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Stories of the missing offer profound insights into the tension between how political systems see us and how we see each other. The search for people who go missing as a result of war, political violence, genocide, or natural disaster reveals how forms of governance that objectify the person are challenged. Contemporary political systems treat persons instrumentally, as objects to be administered rather than as singular beings: the apparatus of government recognizes categories, not people. In contrast, relatives of the missing demand that authorities focus on a particular person: families and friends are looking for someone who to them is unique and irreplaceable. InMissing, Jenny Edkins highlights stories from a range of circumstances that shed light on this critical tension: the aftermath of World War II, when millions in Europe were displaced; the period following the fall of the World Trade Center towers in Manhattan in 2001 and the bombings in London in 2005; searches for military personnel missing in action; the thousands of political \"disappearances\" in Latin America; and in more quotidian circumstances where people walk out on their families and disappear of their own volition. When someone goes missing we often find that we didn't know them as well as we thought: there is a sense in which we are \"missing\" even to our nearest and dearest and even when we are present, not absent. In this thought-provoking book, Edkins investigates what this more profound \"missingness\" might mean in political terms.

Forensic anthropological knowledge has been used in disaster victim identification (DVI) for over a century, but over the past decades, there have been a number of disaster events which have seen an increasing role for the forensic anthropologist. The experiences gained from some of the latest DVI operations have provided valuable lessons that have had an effect on the role and perceived value of the forensic anthropologist as part of the team managing the DVI process. This paper provides an overview of the ways in which forensic anthropologists may contribute to DVI with emphasis on how recent experiences and developments in forensic anthropology have augmented these contributions. Consequently, this paper reviews the value of forensic anthropological expertise at the disaster scene and in the mortuary, and discusses the way in which forensic anthropologists may use imaging in DVI efforts. Tissue-sampling strategies for DNA analysis, especially in the case of disasters with a large amount of fragmented remains, are also discussed. Additionally, consideration is given to the identification of survivors; the statistical basis of identification; the challenges related to some specific disaster scenarios; and education and training. Although forensic anthropologists can play a valuable role in different phases of a DVI operation, they never practice in isolation. The DVI process requires a multidisciplinary approach and, therefore, has a close collaboration with a range of forensic specialists.

Forensic odontology frequently plays a significant role in identification of the victims of multi-fatality disasters, but not in all. It depends on adequate dental remains surviving the disaster and on the availability of dental records to be successful. This paper describes current practice in the techniques of identification in forensic odontology and outlines recent advances that are moving into the mainstream. Key Points Forensic odontology plays a key role in mass disaster victim identification (DVI) when good-quality antemortem (AM) dental records are available. Images including radiographs, computerized tomography (CT) data and three-dimensional (3D) scan data are considered more reliable AM records than written dental charts and odontograms. Interpretation, transcription and comparison of dental datasets are complex processes that should be undertaken only by trained dental professionals. The future of forensic odontology DVI techniques is likely to include the use of 3D datasets for comparison.

On 14 June 2017 at 00:54 h, the worst residential fire since the conclusion of the Second World War broke out in Flat 16, 4th floor of the 24-storey residential Grenfell Tower Block of flats, North Kensington, West London, UK. Seventy-one adults and children died, including one stillbirth. All victims of the Grenfell Tower disaster who died at the scene underwent post-mortem computed tomography (PMCT) imaging using a mortuary-sited mobile computed tomography scanner. For the first time, to the authors’ knowledge, the disaster victim identification (DVI) radiology reporting was undertaken remote to the mortuary scanning. Over an 11-week period, 119 scans were undertaken on 16 days, with up to 18 scans a day. These were delivered to a remote reporting centre at Leicester on 13 days with between 2 and 20 scans arriving each day. Using a disaster-specific process pathway, a team of 4 reporters, with 3 support staff members, trialled a prototype INTERPOL DVI radiology reporting form and produced full radiology reports and supporting image datasets such that they were able to provide 96% of prototype DVI forms, 99% of image datasets and 86% of preliminary reports to the DVI teams in London within one working day of image receipt. This paper describes the first use of remote radiology reporting for DVI and exemplifies how remote PMCT reporting can be used to support a DVI process of this scale.

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.

This study examines the impact of workload demands on mental distress and job retention among healthcare workers (HCWs) handling mass fatalities during the COVID-19 pandemic. We utilized a cross-sectional validated survey to collect self-reported data from 206 HCWs in the United States between April and May of 2023. The survey measured various dimensions of workload, including mental, physical, and temporal demands, as well as frustration, and their effects on mental distress and the intent to leave their job. Partial Least Squares Structural Equation Modeling was employed to analyze the relationships among these variables, providing robust insights into the direct and indirect effects of workload demands on mental distress and job retention. Our findings reveal significant associations between mental, physical, and temporal demands, frustration, and increased mental distress, which in turn heightened the intent to leave their job. Mental distress emerged as a critical mediator, linking workload demands to job retention decisions. This study highlights the cycle of understaffing and workload intensification, exacerbated during pandemics, which contributes to higher turnover rates. It underscores the need for targeted interventions to alleviate workload pressures, especially the physical exertion and mental distress associated with handling dead bodies. This support can help improve HCWs’ mental health and job retention, ultimately enhancing the resilience of healthcare systems in crisis situations.

