The funeral service practitioner is responsible for assisting people with planning and implementing plans for funeral or memorial services.Included in this responsibility are:1)coordinating services with third parties such as clergy, cemeteries or crematories, churches, synagogues, mosques or other facilities;and,2) embalming and/or other preparations of the deceased for burial or cremation.In addition,the funeral service professional that first takes possession of the deceased is also responsible for filing a notification of death within 24 hours and a death certificate within 5 days with the county health department where the death occurred. North Carolina has three license designations for funeral service practitioner:funeral director,embalmer,and funeral service.The practice of funeral service is regulated by the North Carolina Board of Mortuary Science as set forth in North Carolina General Statutes,Article 13A,The Practice of Funeral Service,Chapter 130A Public Health and NC Administrative Code,Title 21, Chapter 34.These laws cover all aspects of the funeral profession, including:NCGS § 90--210.25.(e),which prohibits the moving or embalming of a body when a licensee has information indicating a crime or violence in connection with the cause of death,90-210.45.(a)Cremation procedures, 130A-115.(e) deaths without medical attendance,130A-388.(a)&(b)medical examiner ’s permission needed prior to embalming,burial at sea,or cremation.

Reporting Procedures and Responsibilities

The NC Board of Mortuary Science and relevant general statutes require reports of suspected abuse deaths to be made to local child welfare agencies,local law enforcement,and the medical examiner. Reporting may be made to a local coroner where the office still exists,but,in that event,must also be made to the area ’s medical examiner. In addition to NCGS § 90--210.25,the same statutory reporting requirements apply to funeral service professionals as to any citizen.“If there is reason to suspect the child died from abuse or other maltreatment,the funeral service practitioner must report the case to the director of the Department of Social Services in the county where the child resided or was found as described in NCGS §7B-301 .The Principles and Practice of Embalming ,the standard embalming textbook used in mortuary colleges,also emphasizes the importance of reporting evidence of a crime or violence in connection with a death.The text makes several suggestions with regard to discovery of evidence. Professional Response During the arrangement conference,the funeral service practitio-ner assists the surviving family with determining the type of funeral or memorial services desired and will obtain the statistical information required for the death certificate and information for
an obituary.The funeral practitioner inquires during this time about viewing the body.In the case of infants,the practitioner asks if the parents or family want to actually hold the child. The funeral service provider reports and refers cases of child maltreatment to the appropriate agencies. The other area of response deals with the embalming or other preparation of the deceased for burial or cremation.This may include repairing injuries to allow survivors to view the body.

Duties and Responsibilities

• Funeral directors and embalmers have distinctly different duties. A funeral director is mainly involved with arranging and coordinating the services.The embalmer is involved with the preparation of the body.The funeral service licensee could be involved in one or both areas.The funeral provider may need to respond to a number of different scenarios.For example,in a home death without medical attendance or law enforcement notification, discussions with family may reveal evidence of a possible crime. Injuries to the body inconsistent with the initial stated cause of death may be discovered during embalming or preparation for cremation.
  

• In circumstances of a home death without medical attendance, funeral service providers are required by NCGS § 130A--115(e)to notify the medical examiner and are prohibited from moving the body without permission from the medical examiner .
  

• Report evidence to local law enforcement,child welfare and medical examiner pursuant to NCGS § 90--210.25.

• Refer surviving family members to mental health professionals for counseling.
  

Processes

The funeral home staff:

• facilitates the removal of the body from the place of death or hospital or autopsy facility and sets up a time to meet with the surviving family at first notification of a death.

• determines the type of services (burial or cremation)to be provided by careful and sensitive questioning at the first meeting with family and other survivors.This may be during the first notification,at the place of death,or during the arrangement conference.The type of service requested will determine whether the body is to be embalmed or cremated.
  coordinate arrangements with clergy and/or other participants in funeral or memorial services,and with the cemetery or crematory following the arrangement conference.
  prepare the body for the services.North Carolina law does not require embalming;therefore,written permission is required for embalming and cremation.
  

• determine whether there will be a viewing.Depending on the circumstances of the death,viewing may not be possible.Given the compounded tragedy of a child ’s death due to maltreatment, the opportunity to view is extremely important to survivors.If the injuries are such that restoration and repair are not possible,or are very extensive and noticeable,the funeral practitioner should arrange a meeting to discuss this with the family.The family clergyperson or a mental health professional
  should be briefed on these issues and be present to assist the funeral service practitioner.Privacy and confidentiality can be protected by not divulging the nature of the injuries,but only the way the injuries would effect the survivors upon viewing the body.
  

• assist the family with available service options.For example, there are special caskets available on which family and friends can write,a group of friends could be invited to sit together at the service,or friends and relatives could write notes to be read during the service or given to the family.
  

• consult with the family regarding handling of any media requesting admission to the services.

