Embalming: Restrictions, removals and risks

words: Ben Whitworth, the MazWell Group

Embalming has been practiced in Europe since the 17th century, and as far back as 5,000 years ago in Ancient Egypt. However medical technology has advanced hugely over that period and has particularly accelerated in recent years. Now, working alongside the Institute of Cemeteries and Crematorium Management (ICCM) and the Federation of Burial and Cremation Authorities (FBCA), Ben Whitworth has compiled a guide to highlight the risks new medical implants pose to funeral service professionals. SAIFInsight caught up with him to find out more…

Why did you decide to write the guide?

“I worked with Julie Dunk and Brendan Day, representatives of the ICCM and the FBCA, because there have been some issues whereby crematoria have insisted on the removal of different devices and then this has been met with resistance or difficulty from the bereaved family’s point of view.

“The goal was to write a piece that explains the implications for different devices to give some guidelines as to what they look like, where they might be located within the body, and then how to go about removing them to comply with the requirements of the different crematorium authorities. Each authority is going to have its own rules, regulations and, ultimately, the medical referee is going to make a decision based on the paperwork that’s submitted and they’re all slightly different.”

Is it specifically aimed at embalmers?

“No, I wanted to help to educate and inform all those who worked within the bereavement service sector about the different medical implants and the advances in medical science that have made some of these implants slightly more complicated, or slightly more difficult to detect. Everything is getting much smaller and more compact, and that can be problematic.

“There are various rules that pertain specifically to the cremation of the deceased human body, and some implants that have to be removed under the laws pertaining to cremation. We will have to find newer and better ways of overcoming the challenges these advances have on the care and preparation of the deceased as well as to the care and support that we provide to the bereaved. We will all have seen many changes in our work and what we are required to know and do. Professionally speaking, if we have a desire to learn and share the benefits of our experience with our colleagues, there isn’t much that we cannot overcome.”

As a profession, do we need to talk more freely about embalming?

“Yes. The MazWell Group provided training to a large family group of funeral services. They wanted to be more positive and more proactive about the embalming process. By giving them the tools to talk positively and properly about embalming, and addressing any myths or misconceptions they had, they actually increased the amount of embalming and viewing they did. They had an increase in positive feedback from their clients, too.

“There is a claim that the embalming process is about denying death and that by attending to the body and removing some signs of pain or struggle, and improving the overall appearance of the deceased, we are denying death. I would challenge that. We are not. We’re doing it because we wish to encourage the bereaved to come in to see the deceased person and to confront the fact that the death has occurred, but in a way that is not going to be as distressing. A family which says they do not wish to see a loved one’s body after death may have had a very bad experience previously. A family which has always had a positive experience will probably always embrace that approach. We need to be more aware of what we’re doing and ensure that what we’re doing is done to the best possible standard. Professionally speaking, as funeral directors we are entrusted with the care of the deceased. My own personal view is that embalming is one of the best ways that we can ensure that care of an individual.”

What was your experience throughout the pandemic?

“We have to remember the human aspect to this, and not being able to see a loved one while they’re in intensive care and ultimately dying, is going to have an enormous psychological effect. Being told that jewellery or clothing can’t be removed or returned from the deceased will be very traumatic for some. And, ultimately, as funeral directors within our communities, we’re seen as the experts when it comes to the care and the careful management of the deceased and the bereaved.

The company that I embalm for from time to time found themselves dealing with probably four times the normal volume of continued to embalm. We knew that embalming would kill the virus and that we could sanitise the body. Because the hospitals were so busy, many individuals who had come to us hadn’t necessarily received the same standard of care that they would have done in normal, everyday business. Shaving and bathing of these patients wasn’t taking place with the same frequency, so there was an opportunity to restore dignity to the deceased when they came into our care and to make those attendances that maybe hadn’t been available during that terminal event.

We were facing quite long delays for crematoria facilities. Not only was it that there was a delay at the crematorium, but it could be that the spouse was having to self isolate so we couldn’t have a funeral straight away. By embalming these patients – we were able to ensure their safety and their dignity up until the funeral would take place.”

Why do you embalm?

“For me personally, whether it’s a family that I am looking after as a funeral director, or I am looking after one of my own deceased loved ones or family members, which I have done on multiple occasions, I will always recommend embalming because I believe it’s in everybody’s best interest.

“What’s important is that people are upfront and honest about it, and that they have the tools to be able to accurately explain what’s involved and what’s going on, and why it’s necessary. There shouldn’t be any secrets and, unfortunately, I think we get these myths and then they perpetuate stories which are untrue.”

Apart from training, what other steps would you like to see?

“I think there needs to be a minimum standard by which all funeral homes are accountable in terms of mortuary facilities and back of house infrastructure. It doesn’t have to be overly expensive, but does there need to be some sort of air conditioning or refrigeration for the temporary storage of the body? Yes, there does. Does there need to be some sort of racking? Absolutely, yes, there does. Does there need to be a level of training as to what to do when the deceased is first moved from the place of death to the funeral home, and then last offices or first offices through to dressing or through to embalming and final preparation? These are things that would set us in a better position for the future.

I think some sort of licencing would serve us all well as professionals, and it would better reinforce for the general public that we are professionals within our field, and that they can trust us and that we have their interests at heart. If I go to a dentist, I’m going to a qualified licenced professional; if I use an electrician, I’m using a qualified certified professional, so it should be the same logic for funeral service professionals.”

Finally, does embalming raise any environmental issues?

“There is lots of negativity involved with embalming and people have very different viewpoints on the subject, which have to be respected. There’s also a lot of misunderstanding and mistruths and the biggest relates to formaldehyde. Formaldehyde is a naturally occurring organic compound which exists at very high altitudes in the air. It’s released by human beings as a by-product of metabolic processes and it’s found in the soil and in trees. It’s also broken down in the atmosphere in the presence of sunlight and oxygen and decomposed in the soil by different bacteria, enzymes and elements. Used in embalming, it reacts with the proteins of the body and once that reaction has happened, it’s no longer formaldehyde, so formaldehyde is not leaching from buried bodies into the ground. In the cremation process, what is released is carbon dioxide and water because formaldehyde gets broken down in that process.

As far as the medical implants go, some of the devices are now so small that the manufacturers claim they don’t need to be removed, and there’s no inherent danger to cremating them. That’s very beneficial but there are some questions that come off the back of this. Some of these devices use expensive, very precious metals, so is it right that these devices are simply created and then the metal is recovered as part of the cremation process and sent for recycling? Or is there more benefit to these devices being surgically removed from the deceased so they can then be reprocessed and redeployed in a more sympathetic way? Is there an ethical consideration to be made about that?

Also, a body that has been properly embalmed doesn’t require refrigeration, so I would question the environmental impacts of refrigeration versus the environmental impacts of embalmed bodies.”

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