engleski

Missing persons’ medical certificates of death: review and future steps.

Background: Disappearances greatly affect those close to the missing persons as well as local, state-wise and international communities. Passage of time is often the key determining factor for acquiring legal death certificates for the missing. However, numerous ethical, legal and personal dangers have risen due to wars and natural disasters which cause the largest number of missing persons. These issues are furthered by advances in accuracy of identification of remains that are beyond visual recognition and especially partial remains, which, although proven to belong to the missing person, do not constitute certain death. Central ethical problem: Juridical requirements as well as scientific and medical accuracy of identification of remains promote paternalism in dealings with those affected by disappearances of loved ones. This paternalism is hidden behind the cloak of acceptance of identification offered to relatives of missing persons. Future policy making and international recommendations need to consider the autonomy of the missing person, status, rights and dignity of partial remains, experiences and consequences of the involved parties, and the refusals of identification results by the loved ones. Approach/Methods/Arguments: We provide a review of international policies on medical and legal death certificates for missing persons and analyze their implications and consequences. We used phenomenological and virtue approach, combined with discourse analysis to show societal pressures experienced by relatives of missing persons who were presented with results of DNA analysis of body remains of soldiers disappeared during the Croatian War for Independence (1991-1995). Relatives’ firsthand acceptance, denial and/or later acceptance of identification are discussed. Conclusion: Veiled paternalism of medical and forensic sciences does not hide behind the results of its tests, but behind its consequences. Refusal of the results of identification by relatives of the missing persons is often the only instance when the obligation of handling the remains and death certificates becomes the full responsibility of the state. However, even then many states prolong the decision making, due to the lack of set guidelines and implications that these decisions might have on human rights. International standards for these issues must be expanded in order to help the involved parties, facilitate the grieving process of those affected by the disappearances, and diminish forced disillusions of the bereaved.

missing persons; Jurisprudence; Death Certificates; Croatia

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