• consult with family concerning referral to an appropriate mental health professional.Confidentiality and Other Ethical Issues While the funeral service professional is trained to respect the privacy of each family,there are no statutory requirements incumbent on the funeral provider as there are with medical, mental health,or legal professionals.The funeral service professional must carefully separate the contractual and business obligations for confidentiality from obligations to report cases of
  child death due to maltreatment. It should be noted that many funeral homes employ full time and part time staff.Details regarding a death due to child maltreat-
  ment should be limited to the professionally licensed staff and management.
  

A Case History
This example of the role of the funeral service provider occurred in the Goldsboro area around 1984.The funeral service provider involved had over thirty years of licensed experience in the funeral profession.Removal of the child ’s body was from a hospital morgue so the licensee was not privy to all details of the home death scene. Law enforcement was called to the home and told by the family that the victim,a 9 – 10 year old female,choked to death. The medical examiner was contacted and accepted the report by the law enforcement agency.No autopsy was performed and it is not known if the medical examiner viewed the body or made any examination. During and following the embalming process,bruising began to appear on the child ’s body. The licensee immediately contacted the medical examiner and law enforcement.Further investigation resulted in the prosecution of the father for the murder.
Recommendations for Best Practice
Education
Current mortuary science curricula would benefit from more information on recognizing crime,especially as related to child abuse and neglect.
Training and continuing education
The funeral service provider should endeavor to annually update his/her training and education.The N.C.Board of Mortuary Science should encourage programs to offer continuing education courses to assist funeral service providers with the recognition of child abuse and neglect and ensure distribution of the information in this manual.
First call
When initial contact is received by telephone concerning a home death,the funeral service provider should immediately inquire as to the presence of medical attendance or law enforcement. The caller or funeral service provider should make contact with the local law enforcement agency and medical examiner in all cases of a child dying unexpectedly at home.
At the home death scene
If a funeral service provider arrives at the scene of a death without the presence of law enforcement or medical attendance,the funeral service provider should initiate contact with these parties.He or she listens carefully to the circumstances of the death provided by those present.The provider should not disturb the body or the area of the scene or allow them to be disturbed and should make careful observations of the position of the body and area around the body. This may or may not be a crime scene;however,the law enforcement agency will determine this.The funeral service provider should give his or her information and observations to law
enforcement.
Preparation for embalming or cremation
Regardless of the place of death,a careful examination of the body should be conducted,noting the condition of the body and any injuries present on the embalming case report. If the body is to be embalmed, there should be continued observation, again noting any injuries that may appear during and post embalming. As seen in the case history,a release to the funeral home by the medical examiner or law enforcement does not indicate that all evidence has been discovered and collected. Each deceased body should be treated with the utmost dignity and respect and should be covered completely with a sheet,only to expose the area being examined or
where an embalming related procedure is taking place.

Referral of survivors to appropriate helping agencies
Mental Health Professionals

The funeral service professional should be extremely sensitive to the tragedy the survivors are experiencing.This may be compounded if the death was caused by a caregiver.To fully assist survivors,the funeral service provider should develop resources for referral within the local mental health community.

Victim-Witness Program

When a death occurs as a result of a criminal act,the Crime Victims ’ Compensation Program will provide up to $3500 to assist with the funeral expenses.The program may be contacted by calling 1-800-826-6200.

Referral of funeral service practitioner to mental health professionals
During his or her career,the funeral service professional is exposed to all manner of injury and circumstances of death. The death of a child, regardless of circumstances,has an emotional impact on most funeral service professionals.There may be times, especially with a death due to maltreatment, that a funeral
practitioner experiences greater impact. The funeral services professional should be aware of symptoms of posttraumatic stress or other emotional distress. Colleagues and management can also be helpful to monitor any personality changes that may be related to the child abuse and emotional investment made to assist the family.Management should require the employee to obtain the proper treatment.
Media relations
The funeral home should develop a written policy for media relations.Management should decide on a spokesperson for the funeral home.All employees should be aware of the written policy and to whom any media inquiries are to be directed. Confidential-ity standards as described above should be followed. No information on the cause of death should ever be released, especially in cases of child death due to maltreatment.The ideal answer to media or any other inquiries is a firm “no comment.”
Cultural,ethnic,and/or religious concerns
The funeral service provider must have knowledge of and sensitivity to varying cultural,ethnic and religious customs and practices.The mortuary college curriculum offers a brief study; however, the funeral provider should follow through with continuing education to expand his or her knowledge. While these customs may have an effect on several issues with regard to reporting a death due to maltreatment,they should never prohibit reporting as required by North Carolina general statute.Sug-
gested readings are included in the references.

References
Futrell E.Funeral Service Licensee,Goldsboro (NC).Personal Communication,1999 Oct 13. Irish D,Lundquist KF,Nelson VS.Ethnic variations in dying, death and grief:diversity in universality .Bristol (PA):Hemisphere Publishing,Taylor &Francis Group,1993. NC General Statutes § 130A,,13A,The Practice of Funeral Service, and NC Administrative Code,21,Chapter 34. Strub CG,Frederick LG.The principles and practice of embalming . 5th ed.Dallas (TX):Professional Training Schools and Robertine Frederick,1989.[Available from Robertine Frederick,4722 Bronze Way,Dallas,TX 75236 ]