Dental radiography is perhaps one of the most accurate sub-divisions of the field, because dentition is more likely to survive fire, bombings, flooding and a number of other elements part of mass fatalities, because dental enamel is one of the hardest surfaces in the body. Comparison radiography concerning dentition is 93% effective in identification in these areas (Walsh et al, 2004). The purpose of this paper is to look at the role of forensic dental radiography in investigations following mass fatalities, by examining the role of the radiographer in such investigations and how dentition can be used in a number of ways. The paper will also look at some of the moral and legal issues facing forensic radiographers (including dental specialists) when it comes to dealing with mass fatalities, and some of the ways around these problems. Current UK protocol and the legal and moral issues surrounding forensic medicine (including radiography) is also examined to further highlight some of the problems and limitations to these methods. This first section will outline some of the major definitions needed to tackle this problem. The literature review will systematically investigate each area identified in the aims, and the conclusion will bring together all the information to fully answer the question.
1.1 What is Forensic Radiography? Forensic medicine is recognised as the field of science which uses medical facts and knowledge to solve legal problems. Historically the ancient Egyptians were the first to apply medical knowledge to legal issues. Early civilisations understood the need to have an understanding of medic al knowledge to answer certain questions such as the age of a foetus, use of poisons, virginity and sterility, prognosis of wounds and cause of death. In the sixteenth century, new codes and laws were introduced which required testimonies from medical experts; this lead to forensic medicine becoming recognised as a separate discipline (Brogden et al, 1998). With the discovery of x-rays and their utilisation for medical imaging purposes, modern medicine has come a long way from the traditional methods of ascertaining causes of injury and death. ‘Forensic Radiography is the application of the science of diagnostic imaging to questions of law’ (International Association of Forensic Radiographers. IAFR 2008) and this information can be used in a multitude of ways. Traditionally, the cause of death is determined by surgical autopsy. This is invasive and results in evidence being destroyed or contaminated, and is particularly troublesome when the deceased has religious or personal preferences that require non-invasive techniques (Brogdon, 1998). The advancement of technology has meant that we are now able to perform virtual autopsies using CT, fluoroscopy, ultrasound and MRI, as well as gaining important information from the more traditional X-ray (Brogdon, 1998). These are better suited as cultural sensitivities and ethical issues are not raised due to what some might say is desecration of the deceased (G Rutty et al, 2007). 1.2 The purposes of Forensic Radiography Forensic Radiography can be used to: • Determine the mechanism of injury or death. • Locate foreign bodies e.g. bullets, fragments of glass, and shrapnel. These may also be useful in identification of individuals, particularly in the case of dental metallic fragments present in the ante-mortem state. • Gather evidence for court. In cases of a crime scene, post mortem examinations are performed with the assumption of a criminal prosecution. (C Milroy 2005) • Identify the deceased by comparing ante-mortem and