As our society becomes more and more fragmented, and the economic crisis worsens for more and more people, your jurisdiction may be struggling to pay for the disposition of bodies of indigents. Or, perhaps you've had a recent experience yourself with a neighbor or a friend, or even a local homeless person, who died unable to afford a burial. What happens then?
Procedures for pauper's burials vary widely by jurisdiction. It is one of those little-discussed arenas of public health, a topic that often intersects with the deaths of the homeless.
In Florida, counties bear the cost of burying indigents. But, in Leon County, for instance, friends and relatives may not attend the burial at the Pauper's Cemetery, due to "liability issues," and cremation is not allowed. In Bexar County, Texas, paupers are entitled to a simple casket, a viewing for up to two hours, burial three to a plot (one to a plot for children), a brief gravesite service, and a granite headstone. Cremation is allowed.
When I was a medical resident here in San Francisco, an Office of the Unclaimed Dead (literally) handled paupers' burials. Now, the San Francisco Medical Examiner's office handles them.
San Francisco has roughly 250 indigent deaths a year to manage - approximately one a weekday. Richard Vetterli, adminstrator of the Office of the Chief Medical Examiner, is the person charged with dealing with these cases.
Establishing identity is a crucial first step, Vetterli says. As in most major urban areas, San Francisco's medical examiner investigators use DNA databases and publicity. Most people are conclusively identified fairly quickly. But there are still, even after prolonged and intense efforts, John and Jane Does who remain unidentified, sometimes for years.
Disclaimer: Identifiable patients mentioned in this post were not served by R. Jan Gurley in her capacity as a physician at the San Francisco Department of Public Health, nor were they encountered through her position there. The views and opinions expressed by R. Jan Gurley are her own and do not necessarily reflect the official policies of the City and County of San Francisco; nor does mention of the San Francisco Department of Public Health imply its endorsement.
Photo Credit: Potters Field image from Bcostin via flickr
Photo Credit: Tagged body image from Calvin Cropley via flickr
