Not so simple: Understanding the complexities of establishing identity for cases of unidentified human remains in an Australian medico-legal system

Autopsy doesn't always tell all: The importance of exhuming skeletal remains of cemetery unidentified decedents

The process of personal identification differs according to the state of preservation of the corpse, becoming more complicated when dealing with remains altered by taphonomic variables. Since 2015, the staff of the Laboratory of Forensic Anthropology and Odontology (LABANOF) of the University of Milan has been engaged in recovering the skeletons of 36 unknown people from the cemeteries of the city of Milan, to redraw their biological profiles and give them back the possibility of being identified. Of the 36 starting skeletons, 7 have been identified and therefore are not the object of this study, 25 individuals were previously subjected to an autopsy examination and 4 skeletons were studied for the first time in the present work. The post-mortem data of all the individuals who had previously undergone autopsy and had not yet been identified (n = 25) have been retrieved from the archives of the Institute of Forensic Medicine in Milan and allowed for a comparison with those obtained from the new anthropological study of each exhumed skeleton. The authors aim to present the three most interesting cases to better highlight the results that emerged from the comparison. The autopsy information alone lacked important details. In all cases, the anthropological examination proved to be capable of detailing the biological profile of the unknowns even after a long period of inhumation (even more than 20 years). The limitations of instrumental investigations in achieving the goal single-handedly and the importance of recovering the unknown skeletons from cemeteries for identification purposes are discussed.

Moving from the unknown to the known: a multidisciplinary approach to the identification of skeletal remains from Sandy Point, Australia

When human remains are inadvertently located, case-related circumstantial information is used to generate an identification hypothesis, and the preservation of the remains typically informs which identification methods may then be used to validate that hypothesis. What happens, however, when there is no contextual information to generate an identification hypothesis? This paper presents the case of a near-complete human skeleton discovered at Sandy Point in Victoria, Australia. The circumstances of the case did not facilitate an identification hypothesis, and with no hypothesis to triage the identification process, all possible identification methods were employed. Preservation of the individual meant neither a visual nor a fingerprint identification was possible, and the lack of an identification hypothesis meant there was no antemortem reference data to compare with the postmortem DNA or dental information. Consequently, in addition to historical research, novel methods, such as radiocarbon dating and genetic intelligence, were utilized to complement information provided by the forensic anthropology and odontology analyses, which ultimately resulted in the identification. This example highlights the complexity of cases of unidentified skeletal remains and emphasizes the fact that identification is a process that necessarily requires a multidisciplinary and collaborative approach.

Key points

Human skeletal remains were recovered from Sandy Point, Victoria.The absence of circumstantial information and the poor preservation (i.e. skeletonized) of the remains precluded the formation of an identification hypothesis, rendering the identification process complex.Only through the integration of anthropology, odontology, molecular biology, radiocarbon dating, historical research, and genealogy were the remains able to be identified as Mr. Christopher Luke Moore, who drowned in 1928.Human identification is a process that necessarily requires a multidisciplinary and collaborative approach.

Who are they? A retrospective study of unidentified bodies in Institute of Medical-Legal Paris from 2018 to 2023

"I still don't realize that he's dead.... I cried over it. It makes me sad to know that he was buried unaccompanied on his last trip. We were all shocked." This testimony corresponds to a family whose relative was buried in an anonymous grave 6 months after his disappearance was reported to the police. It is estimated that between 1 000 and 3 000 unidentified bodies are buried in anonymous graves in France each year. Most of these decedents have passed through the medico-legal system. However the identification of these bodies, outside the context of mass disasters, remains a complex problem. Several national and international publications have highlighted the prevalent problem of unidentified burials and the consequences for families who do not know the fate of their loved ones, specifically, whether they are alive or deceased. This 6-year retrospective study (2018-2023), covering a total of 2 324 unidentified decedents admitted to the Institute of Medical-Legal Paris (IMLP), aimed to assess the impact of the identification protocol implemented in 2017 on the number of bodies that remain unidentified (n = 164). In addition, this study aimed to establish profiles for individuals who remained unidentified with the objective of identifying the factors that hinder their identification and developing correlated methods to address these issues. The results of this study were compared with other published studies to highlight the global problem and the ongoing need for collaboration between forensic practitioners and relevant authorities.

