A transdisciplinary integrated approach to improve identification outcomes for decomposed decedents in medicolegal death investigations.

Introduction: Successful identification of unidentified decedents is a priority to address the global burden and health crisis created by such deaths. A newly developed transdisciplinary and integrative approach is presented as a protocol. The aim is to facilitate forensic leads for medico-legal death investigations that utilize external expertise to provide additional information as an act of re-humanization of the decedent. Methods and analysis: There are three critical phases to the protocol. This transdisciplinary research approach in sensitive medicolegal environments requires, first, establishment of a robust ethical framework (implementation of permissions, contracts, and ethics) to maintain evidentiary integrity and protect those involved. It also needs to facilitate dissemination of the generated facial depictions to the public to enable investigative leads. Second, it requires the identification of useful and available scientific analyses and establishment of the multi-disciplinary team. These include a medicolegal death investigation and a forensic pathology postmortem record review inclusive of forensic contextual and case data information (such as unique identifiers and personal belongings), radiographic analyses, osteobiography anthropological assessment, conventional and specialized forensic genetic analyses, and possibly stable isotope analyses to provide a richer picture and understanding of the person. Third, these multifactorial data need to be integrated into a narrative, including facial reconstruction and depiction to elicit memory and identification via public appeals for information on unresolved cases. Should an investigative lead be followed, and a possible forensic identification established, conventional methods to confirm identity can be applied (e.g. DNA profiling). While it is the first time this approach has been applied in an African context, this protocol can be replicated and adapted for other regions to improve medicolegal death investigations, Ultimately, facilitating and improving identification can provide social justice and familial closure.