Disasters, both natural and manufactured, provide ample opportunities for official coercion. Authorities may enact quarantines, force evacuations, and commandeer people and supplies—all in the name of the public's health. When might such extreme actions be justified, and how does a democratic society ensure that public officials exercise care and forethought to avoid running roughshod over human rights? In The Ethics of Coercion in Mass Casualty Medicine, Griffin Trotter explores these fundamental questions with skepticism, debunking myths in pursuit of an elusive ethical balance between individual liberties and public security. Through real-life and hypothetical case studies, Trotter discusses when forced compliance is justified and when it is not, how legitimate force should be exercised and implemented, and what societies can do to protect themselves against excessive coercion. The guidelines that emerge are both practical and practicable. Drawing on core concepts from bioethics, political philosophy, public health, sociology, and medicine, this timely book lays the groundwork for a new vision of official disaster response based on preventing and minimizing the need for coercive action.

The COVID-19 pandemic has posed a serious question over preparedness to deal with mass fatality. The current trend shows that there would be more bodies than the capacity and resources to handle them. The international agencies have alerted governments that the number of deaths may overwhelm the local capacity to handle dead bodies properly. Mass fatality management and planning are important to respecting the dignity of the deceased and surviving family. Inadequate capacity to deal with dead bodies may affect the psychological well-being of survivors which may result in distress to families and community.

CT scanning of the deceased is an established technique performed on all individuals admitted to VIFM over the last 5 years. It is used primarily to assist pathologists in determining cause and manner of death but is also invaluable for identification of unknown deceased individuals where traditional methods are not possible. Based on this experience, CT scanning was incorporated into phase 2 of the Institute's DVI process for the 2009 Victorian bushfires. All deceased individuals and fragmented remains admitted to the mortuary were CT scanned in their body bags using established protocols. Images were reviewed by 2 teams of 2 radiologists experienced in forensic imaging and the findings transcribed onto a data sheet constructed specifically for the DVI exercise. The contents of 255 body bags were examined in the 28 days following the fires. 164 missing persons were included in the DVI process with 163 deceased individuals eventually identified. CT contributed to this identification in 161 persons. In 2 cases, radiologists were unable to recognize commingled remains. CT was utilized in the initial triage of each bag's contents. If radiological evaluation determined that bodies were incomplete then this information was provided to search teams who revisited the scenes of death. CT was helpful in differentiation of human from non-human remains in 8 bags, recognition of human/animal commingling in 10 bags and human commingling in 6 bags. In 61% of cases gender was able to be determined on CT using a novel technique of genitalia detection and in all but 2 cases this was correct. Age range was able to be determined on CT in 94% with an accuracy of 76%. Specific identification features detected on CT included the presence of disease (14 disease entities in 13 cases), medical devices (26 devices in 19 cases) and 274 everyday metallic items associated with the remains of 135 individuals. CT scanning provided useful information prior to autopsy by flagging likely findings including the presence of non-human remains, at the time of autopsy by assisting in the localization of identifying features in heavily disfigured bodies, and after autopsy by retrospective review of images for clarification of issues that arose at the time of pathologist case review. In view of the success of CT scanning in this mass disaster, DVI administrators should explore the incorporation of CT services into their disaster plans.

•Complementarity of first responder and expert action in the management of the dead.•Comparison of Interpol DVI Guide and ICRC/WHO Field Manual for Management of the Dead.•Discussion of suitable guidelines depending on target audience and disaster scope. Catastrophic natural disasters are a regular global issue claiming thousands of lives and having severe and long lasting consequences for communities. Along with the rescue and care of survivors and the provision of basic services, managing the dead in a proper and dignified manner is one of the three pillars of disaster response. Since the 2004 Indian Ocean Tsunami, progress to facilitate better coordination in the management of the dead has been made. Two guidelines contributing to this positive trend are the Interpol DVI Guide, and the “Management of the Dead after Disasters — A Field Manual for First Responders”. The former is aimed at forensic specialists and emergency services, the latter at untrained first responders confronted with the management of the dead when specialist forensic services are not available. This paper sets out the complementarity of the two publications, illustrating that ideally, both first responders and experts are needed to properly manage and identify the dead following large disasters.