Key points

Despite great advances in human identification, unidentified decedents remain a global problem.This 6-year overview study covering a total of 2 324 unidentified bodies admitted to the IMLP provided relevant information about the unidentified decedent population and assessed the impact of a protocol established in 2017 on the rate of deceased buried without identity in Paris.The need to establish a national database in France to properly document and disseminate information on missing persons and to centralize the biological profile of unidentified bodies is key, as without antemortem information or a biometric database there can be no matching.

Managing large volume data sets in the process of identifying missing persons: Contributions from the International Commission on Missing Persons

The process of locating and identifying missing persons presents a complex challenge that hinges on the collection and comparison of diverse data sets. This commentary offers an overview of some of the difficulties and considerations associated with data management in the context of large-scale missing person identifications. Such complexities include the uniqueness of each disaster event, the response time to the event, the variable quality and quantity of data, and the involvement of numerous stakeholders, all of which contribute to the intricacies of data management. In addition, the paramount considerations of privacy and ethical standards further compound these challenges, especially when dealing with sensitive information such as genetic data. This commentary describes the integrated Data Management System (iDMS) developed by the International Commission on Missing Persons (ICMP) as one example of a comprehensive, freely available solution for data collection, storage, protection, and analysis in missing person cases. The various advantages of the system are discussed, including the system's interoperability among the diverse array of stakeholders involved. While the iDMS streamlines data management processes and therefore represents a significant advancement in the field of missing person identification, it is concluded that the pending issue extends beyond the software tools to encompass the lack of political will among stakeholders to collaborate there remains a pressing need for all stakeholders involved in the identification process to commit to a mechanism that facilitates compatibility and interoperability if different tools are used in disaster victim identification (DVI) scenarios.

Management of unidentified and unclaimed bodies: a comparison of model from four countries in the Asia Pacific Region

Managing mass fatality incidents or disasters involving multiple deaths are not uncommon among forensic practitioners. In fact, management of unidentified or unknown bodies is also a vital component of the day-to-day mortuary work practice. The unidentified and subsequently unclaimed bodies have always been a "silent mass disaster," a problem that needs to be tackled within the forensic community and raises the global issue of ethics, law, and human rights. Unidentified bodies' in Malaysia make up an average of 4.02% of all death cases where a total postmortem examination was performed which is comparable with other developing countries within 4-10% which can go up to 25%. Moreover, unstandardized procedures in all mortuaries in different states and districts in Malaysia have worsened the scenario even with guidelines in place. This study aims to address the issues surrounding unidentified and unclaimed bodies including body disposal from a social and legal perspective using case study methodology by comparing four different countries in the Asia Pacific Region through document analysis and interview methods. One of the major findings is evident in 3 out of the 4 models, whereby there is a considerable gap in consolidating the missing person report and information to match with the unidentified bodies received in forensic institutions in an attempt to enhance the identification process which ultimately intends as a closure for the family members. It is also timely to think out of the box beyond dental records and DNA profiling to improve the identification rate for skeletonized remains through means of anthropology biometrics comparison. With the limited literature published surrounding this domain, it is hoped that the suggestions and recommendations to standardize the management of unidentified and unclaimed bodies can benefit many forensic institutions and public mortuaries in this region.

Validity of postmortem computed tomography for use in forensic odontology identification casework

Forensic Odontology (FO) identification compares antemortem (AM) and postmortem (PM) dental datasets and is widely accepted as a primary identifier. Traditionally, a PM dental examination is undertaken in the same manner as a dental examination conducted for a living patient. Recently, the increased forensic application of computed tomography (CT) offers an alternative source of PM data. While charting from PMCT is widely accepted as less accurate, the impact on reconciliation is unknown. This study aims to determine if reconciliation outcome differs when PM dental data is collected from PMCT, compared with conventional PM examination. PMCT data was reviewed for 21 cases previously completed using conventional PM dental examination. Operators blinded to original identification outcomes charted from CT images before comparing to AM data to form an opinion regarding identity. Opinions formed were compared with original identification outcomes. Differences in PM dental charting between the two methods and the evidentiary value of AM and PM datasets were assessed to determine driving factors of differences in identification outcome. Compared to conventional PM dental examination, PMCT examination resulted in similar or less certain identification outcomes. Discrepancies in outcome were driven by the quality of AM and PM datasets rather than inaccuracies in charting from PMCT. Based on the results of this study, both conventional and PMCT methods of PM dental examination can reach similar identification outcomes. However, operators remained more certain in establishing identity when conducting conventional PM dental examinations especially when AM data was lacking.

