Patient and mortuary neglect

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Neglect is defined as giving little attention to or to leave undone or unattended to, especially through carelessness. Mortuary neglect can comprise many things, such as bodies being stolen from the morgue, or bodies being mixed up and the wrong one was buried. When a mortuary fails to preserve a body correctly, it could also be considered neglect because of the consequences.

Contents

Patient neglect is similar to mortuary neglect with one major difference: that patient neglect has to do with people who are still living and that neglect could ultimately lead to their death. Patient neglect concerns people in hospitals, in nursing homes, or being cared for in home. Usually in nursing homes or home-assisted living, neglect would consist of patients being left lying in their own urine and/or feces, which could, in turn, possibly attract flesh flies and lead to maggot infestation. It also encompasses patients getting rashes, lice, and other sores from being improperly cared for. [1]

Types of mortuary neglect and the law

The general sign of mortuary neglect (in terms of forensic entomology) is an infestation of maggots or some other insect (such as cockroaches) of a corpse. This should not be confused with insects found on a body before they are transferred to the morgue. The following examples are forms of mortuary neglect that pertain to the ethical treatment of a corpse.

Improper embalming

Improper embalming is the utilization of embalming techniques that cause premature decomposition of the body especially in cases where the body in question is to be presented in an open-casket funeral. In addition, not refrigerating the body immediately following death, but before the embalming process could lead to rapid deterioration of the human remains as well.

Washington v. John T. Rhines Co.

On August 29, 1994, widow Marian Washington filed suit against funeral home, John T. Rhines Co., for improperly embalming her late husband Vernon W. Washington. She claimed that the embalming fluid was leaking and that her husband's skin was decomposing at an alarming rate. John T. Rhines Co. re-embalmed Mr. Washington in efforts to make his body presentable. However, they failed to restore Mr. Washington's body completely. [2]

Cooley v. State Board of Funeral Directors and Embalmers

On May 3, 1956, Cooley, a petitioner of a particular funeral home tried to appeal the revoke of his license by the California state board of funeral directors and embalmers. The case reveals the reasons as to why the license was revoked. Cooley's practices were described as unsanitary for the following reasons: an infant was discovered improperly embalmed after maggots were seeping out of its orifices, commingling of bodies, blood stains were found on the walls, and tools used were not cleaned from one autopsy to the next. Needless to say, the appeal was not granted. [3]

Fencing stolen organs

This form of abuse consists of selling body parts stolen from carcasses that are sent to the morgue for embalming.

Commingling of ashes

Commingling of ashes is putting several bodies in the same crematorium during the same burn cycle. This act undermines the respect due a passed loved one.

Unauthorized disposal

In this form of abuse, funeral home operators dispose of the body in a manner not authorized by the deceased's loved ones.

Christensen v. Superior Court of Los Angeles County

On June 28, 1990, a court heard a case on a class action suit against multiple funeral service operators. These acts included all of the types of mortuary neglect mentioned above in this section. The case contended that the defendants violated conscionable standards regarding the treatment of the deceased. This practice occurred for nearly a decade and victimized approximately 17,000 decedents and their families. [4]

Unethical treatment of the deceased

Any violation of the standards that any reasonable person would expect of a Mortuary operator could be considered in this category.

Dennis v. Robbins Funeral Home

James Dennis, widower of Molly Dennis, sued Robbins Funeral Home on August 24, 1987. Before Mrs. Dennis was to be cremated, Lee Miller, the funeral director of Robbins Funeral Home called the family to see the body. When the family arrived, to their dismay, they found Molly Dennis's body unprofessionally presented in an unhygienic environment as unspecified limbs were hanging off the dissection table and into a dirty sink. Mr. Dennis was not, however, able to successfully sue the funeral home because the judicial history in the area did not include a precedent for funeral home malpractice. [5]

National Funeral Directors Association

The National Funeral Directors Association (NFDA) is an organization in the United States that regulates mortuaries and morgues and their activities regarding the embalming and interring of the deceased. [6] With any complaint including mortuary neglect, the NFDA has a fifteen step disciplinary process it goes through to determine the severity of the situation. After receiving a complaint, a committee reviews the situation even to the extent of an investigation and then they determine the consequences of the violation. Those considered in violation of the NFDA's policies could face punitive action ranging from a warning to suspension from the organization. [7]

There are certain segments of the health care industry that are seeing downward moves in neglect, while other sections are experiencing unfortunate growth. In modern hospitals the most prevalent form of neglect deals with the patients themselves neglecting their own care. However, in other segments such as assisted living for mentally deficient patients the rates of abuse and neglect are still relatively high. [8]

Mortuary neglect is another segment that has peculiar trends. There are relatively few morticians that just refuse to perform their duties. However, cases of ethically questionable practices can be easily found. Morticians only preserving visible body parts, incomplete embalming and defrauding families are just a few examples of reported cases of neglect.

