The ghost dead: ethical and medico legal analysis on the Mediterranean tragedies.

Background: Cadaveric identification represents a legal, moral and medico-legal obligation and also fulfills the ethical function to allow the living to offer their dead a merciful burial. In the Mediterranean basin we have been witnessing for years a struggle for life where hundreds of migrants die in an attempt to reach Europe. For these people right to be recognized is not easy because of ante-death biological data are not always available for comparison, and DNA analysis is not always feasible cause for the absence of data with which to compare. In Italy a multidisciplinary protocol has been adopted that involves the acquisition of data provided by family members present in the countries of origin. Materials and Methods: Between August 2015 and December 2021, bodies of 879 migrants of various nationalities washed up on the shores of Sicily and Calabria. These men, women, and children, in various states of preservation, were examined. Each body underwent a multidisciplinary approach. External examination and autopsy aimed to determine the cause of death for judicial purposes and to facilitate individual identification. Whenever possible bodies underwent total body post-mortem computed tomography examination to identify fractures and prosthetic implants. including inspection of the third molar to provide an estimate of the age. Conclusions: The activity carried out in cooperation with Prefecture, Scientific Police, and National and International Red Cross highlighted the importance of employing multiple scientific skills to compensate for the lack of biological information. The importance of appropriate behaviors to avoid contamination and ensure proper preservation underlines the importance of the establishment of a dedicated database.

Charles Byrne, Last Victim of the Bodysnatchers: the Legal Case for Burial.

The retention and display of the remains of Charles Byrne, an Irishman with acromegaly, by the Hunterian Museum of the Royal College of Surgeons has been contentious for some years, and the moral case for his release for burial has been repeatedly made. This article makes the legal case through five arguments. The first three concern common law rights and duties; Byrne's right to burial, the duty of the State to ensure his burial where others do not, and the right of his friends to assume that duty. The fourth concerns Byrne's common law right to direct his disposal, and, related to this, not to be retained and displayed. The fifth, which underpins the rest, is that Byrne is not, and has never been property, and it is in fact intuitively and legally arguable that he, like other corpses, remains a person. The article finally outlines three options available to those wishing to ensure Byrne finally has the burial at sea that he sought to ensure in 1783.

The International Committee of the Red Cross and the protection of world war dead.

The first Geneva Conventions were signed in 1864 and this initial effort to put humanity in war has since developed into a network of international conventions and customary rules which include the dead as a group that must be protected during and following armed conflicts. During the First and Second World Wars, parties to the conflict were obliged to recover the dead from battlefields, document identifying marks including the collection of identification discs, and to bury the body in a marked grave. Those parties' signatory to the laws regulating war at the time, could not have predicted the millions of losses of civilians and combatants resulting in the thousands of casualties left unrecovered at the end of both world wars. The prolonged requirement to recover, identify and bury newly-found World War dead is managed differently by each country; albeit with no universal approach that acknowledges the need to integrate the moral imperative of dignified post-war care of the dead with rapidly changing technology and equally rapidly ageing of families of the missing. The International Committee of the Red Cross is a longtime actor in providing humanitarian service to soldiers and civilians in war. This includes expertise in the legal framework regulating armed conflict, in the provision of a central system to aid in tracing those who go missing during war, including those from the world wars, and in the growing field of humanitarian forensics. This paper will discuss the applicable international frameworks for the protection world war dead, while promoting the ICRC's role as resource and advocate.

[Safe management of COVID-19 dead bodies in sub-Saharan Africa: could families be allowed to bury their dead?] / Gestion sécurisée des dépouilles de personnes décédées de la COVID-19 en Afrique sub-Saharienne: et si on laissait les familles enterrer leurs morts?

Sub-Saharan African countries have been hit by the Coronavirus 2019 pandemic (COVID-19) since March 2020. Besides the resulting health and economic disasters is the psycho-socio-cultural problem related with the management of corpses of people dead from the disease, which might hinder the implementation of the response strategy. In Cameroon for instance, the current corpse management policy is very disputed. In fact, although they were recently made more flexible, the restrictions applied to burials still ban any transfer of dead bodies between cities. In light of the African cultural considerations of dead persons, the disputes observed between the families and the health personnel, the legislation and the available scientific evidence, this article analyses the risks and benefits of allowing families to bury their relatives. It thereafter suggests solutions that reconcile dignity (by allowing families to bury their dead relatives in their homes) and safety (by ensuring a sealed handling and the surveillance by a judiciary police officer). Applying these solutions could improve the population's trust towards the health system, and positively contribute to COVID-19 case prevention, identification and management.

International Committee of the Red Cross (ICRC): Cemetery planning, preparation and management during COVID-19: A quick guide to proper documentation and disposition of the dead.