Public/family concerns for providing DNA in missing persons cases: Paper 2: The main concerns raised and implications for policing policy

Identification of unidentified human remains, and long-term missing persons (LTMP) is imperative, allowing for missing persons to be reunited with their families, which could provide closure to families experiencing ongoing ambiguity surrounding the situation. However, identification remains problematic for several reasons, including the absence of DNA provision in the investigation. The research reported here is the second in a two-part series exploring public/family support for providing DNA in LTMP cases. In the first study, quantitative results showed that participants had concerns when asked if they thought there would be implications for a person providing DNA to police in LTMP cases. The aim of this second study was to explore further using qualitative methods the nuances and themes underpinning concerns for providing DNA in LTMP cases. Participants described their concerns about providing DNA in four hypothetical LTMP case scenarios (a child, an adult with dementia, a runaway 19-year-old adolescent, and an estranged adult). Through thematic content analysis, ten themes were identified. Nine themes run across all four LTMP case scenarios. The tenth theme was only observed in two scenarios; cases involving adolescents with a history of runaway, and in cases involving adults estranged from their family. Results showed public concerns differed according to LTMP case circumstances. Key findings point to public education about how DNA is used in LTMP investigations, the applicable legislation relating to police use of DNA in investigations and increasing public awareness around the benefits of DNA use in LTMP investigations. Potentional policy options are discussed that could guide the future development of nuanced police practice in different types of LTMP cases.

Understanding the burden of unidentified bodies: a systematic review

While human identification is a crucial aspect of medico-legal investigations, many individuals remain unidentified each year across the world. The burden of unidentified bodies is often referred to when motivating for improved methods of identification, and anatomical teaching, yet the actual burden is somewhat unclear. A systematic literature review was undertaken to identify articles that empirically investigate the number of unidentified bodies experienced. Despite the large number of articles returned, an alarmingly low number (24 articles) provided specific and empirical details on the number of unidentified bodies, demographics and trends thereof. It is possible that this lack of data is due to the variable definition of 'unidentified' bodies and the use of alternative terminology such as 'homelessness' or 'unclaimed' bodies. Nevertheless, the 24 articles provided data for 15 forensic facilities across ten countries of both developed and developing statuses. On average, developing countries experienced more than double (9.56%) the number of unidentified bodies when compared to developed nations (4.40%). While facilities were mandated under different legislations and infrastructures available varied greatly, the most common issue faced is the lack of standardised procedures for forensic human identification. Further to this, the need for investigative databases was highlighted. Through addressing the standardisation of identification procedures and terminology, alongside the appropriate utilisation of existing infrastructure and database creation, the number of unidentified bodies could be significantly reduced globally.

Public and family support and concerns for providing DNA to law enforcement in long-term missing person cases

The identification of long-term missing persons and unidentified human remains is a global challenge. Many people stay on missing persons registers, with unidentified human remains stored for extended periods in mortuaries around the world. Research exploring public and/or family support for providing DNA in long-term missing persons cases is scarce. The aims of this study were to examine whether trust in police predicted the level of support for providing DNA and explore public/family support and concerns for providing DNA in such cases. Trust in police was measured through two widely used empirical attitude scales; "The Measures of Police Legitimacy and Procedural Justice". Support and concerns for giving DNA were measured through four hypothetical missing persons case scenarios. The results showed more positive attitudes towards police legitimacy and procedural justice significantly predicted support, with the percentage level of positive support across the four case types as follows: cases involving a long-term missing child (89%), elderly adult with dementia (83%), young adult with a history of runaway (76%), with the lowest level of support for an adult with an estranged family (73%). Participants also reported more concerns about providing DNA when the missing person circumstances involved family estrangement. Understanding levels of public/family support and concerns around providing DNA to police in missing persons cases is vital to ensure that DNA collection practices reflect what the public/family support and, wherever possible, alleviate public concerns.