have little resources and education. The following proposed standard operating procedure produced by the authors of the study should be followed by emergency personnel handling unknown patients in third world countries:

 

Third world countries also have trouble respecting the dignity of individual’s death after natural disasters. A good example of this is the 2010 hurricane in Haiti when the government mishandled the dead. The disorganized handling of the dead can be due to in part by the corrupt politics and unstable government prior to the natural disaster. Many survivors who were related to the victims were resentful towards the recovery teams as they were put into dump trucks and scattered in mass graves with no input from loved ones. It can be particularly emotionally damaging when someone does not know the fate of a loved one (Recovery and Identification of the Missing after Case Studies, 20). The deceased from natural disasters should be identified rather than buried in mass graves. Then, the living can begin the proper coping process and protects the dignity of the deceased. Like the issue with neurology emergency services, third world countries should put policies in place for the handling of the dead after natural disasters. A permanent disaster relief organization should be created to coordinate rescue teams and put identification efforts as a priority to bring relief to the victims (Recovery and Identification of the Missing after Case Studies, 29).

While many different issues may cause a body to be unidentified, there are not many options for identification in such an instance that do not involve invasive procedures. According to The National Association of Medical Examiners’ Forensic Autopsy Performance Standards, autopsy must be performed in the event that a body is discovered and autopsy may help identify the subject. The practice of performing autopsies on unidentified human remains is incredibly common. One study at the Calcutta police morgue in India looked at two thousand five hundred and fifteen autopsies that occurred over a two year period, and found that about 25% were subject to this invasive procedure (Chattopadhyay, Observations).

This creates a dilemma as autopsy runs up against many cultural and religious traditions and practices. Besides Christianity, the three other most common world religions all hold some objection to the performance of autopsy in their religious canon. The Jewish tradition requires the burial of the dead as quickly as possible, with the entirety of the remains intact. This means that autopsy is performed only in rare cases. Israeli law, up until recently, required the consent of the next of kin and three legal officials before the performance of an autopsy, which would notably be impossible in the event of an unidentified body (Parks, 512).

The Islamic tradition similarly forbids the procedure in theory. The Q’uran states that “the breaking of the bone of a dead person is like the breaking of the bone of a living person.” However, some less conservative Muslims allow for autopsy, even in cases not mandated by the courts. In these cases, the consent of the next of kin is needed, in keeping with tradition (Parks, 512).

Hinduism considers autopsies to be “extremely distasteful” (Parks, 512). But these are not the only traditions that reject this proceeding of modern forensic science. Rastafarianism, Greek Orthodoxy, Shintoism, and Zoroastrianism all have religious oppositions to the performance of autopsies.

This presents some legal challenges in nations like the United States, where religious freedom is tantamount. It is a cultural issue wherever it may occur, as respect for religious tradition is a human right – but there has been pushback by the legal system here in the US. In Harris County, Texas, lawmakers are pushing back against religious exemptions to autopsy. Two laws run up against each other in this case – one which requires autopsies to be performed in the event of unknown cause of death, and one that permits families to reject autopsy for religious reasons. This is not quite as relevant to out topic, since in order for a religious exemption to be considered the identity of the deceased must be confirmed, however, in cases where the dead remains unidentified, we may still be violating religious tradition with knowledge.

 

 

 

Bibliography:

 

Jay David Aronson, Alex John London. “Recovery and Identification of the Missing after Disaster: Case Studies, Ethical Guidelines and Policy Recommendations.” (2011): 1-53.

Parks, David G. “Legal Issues: Religious Beliefs and Objection to Autopsies.” Laboratory Medicine, vol. 27, no. 8, Aug. 1996.

Peterson, Liz Austin. “Harris County Challenges Religious Limits on Autopsy.” Houston Chronicle, 2008, www.chron.com/life/houston-belief/article/Harris-County-challenges-religious-limits-on-1664818.php.

Scully, Jackie Leach, and Rachel Woodward. “Naming the Unknown of Fromelles: DNA Profiling, Ethics and the Identification of First World War Bodies.” Journal of War & Culture Studies5, no. 1 (2012): 59-72.

Yadav, Ravi, Achary Umesh, Gurus Gowda, Channaveeracharinaveen Kumar, Dwarakanath Srinivas, Bharathrose Dawn, Ragasudha Botta, and Sureshbada Math. “Unknown Patients and Neurology Casualty Services in an Indian Metropolitan City: A Decades Experience.” Annals of Indian Academy of Neurology20, no. 2 (June 2017): 109-15.