Increasingly medical journals are recommending that doctors become more active in attempting to persuade parents and guardians of children to either accept or continue treatment for diseases or injuries in order to avoid a neglect case. In the American Orthopedic Journal a case study was presented where a doctor suggested that an effort to convince a girl's mother to adequately treat a case of amblyopia to avoid potential neglect. While a viewpoint arguing this was unnecessary, it shows a growing trend to go beyond traditional measures to avoid neglect charges. [9]

History

From the times of the ancient Egyptians, cases of mortuary neglect have been recorded. The process of embalming is to preserve the dead for burial, as the Egyptians believed the afterlife was just as important as life itself. However, if a woman was married to an embalmer, he would likely keep her preserved for his own benefit until obvious decomposition took place.

Dignity for the dead is now a legal matter, as patient neglect has always been. Abuse in the healthcare system is another huge problem in today's society. Nursing homes and hospitals are preying grounds for predators of the weak and disabled. In 2001 a nursing home in Ossining, New York was closed because of neglect and unsafe conditions that existed for the patients. [10]

US state laws

For the most part, mortuary standards are created by the states, not by the federal government. The following are links to state policies (where available) on mortuary practices:

Related Research Articles

<span class="mw-page-title-main">Funeral home</span> Death care business

A funeral home, funeral parlor or mortuary, is a business that provides burial and funeral services for the dead and their families. These services may include a prepared wake and funeral, and the provision of a chapel for the funeral.

<span class="mw-page-title-main">Service Corporation International</span> American deathcare provider

Service Corporation International is an American provider of funeral goods and services as well as cemetery property and services. It is headquartered in Neartown, Houston, Texas, and operates secondary corporate offices in Jefferson, Louisiana. SCI operates more than 1500 funeral homes and 400 cemeteries.

Embalming is the art and science of preserving human remains by treating them to forestall decomposition. This is usually done to make the deceased suitable for viewing as part of the funeral ceremony or keep them preserved for medical purposes in an anatomical laboratory. The three goals of embalming are sanitization, presentation, and preservation, with restoration being an important additional factor in some instances. Performed successfully, embalming can help preserve the body for many years. Embalming has a very long and cross-cultural history, with many cultures giving the embalming processes religious meaning.

<span class="mw-page-title-main">Morgue</span> Place for the storage of human corpses awaiting identification or burial

A morgue or mortuary is a place used for the storage of human corpses awaiting identification (ID), removal for autopsy, respectful burial, cremation or other methods of disposal. In modern times, corpses have customarily been refrigerated to delay decomposition.

<span class="mw-page-title-main">Burial vault (enclosure)</span> Container that encloses a coffin

A burial vault is a container, formerly made of wood or brick but more often today made of metal or concrete, that encloses a coffin to help prevent a grave from sinking. Wooden coffins decompose, and often the weight of earth on top of the coffin, or the passage of heavy cemetery maintenance equipment over it, can cause the casket to collapse and the soil above it to settle.

Disposal of human corpses, also called final disposition, is the practice and process of dealing with the remains of a deceased human being. Disposal methods may need to account for the fact that soft tissue will decompose relatively rapidly, while the skeleton will remain intact for thousands of years under certain conditions.

<span class="mw-page-title-main">Natural burial</span> Method of burial

Natural burial is the interment of the body of a dead person in the soil in a manner that does not inhibit decomposition but allows the body to be naturally recycled. It is an alternative to typical contemporary Western burial methods and modern funerary customs.

<span class="mw-page-title-main">Embalming chemicals</span> Chemicals that prevent body decomposition

Embalming chemicals are a variety of preservatives, sanitising and disinfectant agents, and additives used in modern embalming to temporarily prevent decomposition and restore a natural appearance for viewing a body after death. A mixture of these chemicals is known as embalming fluid and is used to preserve bodies of deceased persons for both funeral purposes and in medical research in anatomical laboratories. The period for which a body is embalmed is dependent on time, expertise of the embalmer and factors regarding duration of stay and purpose.

A tissue bank is an establishment that collects and recovers human cadaver tissue for the purposes of medical research, education and allograft transplantation. A tissue bank may also refer to a location where biomedical tissue is stored under cryogenic conditions and is generally used in a more clinical sense.

Mortuary science is the study of deceased bodies through mortuary work. The term is most often applied to a college curriculum in the United States that prepares a student for a career as a mortician or funeral director. Many also study embalming to supplement their mortuary science studies. Some states require funeral directors to be embalmers as well.

The death care industry in the United States includes companies and organizations that provide services related to death: funerals, cremation or burial, and memorials. This includes for example funeral homes, coffins, crematoria, cemeteries, and headstones. The death care industry within the U.S. consists mainly of small businesses, although there has been considerable consolidation over time.

Cincinnati College of Mortuary Science (CCMS) is a private mortuary science college in Cincinnati, Ohio. CCMS is the oldest school of its kind in the United States, tracing its history back to the Clarke School, which organized its first class on March 8, 1882. The school was later called the Cincinnati College of Embalming, arriving at the present name in 1966. CCMS offers associate degrees and bachelor's degrees in mortuary science.

