TALES OF THE CRYPT FOR PSYCHIATRISTS - MOURNING, MELANCHOLIA, AND MORTUARY MALPRACTICE

Death awaits all, leaving in its wake relatives and friends affected b y the loss of a loved one. Immediately following death, the funeral pr ocess begins, resulting in permanent burial in a cemetery. This report investigates the dysfunctional interactions between grief-stricken re latives and mortuaries that are associated with civil litigation for n egligence. Psychiatric evaluations of 25 bereaved plaintiffs from nine separate lawsuits were performed. In addition, medical records and le gal pleadings were reviewed as sources of additional information. Gene ral themes from the clinical material are identified and illustrated b y two cases. Surviving relatives are in an acute state of emotional tu rmoil, rendering them exquisitely sensitive to lapses in expected rout ine and perceived disrespect toward the deceased. These issues are int ensified when the circumstances of the death were traumatic, when the relationship with the deceased was ambivalent, when specific cultural and religious factors are present, and when the influence of litigatio n is felt. If the burial process is disrupted, civil suits for neglige nce may be filed that exacerbate grief and challenge the psychiatrist' s efforts to resolve diagnostic ambiguity in the face of emotionally c harged cultural and religious practices.