ICRC. “MISSING PEOPLE, DNA ANALYSIS AND IDENTIFICATION OF HUMAN REMAINS.” A guide to best practice in armed conflicts and other situations of armed violence, second edition, (2009): 1-52.

 

14 Comments

  1. The ethical issues that arise in this post are very troubling to hear. I feel as though I am missing the other perspectives, scientific and cultural, but I do agree that the procedure for autopsies to the unidentified dead should respect cultures and religious beliefs. However, that is the only way that I believe they would be able to identify the abandoned dead. Is there any other way to identify a dead body when the person has been forgotten?

  2. The paradox of wanting to identify the dead while respecting their privacy is troubling. I think you did a great job of describing how this paradox has come to be and how it creates problems. I also like how you compared different religions views on autopsies to show similarities and further problems. I would have liked to see more information on the scientific side, on DNA testing itself. If this is not an option, where do researchers go from here? What does the future hold for bodily identification?

  3. This article brought up many ethical concerns regarding the identification of unknown bodies. My biggest question after reading this article is how are investigators supposed to identify unknown bodies if no one can give consent except the deceased? This is confusing to me because I would assume that family members want to discover the identification of the unknown body under every circumstance. I was also confused on the next steps of identification if one cannot give consent? Are the bodies remained unidentified and what are done with them? I loved reading this compelling article but was still left with so many unanswered questions.

  4. This post was intriguing because it is not something usually discussed as it leads to feelings of shame for not being able to identify bodies and give those families closure. This post greatly relates to the Death During Migration post as they both discuss closure being an issue due to uncertainty and no answers for the families of the deceased. I found the bit about Haiti to be shocking, because I had never heard about their horrendous actions. However, I want to know what exactly is done with the unidentified bodies? Unlike Haiti, what is the right system? Also, there is the Tomb of the Unknown Soldier in the United States, but what are the choices of developing countries?

  5. What is the process for identifying an individual through DNA? Another post on this website, “The CSI Effect,” discussed the protocol for collecting evidence at a crime scene. Is it only illegal to disclose DNA results, or is it also illegal to do the tests in the first place? What about DNA collection and testing makes it more unethical than conducting autopsies?

    It is horrible that other countries may not respect the dead, as in the case of the hurricane clean up in Haiti. What are some solutions in handling a mass population of unidentified individuals? How does America handle unidentified bodies after autopsies are done? Personally, I think that it is interesting that the US allows for autopsies to be done on the unidentified, but the collection of the DNA is considered legally invasive. Do those who oppose the practice take longer to grieve? Has there been any legal action against those who preform autopsies on the unidentified individuals once the family is identified? I think a reform to the law to allow for DNA testing by those who are legally authorized would be far less invasive. This may also be a compromise with those who have religious objections to autopsies, while still identifying the individual.

  6. Cee Cee Huffman

    April 24, 2019 at 8:47 pm

    While I do appreciate the ethical attempt the IRC made when compiling a set of legal principles, it is difficult for me to understand precisely how that gives the unidentified deceased autonomy. Using an unknown deceased individual’s body for any reason seems to be an immediate and complete violation of autonomy. Additionally, it is difficult for someone deceased to provide any consent, and providing the exception “except if required by a substantial public interest” seems to create a gray area immediately. And, to play devil’s advocate, it could be argued that the deceased doesn’t necessarily deserve the dignity to be identified, because the most significant effect of an individual’s death is on the deceased’s family.

  7. Given that the deceased can no longer make autonomous decisions, and that DNA information is legally protected, are there arguments for other methods of body identification that do not function in such a grey moral area? I find it interesting that you state that DNA sampling may be a “necessary evil” in body identification, as its potential implications for the living reminds me of some of the questions I was asking in my own posting- to what do we owe the dead? Should this be held in the same regard of what we might owe to those they leave behind? In continuing, your discussion on autopsies and the many views surrounding them was interesting, but it left me wondering- what are the implications/potential consequences of handling unidentified bodies in ways that are not in line with their religious and cultural identities? Is there any standard that might be put in place that would honor these preferences across contexts, or is this too broad of an ambition?