Insect development during storage requires special consideration when further criminal investigation is necessary to solve a crime. Decomposition is a natural process of the body, dissipating slowly over time. This process is aided by insects, making the rate of decomposition faster. For forensic entomologists, it is important to carefully collect, preserve and analyze insects found near or on a victim. By doing that, they can provide an estimated time of death as well as the manner of death and the movement of the corpse from one site to another. The role of a forensic entomologist adjunction to the pathologist is to “collect and identify the arthropods associated with such cases and to analyze entomological data for interpreting insect evidence.”

Entomological evidence is legal evidence in the form of insects or related artifacts and is a field of study in forensic entomology. Such evidence is used particularly in medicolegal and medicocriminal applications due to the consistency of insects and arthropods in detecting decomposition quickly. Insect evidence is customarily used to determine post-mortem interval (PMI) but can also be used as evidence of neglect or abuse. It can indicate how long a person was abused/neglected as well as provide important insights into the amount of bodily care given to the neglected or abused person.

Lazarus syndrome, also known as autoresuscitation after failed cardiopulmonary resuscitation, is the spontaneous return of a normal cardiac rhythm after failed attempts at resuscitation. It is also used to refer to the spontaneous return of cardiac activity after the patient has been pronounced dead. Its occurrence has been noted in medical literature at least 38 times since 1982. It takes its name from Lazarus who, according to the New Testament, was raised from the dead by Jesus.

<span class="mw-page-title-main">Butterworth Building</span> United States historic place

The Butterworth Building or Butterworth Block at 1921 First Avenue in Seattle, Washington was originally built as the Butterworth & Sons mortuary, which moved into this location in 1903 and moved to larger quarters in 1923. Located on a steep hill, the building has only three stories on the First Avenue side, but five on Post Alley. The building is listed on the National Register of Historic Places (NRHP); adjacent to Pike Place Market, it falls within the NRHP's Pike Place Public Market Historic District and the city's Place Market Historical District. Now owned by the McAleese Family since 2005.

Patient abuse or patient neglect is any action or failure to act which causes unreasonable suffering, misery or harm to the patient. Elder abuse is classified as patient abuse of those older than 60 and forms a large proportion of patient abuse.

<span class="mw-page-title-main">Bob Boetticher</span> American funeral director

Robert Michael Boetticher Sr. is an American funeral director, best known for the planning and implementation of memorial services for celebrities and notable individuals. He was the lead funeral director and embalmer for the state funerals of George H. W. Bush, Gerald Ford and Ronald Reagan, and has coordinated and directed some with the assistance of the members of the SCI Ceremonial Funeral Team of the most visible funerals in recent history.

Women have had varying roles in the death care industry in the United States since its mid-nineteenth century inception.

James E. Reveley was an American mortician, dentist, and consumer advocate for the regulation of the American funeral industry. Through the 1970s, he helped push the Texas Legislature to overhaul the funeral industry's oversight body, eliminate antiquated laws requiring embalming, and pass ground-breaking legislation to protect grieving consumers from exploitative practices. Following his success in Texas, Reveley continued his fight at the national level helping the Federal Trade Commission's Funeral Rule overcome industry opposition and survive congressional veto, transforming the way the funeral industry operates nationwide.

References

  1. ↑ Arnoldi, Kyle. "Noncompliance vs. Medical Neglect." American Orthopedic Journal 2007: 137-143.
  2. ↑ "Washington V. John T. Rhines Co." National Association of Personal Injury Lawyers. 2005. 10 Mar. 2008.
  3. ↑ "Cooley V. State Bd. of Funeral Directors and Embalmers." Texas A&M Database Search (1987): 293-296. Westlaw. Texas A&M. 13 Apr. 2008.
  4. ↑ "Christensen V. Superior Court of Los Angeles County." National Association of Personal Injury Lawyers. 2005. 10 Mar. 2008.
  5. ↑ "Dennis v. Robbins Funeral Home." Texas A&M Database Search (1987): 698-701. Westlaw. Texas A&M. 13 Apr. 2008.
  6. ↑ National Funeral Directors Association Overview Archived 2008-05-10 at the Wayback Machine National Funeral Directors Association. 13 Mar. 2008.
  7. ↑ NFDA Code of Professional Conduct. [ permanent dead link ] National Funeral Directors Association. National Funeral Directors Association. 13 Mar. 2008.
  8. ↑ Scott, Graham. "Patients at Risk of Neglect in Mental Health Trusts" Nursing Standard 7 Jan. 2004: 8.
  9. ↑ Bolin, Jane N. "Avoiding Charges of Fraud and Abuse: Developing and Implementing an Effective Compliance Program." Journal of Nursing Administration Dec. 2004: 546.
  10. ↑ Finkelstein, Katherine. "Nursing Home Shuts Down After U.S. Finding of Danger." New York Times [New York City] 23 August 2001: 5.
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