Based on its forensic capacity and experience gained worldwide from the management of the dead in emergencies, including epidemics, the International Committee of the Red Cross has been asked by the authorities and other relevant stakeholders in some of its operational contexts to advise on the planning, preparation and management of cemeteries during COVID19. The management of the dead process includes proper documentation and appropriate disposition, including temporary burials. If there is a sudden and significant increase in the number of deaths, local capacities can quickly become overwhelmed. This guidance, prepared for the COVID19 pandemic, can be applied to any incident involving mass fatalities when the local capacity to provide safe, appropriate and dignified burials is overwhelmed. Specifications on size, spacing, excavation depths, and information about other important considerations are provided. In addition, it provides recommendations on how to correctly map graves while ensuring the traceability and correct management of bodies in a cemetery. Procedures for receiving bodies, as well as measures to ensure the health and safety of relatives and cemetery staff are also covered in this guidance.

Gestión de los cadáveres durante la pandemia por COVID-19 en España / Management of corpses during the COVID-19 pandemic in Spain

El brote por el Coronavirus/COVID-19, declarado Emergencia de Salud Pública de Importancia Internacional el 30 de enero de 2020 por la Organización Mundial de la Salud, ha sobrepasado en numerosos países la capacidad de respuesta del sistema sanitario por su alta contagiosidad, y la de gestión de las personas fallecidas por su elevado riesgo de letalidad. Se revisan las principales guías y protocolos promovidos por las instituciones y las principales sociedades científicas, orientados a la contención de la pandemia mediante la adopción de medidas de protección de los profesionales y a la adecuada gestión del alto número de cadáveres. Se analizan los centros especiales de recogida de cadáveres en situación de epidemias y las clasificaciones de los cadáveres en función del riesgo infecto-contagioso. Específicamente se resumen las resoluciones dictadas por las autoridades sanitarias y se describen los protocolos de actuación ante fallecidos durante la pandemia COVID-19, incluyendo las autopsias forenses

The Coronavirus/COVID-19 outbreak, declared a Public Health Emergency of International Importance on January 30, 2020 by the World Health Organization, has in many countries exceeded the capacity of health systems to respond, due to its high contagiousness and the capacity to manage the deceased, due to its high fatality risk. A review is necessary of the principal guidelines and protocols promoted by the institutions and the main scientific societies, aimed at containing the pandemic by adopting professional protection measures and appropriately managing the high number of cadavers. The temporary mortuaries in an epidemic crisis and the classification of bodies according to infectious risk are analysed. In particular the resolutions issued by the health authorities are summarised and the protocols for dealing with deaths during the COVID-19 pandemic are described, including forensic autopsies

How Should Public Health Officials Respond When Important Local Rituals Increase Risk of Contagion?

During the 2014-2015 Ebola epidemic in Sierra Leone, people were required by law to call a trained "safe burial" team to dispose of the body of a person who had died from Ebola. It took days for a team to arrive, however, due to limited resources and rural travel obstacles, so some villagers felt obliged to bury their loved ones themselves. Even with timely arrival of a team, there can be cultural priorities that deserve attention. One man's case discussed in this article suggests the need for Ebola responders to consider villagers' perspectives and possibilities for compromise.

Sobre la dignidad humana del mortinato y nasciturus. Un nuevo reto bioético a propósito de la STC 11/2016 y la jurisprudencia del TEDH / On the human dignity of a stillborn and unborn child. A new bioethical challenge before the Spanish Supreme Court Case Law 11/2016 and the ECHR Jurisprudence

En febrero de 2016, de forma inédita se falló un asunto concerniente a la bioética y el respeto por los derechos fundamentales de la persona concerniente a la prohibición de dar sepultura digna a un mortinato al que el derecho le negó su existencia por no superar unos límites desnaturalizados. Sin esgrimir una norma verdaderamente habilitante, sin cobertura legal y sin justificar la existencia de un riesgo real para la población o en beneficio del interés general, la administración pública española denegó el ejercicio de los derechos fundamentales a la libertad ideológica, de culto y a la intimidad personal y familiar. Afortunadamente, en esta ocasión el más alto interprete constitucional priorizó la dignidad humana a la codificación siguiendo escrupulosamente la moderna jurisprudencia del Tribunal Europeo de Derechos Humanos

In February 2016, Spanish justice decided - without precedent - on an issue concerning bioethics and the respect for the fundamental rights of the individual, in reference to the prohibition of giving decent burial to a stillborn, whom the law denies its existence for not reaching the established unnatural limits. Without wielding a truly enabling standard, without legal cover and without justifying the existence of a real risk to the population or the benefit of a general interest, the public Spanish administration denied the exercise of fundamental rights based on ideological freedom, of worship and personal and family privacy. Fortunately, in this case, the Spanish Constitutional Court gave priority to the human dignity instead of the codification following the latest European Court of Human Rights case law

Secularizing funerary culture in nineteenth-century Belgium: A product of political and religious controversy.

