Professional Documents
Culture Documents
doi:10.1093/bjsw/bct011
Advance Access publication February 13, 2013
Bodies-in-Life/Bodies-in-Death: Social
Work, Coronial Autopsies and the Bonds
of Identity
John Drayton is the Senior Coronial Counsellor at Queensland Health Forensic and Scientific
Services. He is a social worker and engaged in Ph.D. research at the University of Queensland.
Abstract
This paper addresses an aspect of bereavement which has received scant attention: the
various meanings of the dead body for the bereaved person and the practical implica-
tions of these for social workers in the field of grief and loss. The discussion is embedded
within a consideration of the role of social work in the field. The practice context is dis-
cussed and the literature of attachment in bereavement and conceptualisations of the
dead body briefly reviewed. The core of the paper derives from a series of interviews
with relatives of people whose bodies underwent autopsy-based coronial investigations
involving the retention of whole organs in Queensland, Australia. A number of emer-
gent themes are identified regarding the resonance of identity and the ways it is con-
tained, asserted and incorporated into the life and grief of the bereaved. Conflicts
and concurrences between the perspectives of interviewees and dominant medico-
legal perspectives are also considered. The paper concludes by discussing the role of
social work in bringing the perspectives of the bereaved person to the fore. It suggests
the profession, by virtue of its familiarity with the Ambiguous and Contradictory, is well
placed to develop practical understandings of death and bereavement and to enhance
the various governmental systems in which they are enacted.
Introduction
The coronial jurisdiction in Australia, like the English system from which it
derives, is a medico-legal forum in which the causes and circumstances of
sudden and unexpected deaths are investigated. Since 1995, I have been
employed as a social worker within the forensic pathology branch of the
system, first in New South Wales and since 2001 in Queensland. This
paper arises from an on-going qualitative study of the experiences of
bereaved families faced with a stark reality of the jurisdiction: the internal
autopsy and the retention of whole organs from the body of their relative.
The Queensland 2003 Coroners Act requires that coroners consider any
only hours before hearing from the worker and which is already enmeshed
in jargon, unfamiliar practices and seemingly unanswerable questions. In
order to effectively fulfil this role, however, workers need to engage with
a more confronting space: that between the bereaved person and the
body of the person they loved.
Further, the social workers function to enable the validity of ambiguity
within a governing system based on certainty (cf. Roose et al., 2012).
Their professional focus on the experiences and understandings of the
bereaved person means they are without both the limitations and certain-
ties of the fact-based disciplines which dominate the jurisdiction. To para-
phrase Imre (1984, p. 44), social workers in the coronial field are challenged
Bodies-in-death
The ambiguous status and meaning of the dead body was noted by Hallam
et al. (1999). They argued for the need to problematise notions of the corpse
in order to deconstruct common-sense notions of it as an incontrovertible
biological reality (p. 64), suggesting instead that the dead body carries a
range of meanings and significations which are inadequately represented
by an assumption that its materiality is self-evident (p. 63).
Haddow (2005) distinguished two basic attitude sets regarding the dead
body. A broadly Cartesian conception of death as a point of division
between the self and the body, following which the remains are devoid
of particular significance, is contrasted with a belief that the body retains
its value as the embodiment of an individual person (see Hockey (1996)
for a related perspective). The former position represents a foundational as-
sumption on which much Western science and epistemology is based (see,
e.g. Turner, 1984; McNay, 1994; Gatens, 1996). It is, as we have suggested,
inherent in the coronial system in which the dead body within the coronial
field is discursively constructed as the location of the underlying cause of
death (Prior, 1985, p. 174).
The second category of attitude identified by Haddow, the dead body as
the yet-significant embodiment of an individual, is poignantly illustrated in
Hockeys (1996) analysis of practices whereby parents are encouraged to
nurse the body of their still-born infant. She argues that the corpse is the
locus of identity for the parents would-be daughter or son (Hockey,
1996, p. 55). More generally, Haddow (2005, pp. 108ff.) suggests that the
newly dead body remains a powerful representation of the selfa position
shared by Downie (2003): given that, in bereavement at least, our memories
of others are based on behaviour associated with their bodies, the close
identification between those others and their bodies is not immediately
removed at their death. The bereaved persons conception of the dead
body is consequently fraught (Hockey, 1996): the corpse has at least a
268 John Drayton
dual existencedetritus and person: the body is at once dead and alive
feeling and unfeeling, an object of, perhaps, love and of fear and repulsion.
Research notes
Sampling and recruitment
The interviews were based on the model Minichiello et al. (2008) link to
in-depth interviewing. This involves a general topic list rather than a set
of specific questions and a conversational rather than interrogative ap-
proach, enabling a focus on the subjects account rather than on the
researchers perspective. The interview schedule I used identified four
topics: memories of the person who had died; events surround the death;
responses to, and understanding of, the autopsy and organ retention; the
grief experience. All interviews were digitally recorded and transcribed
by the author.
All names used in the following are fictitious, in keeping with confiden-
tiality arrangements.
Analysis
Data coding was managed using the following categories: participants as-
sessment of their relationship with the person who had died in life, partici-
pants views on the autopsy process, seeing the body, disposal of the body
and participants assessment of their relationship with the person who has
died in death. Thematic analysis was then conducted, focusing on contradic-
tions and concurrences in responses across categories and across interviews.
Key thematic concerns which emerged include ambiguity of the body, con-
tinuity of identity, continuity of relationship, intimate knowledge and
insight. Coding and analysis were done manually: qualitative research soft-
ware was not utilised.