  8. Approximately two thirds of the way through this post is the quote: “One study at the Calcutta police morgue in India looked at two thousand five hundred and fifteen autopsies that occurred over a two year period, and found that about 25% were subject to this invasive procedure (Chattopadhyay, Observations).” What is the “invasive procedure” mentioned here? I couldn’t figure this out directly or through context clues. I also find the discussion of the responses of different religions to autopsies interesting, but largely irrelevant to the thesis of this post, which I assume deals with the topics listed in the title.

  9. I chose to comment on this because the title really caught my eye. As I began reading, I thought that it was very interesting that identifying bodies even has an ethical concern because if my loved one had passed, I would want their body to be recovered. However, as I kept reading, I realized the reasoning behind this was good. Like in third world countries, like Haiti, I think the dead bodies should be dignified in some way by at least being identified. The legal and religious challenges that are faced in these regards are very interesting as well. This causes me to wonder how different religions have caused differences in these practices in different areas.

  10. This article provided a different perspective from my own on the importance of identifying a dead body. My primary reason for identifying a dead body would be to reconnect an individual with their loved ones, and allow them to grieve and move on peacefully. It is scary to think that preservation of privacy through strict regulations on DNA protection is such a widespread concern. However, I find it comforting that DNA can be utilized for so many important uses, such as matching descendants to their relatives via DNA profiling. What sorts of laws have been put in place in the United States to ensure adequate privacy rights for an unidentified deceased individual? Is it a doctor’s obligation to continue searching for the identity of a deceased patient until they uncover the truth?

  11. I was immediately drawn to your posting because I found it extremely sad that there are those whose memory is not honored for one reason or another. With few exceptions, I believe that everybody should be celebrated at the end of their life. The points brought up by the posting I found quite interesting. I did not even think to consider the idea of acquiring consent to use the DNA of the dead to identify them. I just assumed that is simply the way things went and did not think to consider the possibility of the requirement of the acquisition of consent first. However, how realistic would acquiring this consent truly be? Most people die suddenly without enough time to provide this consent so I think that consent might be quite difficult to obtain. I also think it is sad that the dead are mishandled in some parts of the world simply because of corruption or lack of resources. I believe that everyone deserves the right to be celebrated and a large part of that is at least being properly handled with respect. I especially liked how this group compared how different regions of the world or different religions dealt with the dead or viewed certain post-death procedures. My group focused on the US mostly but we did mention other disasters around the world which I think is beneficial for comparison. Overall, good job!

  12. Miyah Lockhart

    April 25, 2019 at 2:18 am

    Preserving the DNA of unidentified bodies is undoubtedly very tricky. The amount of ethical issues surrounding this is almost never-ending. I found it interesting that there are so many factors to consider when simply trying to identify a person after their death. It is also very saddening to hear that the paradox of respecting an unidentified person has caused so many hardships. Reading this article allowed me to propose this question: What can be done legislatively to make this process run smoother? I know, many things are easier said than done. Thank you for educating me on the logistics of unidentified dead bodies.

  13. The dilemma of not having consent of DNA data and the requirement to identify the body seems really hard for the researchers. The thorough elaboration of the challenges in identifying bodies lead me to appreciate the huge amount of efforts behind all bodies that have been successfully identified before. For massive death events, such as wars, disasters, and terrorism, looking for and identifying bodies become an incredibly difficult job. It reminds me of the missing Malaysian Airline MH370, which result is still a myth. Tremendous grief is caused to the families when they neither see the person alive nor receive their bodies confirming death.

  14. I think the ethical concerns are greater than you present them as.
    Read #4 from here: https://www.cnbc.com/2018/06/16/5-biggest-risks-of-sharing-dna-with-consumer-genetic-testing-companies.html

    “Remember the Golden State Killer case that was recently cracked after decades? It was cracked with the help of DNA from a genealogy company. Catching a murderer is a good thing, but the ability of law enforcement to target your DNA through these testing companies is a big issue.

    Darnovsky noted that in the Golden State Killer case, law enforcement found their way to the suspect by using DNA from relatives. She said there is a lesson in this for consumers. ‘When you provide your genetic information to a DNA testing company, you are also providing information about those related to you — including distant cousins. When your relatives, including distant ones whom you may not even know, provide their DNA, they are also providing genetic information about you.'”

    So similarly, just say your distant, or maybe not even that distant relative died and became “The Forgotten, Unidentified, and Abandoned Dead”. That puts YOU, along with your family, at additional scrutiny, first to be targeted, whenever someone else you are related to commits a crime. This is arguably more of a threat than the insurance company knowing that you are closely/distantly related to someone with an inherited disease or predispositions.

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