Modern historiography of collective attitudes, practices, and conflicts surrounding death often focuses on the institutional history of cemeteries and nonreligious funerals in 19th-century France. Institutional and cultural discussions concerning funerals and cemeteries also divided nineteenth-century Belgium. This article explores emblematic civil burials and the secularization of cemeteries in major Belgian cities. The article distinguishes different dimensions of the secularization of death and highlights the particular nature of Belgian funerary conflicts and burial reform within a broader European context.

Autopsy in Islam: Considerations for Deceased Muslims and Their Families Currently and in the Future.

Religious beliefs and cultures have influenced treatment of dead bodies in different ways by nations throughout history, and attitudes toward the deceased individuals have changed across time and so has the role and mechanism of autopsy. Islam has been a part of Europe for a long time; therefore, we would like to emphasize the important issues for Muslims and their families regarding death, autopsy, and funeral and to describe international perspectives of Muslim autopsies. Muslims have expressed their views on autopsy publically and internationally, and there have been claims of violation of the deceased, delays in burial, and nonconsideration of their religious beliefs. In this article, we aim to increase awareness and understanding of doctors about the religious and ethical issues important to Muslims and their families, so that appropriate considerations may be made where possible with regard to respectful treatment of deceased loved ones to decrease tensions presently being faced. Forensic medicine doctors could assist by undertaking autopsy without delay, in a private room by those of the same sex, and covering parts of the body not being worked on at that time.

About the influence of burial on the development of forensically relevant blow fly larvae.

The determination of the minimum post-mortem interval (PMImin) based on the age estimation of necrophagous blowflies is an established forensic technique. Blow fly larvae are able to continue their development to the adult insect on buried corpses. However, it is not clear which factors influence their viability under these circumstances or to what extent. This was investigated in the present paper for Calliphora vicina, one of the most common blowflies in Germany. In respect to forensic casework, an explicit question was if reference values obtained by rearing blowfly larvae under laboratory conditions could be applied to individuals growing in a shallow grave. Under variable ambient temperature conditions, hatched flies exhibited a slightly lower length of the wing veins (0.2 mm) and of the tibia (0.1 mm) than the larvae which had been buried. The period of development, expressed as accumulated degree days (ADD), was 399.8 in buried larvae and 406.1 in larvae not covered with soil as control. Under constant temperature conditions no significant differences in the body length of the larvae and the average time of development (20.3 respectively 20.4 days) was observed. The results of the present study thus suggest that the data published on the development of C. vicina larvae can be used to calculate the PMI of a corpse found in a shallow grave of not more than 20 cm depth.

[Perinatal and intrauterine infant death: professional practices and their effects on healthcare personnel]. / A perinatalis veszteségek és intrauterin magzati halálozások aktuális szakmai gyakorlatának, valamint a szakemberekre gyakorolt hatásainak vizsgálata.

INTRODUCTION: The sorrow caused by perinatal loss is a phenomenon of pathological mourning, a burden for the parents, their environment and the medical personnel, yet, it is a less studied field. AIM: (1) To present the applied practice in healthcare institutions, to compare the valid protocol with the effective help provided and to study how these events affect the helping personnel professionally and psychologically. METHOD: In-depth interviews with the involved personnel (n = 8). The authors studied the practice of the given institution; existing and wanted theoretical and practical competencies; personal attitude and the experienced difficulties. RESULTS: Acting well professionally is a specially demanding task, with few tools to use when communicating, when helping the parents cope with sorrow, or when coping with their own feelings, all these involving a risk for burn-out. CONCLUSIONS: The results can serve to create trainings aimed at helping the patients with adequate support and improving coping strategies.

A problem of modernity: Dual burial plots, the right to inter, and the interrelationship between the two.

Vosnakis v Arfaras directly raises the issue as to how private law will resolve the tensions that can exist between family members in relation to burial licences and the right to inter. In evoking contract, property and statute; the case reveals the complexity associated with this area, specifically in relation to dual burial plots, and how rather simple family disputes can escalate significantly beyond their economic worth. Recommendations to include a registry system to record details of funeral arrangements is encouraged to ensure that the many thousands of dollars spent by the litigants in this case is not repeated by other families. This, along with courts being required to give effect to the wishes of the deceased, will provide a clarity that is currently missing. In a time when the population is increasing, a changed dynamic to family life in Australia, and less land available for internment, the problem of the relationship of a dual burial licence and the right to inter is one of modernity, but one to which the community should expect the application of policy initiatives to complement a coherence within the legal position. This coherency and such policy initiatives are currently lacking but, with simple measures, this position can be rectified.