Ethics
Bodies-in-life/bodies-in-death
Appearance
The majority of participants chose to view the body of the person who had
died, either at the mortuary or, following the autopsy, at the funeral home
a process which is well established in grief literature as representing a po-
tentially beneficial opportunity for bereaved people to begin processing
the reality of the death on a cognitive level (Hockey, 1996; Worden,
2001; Chapple and Ziebland, 2010). A number of interviewees, however,
described a somewhat more complex process. Physical features were
spoken of as representative of continuity at the same time as they confirmed
the severance of death. The body is empty, but rich with expressions of the
beloveds individuality from which participants found a reaffirmation of
relationship.
Rhiannons experience of seeing the body of her seventeen-year-old
daughter Jasmine illustrates the complexity of the issue. Jasmine died at
a friends house as a result of an epileptic seizure:
[She] had a tiny grin on her face, you know, a little expression that Ive seen
on Jas a lot when she was alive; and I know that doesnt quite make any
sense, because all her, you know, everythings relaxed and shes, you
know, she shouldnt have an expression, but, but as a mum, you know, I
can see this little expression that Id seen a million times. . . . [A]s far as
the Coroners office is concerned theyre dealing with a body. . . . Whereas
to us shes still Jas, you know?
When I went in to see him . . . that was the first thing I did, was look to see if
his head was still as big because it didnt have his brain in there. That sounds
really stupid coming from a 50 year old woman but thats the first thing I did,
cause I thought if his heads not as big it wouldnt be Andrew.
In the event, she found that not only was she seeing her son, but that she
also found the appearance resonant of an earlier loss:
I could see Andrew laying there, I could see my dad laying there; cause
Andrew looked a lot like my dad, even though they were way different
272 John Drayton
builds and everything else; but he had features that were like my dad; and I
never seen my dad when he died.
sort of stuff . . . that didnt worry me. I wanted to know why he died. . . . It
was, like, its a burning desire; its a need to know. . . . Its like being
caught in a vacuum; and you cant get out because . . . there is a piece
missing. . . . I cant move on.
Wholeness
This anecdote neatly encapsulates the dilemma facing many of the people
There is a sense here that the wholeness of the body (and the spirit), dis-
rupted by the autopsy, is socially reinstated. Nicoles sense of Alec at peace
derives from a rituala physical bringing together of his friends and family
276 John Drayton
at a church for the funeral. The unity he lost is restored, enacted for him in
the gathering of those who cared.
The interview with Paula included an extended discussion of this issue
and its implications. Lee, Paulas son, was forty-five when he died from a
previously undiagnosed heart condition. Paula described the troubled rela-
tionship she had with Lee and his struggles with the traumatic impact of his
experiences in the South African military some years before coming to Aus-
tralia. Wholeness of the body, for Paula, is inseparable from integrity of her
sons identity. It emerged that she considered Lee to have been psycho-
logically fragmented throughout his life: a situation she feared the brain re-
tention would perpetuate:
Alone among the interview participants, Paula chose to delay the funeral
for some weeks until the brain could be returned to the body. Interestingly,
Paula was also the only participant who chose to divide the ashes, half
staying with her and half going to Lees father in South Africa. She accepted
the apparent contradiction:
Paula: I didnt do that easily, but to me justice is more important . . . theres
the issue of Lees father . . . to me it was inconceivable that he should not be
part of that process. If we were in the same country he would have been part
of that process.
I turn now to consider the implications for social work practice and, in so
doing, I will outline briefly four practice orientations which relate directly
to the issues we have been discussing.
Bodies-in-Life/Bodies-in-Death 277
A focus on process
A focus on meaning
A focus on ambiguity
beliefs about, for example, the body or the impact of the autopsy. The chal-
lenge facing social workers is profound: to resist the urge to make sense of
what they are being told, to work from the assumption that the apparent in-
coherence of the bereaved persons view may be more a function of the in-
ability of our language to cope with metaphysics than individual distress or
delusion or wishful thinking; that the perceptions of bereavement are
rooted in practical experience and thus imbued with their own validity.
Conclusion
I argue on the basis of the interview data discussed above that the invasive
disruption of the internal autopsy, a key element of coronial investigations,
is necessarily problematised for the bereaved by their sense of an on-going
vital identity within and about the dead body. This sense, avowedly
non-empirical, is at odds with the positivist underpinnings of the jurisdic-
tion. It is important to avoid oversimplification, however: the interviewees
were not opposing those underpinnings; wanting the information it could
potentially provide, they did not argue against the practice of the
autopsythey demonstrated the complexity of its consequences. By involv-
ing bereaved people in deliberations about the autopsy, therefore, the
system engages with a set of responses arising from a distinct epistemologic-
al base. Social workers enable this engagement through their direct commu-
nication with the bereaved person, operating within a space of discursive
intervention I depicted above as being between the body and the grieving,
the jurisdiction and the family.
Bodies-in-Life/Bodies-in-Death 279
For all the information it contains about death, the body remains the
beloved. The people interviewed for the study underlying this discussion
clearly articulate their on-going, embodied attachment to the person who
has died at the same time as they acknowledge the reality of the death
and the at times devastating means by which that death is investigated
and explained. It misrepresents the responses of interview participants to
draw pro or anti autopsy conclusions: the body is depicted as neither
some sacred relic to be forever left untouched nor insignificant detritus.
It remains the person, even as its changes in appearance confirm the per-
manent absence of the person. She is dead, he is dead. We are challenged
to hear the personal pronoun and the present tense in this stark formula-
Acknowledgements
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