odontology
by Leif Kullman
Some ethical issues in working with identification of human beings.
This month I would like to give you my opinion about some ethical considerations that may face a forensic odontologist during his work. I have met this questions in especially mass catastrophes, but they can be of current interest in cases with single identifications.
About ten years ago there was a terrible bus crash in Norway with a Swedish school class involved. It was an elementary class. The pupils were about 13-14 years old. They had saved money for a long time to be able to go to a school trip to Great Britain in August. The travel had started the same day from Stockholm and the bus had reached a tunnel outside Bergen, in a stretch where the road is declining a lot, when the thing happened that never should happen.
The brake systems of the bus stopped to function as they should, due to overheating and the bus raced faster and faster within the tunnel. Finally they were approaching the mouth of the tunnel when the driver who knew, that there was a very sharp curve just outside the tunnel, probably voluntarily drove into the rock face to bring the bus to a halt (he was one of the victims). The crash was immense and 12 children and some adults were more or less immediately killed by multiple skull fractures.
The Norwegian and the Swedish Identification commission were called up and a very precise identification process was started. The bodies were first sustained to a police investigation, where clothes and other belongings were recorded and a visual ante- and postmortem comparison was performed with passport photos and so on. Then we carried on with an odontological examination, which included postmortem radiographs in an all victims. Antemortem radiographs were available on all children so a very safe identity could be established in all. Finally a brief and short autopsy was performed to establish the cause of death for everybody.
Already after a couple of days the work could be closed and the bodies were planned to be flied to Stockholm and the funerals. During all our work the relatives had visited the hospital in Bergen, where the bodies were identified and now several of them wanted to see the victims before the final transport at home. The commissions ended up our work with a meeting were the final victim identification reports should be issued. Now the question popped up and was discussed: Should anyone who wanted, has a possibility to see their children? Some of the forensic examiners said no……it is not possible. Due to the bodies' appearance, with the faces engaged in multiple fractures, they regarded it unethically for the relatives to be confronted with this. But several of us had a different viewpoint including myself. I think that you must explain the problem and the appearance for the relative and then it will be up to them to take the decision.
In this accident the discussion ended with, that those who wanted to meet their children for a last time were allowed to do it after some information and appearance arrangements. I was grateful for that and later on I have been involved in more cases, where a surviving relative has been very thankful for having been given a possibility to meet and spend some time with the body. Once a father, who had been very eager to be allowed, spent half an hour to "talk to" the remains of his son. The remains were only a big black lump after a train collision and a fire afterwards. The father was like a new human being after the confrontation, it showed itself that he had lost the contact with his son several years ago, when he divorced the son's mother.
