Ethical issues in the management of dead bodies during infectious disease outbreaks
The Ebola epidemic of 2014 and the current COVID-19 pandemic have revealed some of the practical and ethical complexities related to the management of dead bodies.
Recently, some of the most searing and distressing media images of the current pandemic are related to the handling of the deceased. The images of mass graves in Brazil, cremated en masse or dumped in rivers in India or left in refrigerated trucks in car parks outside of New York hospitals have highlighted the lack of attention to what happens when global health goals to preserve life during infectious disease outbreaks are not achieved and when people die.
Our collective discomfort with these images is indicative of the presence of unresolved ethical questions such as how should dead bodies be treated during an infectious disease outbreak? There are numerous issues at stake. Epidemics exacerbate the practical problems of adequately and respectfully storing dead bodies, scarce burial spaces, overburdened crematoria, and scarcity of wooden logs for a traditional burial.
Infectious disease outbreaks demonstrate the ethical tensions arising from questions such as how a contagion should be controlled to ensure the safety of the living while managing respect for persons, and the cultural and social significance placed on the sacred obligations towards the dead.
Furthermore, infectious disease outbreaks also pose huge challenges for last responders, such as funeral home attendants and medical examiners, who often struggle to acquire the supplies needed to examine bodies to identify them or ascertain the cause of death and then have to make resource allocation decisions during the conduct of their roles.
As such, this project seeks to engage with the ethical issues involved in the management of dead bodies during infectious disease outbreaks. We aim to provide a comprehensive understanding of how dead bodies are treated and to highlight various ethical, social and political implications of those practices on future outbreaks and evaluate the extent to which findings can be valuable in pandemic preparedness strategies.
Project team
- Halina Suwalowska Ethox Centre, Wellcome Centre for Ethics & the Humanities, University of Oxford, UK
- Patricia Kingori Ethox Centre, Wellcome Centre for Ethics & the Humanities, University of Oxford, UK
- Joseph Ali Berman Institute of Bioethics, Johns Hopkins University, USA
- Taline Garibian Université de Genève, Switzerland
- Dr David Bukusi Kenyatta National Hospital, University of Nairobi Department of Psychiatry, Kenya
- Dr Robert Lukande College of Health Sciences, Makerere University, Kampala, Uganda
- Dr Tanvier Omar University of the Witwatersrand, Johannesburg, South Africa
- Dr Vina Vasvani Yenepoya University, Deralakatte, Mangalore, India
Related publications & outputs
Halina Suwalowska, Joseph Ali, João Rangel de Almeida, Stephen Antonio Fonseca, Laura Jane Heathfield, Craig Adam Keyes, Robert Lukande, Lorna J Martin, Kate Megan Reid, Vina Vaswani, Harihar Wasti, Regis O Wilson, Michael Parker, Patricia Kingori “The Nobodies”: unidentified dead bodies—a global health crisis requiring urgent attention, Lancet Glob Health, Published Online September 26, 2023, doi.org/10.1016/S2214-109X(23)00420-5
Halina Suwalowska (2022) The invisible body work of ‘last responders’ – ethical and social issues faced by the pathologists in the Global South, Global Public Health, 17:12, 4183-4194, DOI: 10.1080/17441692.2022.2076896
Halina Suwalowska, Patricia Kingori & Michael Parker (2023) Navigating uncertainties of death: Minimally Invasive Autopsy Technology in global health, Global Public Health, 18:1, DOI: 10.1080/17441692.2023.2180065
Image credit and copyright: Anna Suwalowska