The Ethical Use and Legality of Medical Examiner Data: Preliminary Lessons From the New Mexico Decedent Image...

Advances in postmortem imaging technologies are transforming medical examiner practice, enabling the creation of large-scale digital collections of decedent data that support research across medicine, public health, forensics, bioarchaeology, paleoanthropology, demographics, and anthropology in general. Drawing on the case of the New Mexico Decedent Image Database (NMDID), this paper explores the promises and risks of virtual medicolegal collections, introduces the perspectives of next-of-kin from a pilot focus group, and confronts the gaps in existing professional and legal frameworks. Finally, this work attempts to establish a foundation for developing standards for ethical stewardship of digital remains in the modern medicolegal landscape.

One pilot focus group (n = 5) was conducted in Kalamazoo, Michigan in 2022. De-identified transcripts underwent a thematic analysis by anthropologists, ethicists, and biomedical informaticians. Themes were determined when the majority of the focus group agreed or shared the same or similar statement.

From the small group of five participants, seven unique themes were identified relating to the use of decedent data, from the conversations with NOK: legitimate identifiability, closure, advocacy, legitimacy of research, timing of inquiry, notification, and agency.

Despite not obtaining saturation due to small group size, the thematic analysis still provides an important stakeholder perspective to help identify key aspects of the history and legal context of the unique ethical challenges posed by using medical examiner imaging-based collections for research purposes. Building on this foundation, we propose eight preliminary ethical guidelines that emphasize confidentiality, security, stewardship, and respect for next-of-kin.