Disposal of unclaimed remains in Chinese medical institutions: power-responsibility conflicts, standardization deficits, and legal regulation.

Background: The disposal of unclaimed remains is an interdisciplinary governance issue at the intersection of public health security and funeral governance in China, involving health, public security, civil affairs and finance authorities. Medical institutions, as the frontline implementers of temporary storage, death-information verification and custody handover, bear obligations that are not matched by corresponding administrative authority. This study addresses three questions: what legal and procedural norms govern the disposal of unclaimed remains in Chinese medical institutions; why power-responsibility conflicts arise and persist; and how they can be resolved through legal regulation. Methods: A triangulated qualitative design was adopted. First, national laws and administrative regulations (including the Regulations on Funeral and Interment Administration, as revised in 2025, and the Civil Code) and eight local administrative measures were analyzed through structured policy-text coding. Second, documented disposal cases and public statistics from media investigations and field-research reports (2001-2025) were examined. Third, institutional rules across regions were compared along five dimensions: publicity cycle, storage time limit, ash retention period, financial guarantee and departmental responsibility allocation. Results: Four structural problems were identified: (1) fragmented legal norms with substantial provincial variation and no unified national implementation standards; (2) nominal cross-departmental collaboration without enforceable linkage mechanisms; (3) a severe power-responsibility imbalance that shifts storage costs, public health exposure and legal liability onto medical institutions; and (4) inconsistent judicial adjudication of disposal disputes. These problems are explained as the outcome of uneven standardization in China's funeral governance, in which local standards proliferate while universal, enforceable national standards remain absent. Conclusion: The 2025 revision of the Regulations on Funeral and Interment Administration provides a window for institutional reform. We propose five integrated strategies - unified national standards, a multi-departmental collaborative mechanism, dedicated public funding, judicial guidelines and hospital-level internal control - and conclude that legal regulation of unclaimed-remains disposal should be understood as a standardization project that balances public health security, deceased dignity and institutional equity.