Project COVID-19: Cremation or Burial

Between Medical Precaution and Religious/Cultural Rights
for Performing the Postmortem in the Time of COVID-19
Pandemic
Sriprapha Petcharamesree
Institute of Human Rights and Peace Studies, Mahidol University in Thailand

The coronavirus (COVID-19 pandemic) has brought disruption to the everyday life of
human beings around the globe. The virus spread indiscriminately regardless of color, race,
age, religion, gender, region, or any other social status. The situation of postmortem has
posed questions for how to deal with the bodies of COVID-19 victims; how to balance
between medical precaution of health risks and performing religious/cultural rights for thedeceased and the family; whether government authorities, supposedly having duties topromote and protect human rights, restricting the right to decent postmortem culturalrights practice constitute human rights violations? The paper aims to address all questions
brought forward. The paper concludes that where the division between private and publicmatters is no longer clear, where the government intervenes with this tradition using healthand safety as reasons, human rights violations cannot be avoided. In all cases, rightprinciples should prevail.

1. Introduction
As of 29 January 2021, the WHO reported 101,053,721 confirmed cases of COVID-19,
including 2,182,867 deaths.1 The pandemic which started in early 2020 in one place has
been spreading indiscriminately throughout the globe. It was predicted that, despite thedevelopment of a COVID-19 vaccine and practice of vaccination in some countries, thenumber of deaths will rise on a daily basis, at least for the next few months. The
coronavirus pandemic has brought disruption and uncertainty to everyday human life. It
is a new infection that is not sparing anyone on the basis of color, race, age, region, gender,social status, religion, or any other discriminatory factor. 2 This situation has posed anumber of questions: how to deal with the dead bodies of the victims who die due to this1

Project COVID-19: Cremation or Burial

infection?; will it spread to living people through the affected ones’ dead bodies?; how tobalance between medical precaution and religious/cultural rights in performing thepostmortem during the COVID-19 pandemic for the deceased and the family?; whether
government authorities, supposedly having duties to promote and protect human rights,
have authority to restrict the right to decent postmortem cultural rights and if such apractice constitutes human rights violations? This paper aims to address all questions
brought forward. Concepts of human rights will be clarified through cases from different
countries, examined as part of the discussions.

2. Human Rights in the Time of COVID-19
The UN human rights bodies are among the first to remind States that human rights are to
be respected and protected even during a pandemic.3 The Council of Europe may be themost vocal to reiterate to governments that human rights must be respected and democracy
and the rule of law, which constitute the three founding pillars of the Council, must be
upheld during the COVID-19 crisis. “The virus is destroying many lives and much else ofwhat is very dear to us. We should not let it destroy our core values and free societies,”
said the Secretary-General of the Council of Europe.4 The Council issued a Toolkit, which,among others, emphasizes the protection of fundamental human rights standards including
freedom of expression, privacy and data protection, protection of vulnerable groups fromdiscrimination, and the right to education.5 In fact, due to various measures introduced by
States, including the imposition of emergency law, we witness deterioration of rights,
including rights to freedoms, the right to education, the right to health care of some groupsof peoples, as well as cultural rights and the right to freedom of cultural beliefs andpractices. However, most discussions on rights during the pandemic focus mainly on therights of living human beings not the deceased and families.
In April 2020, the UN Committee on Economic, Social and Cultural Rights issued aStatement on the coronavirus pandemic and economic, social, and cultural rights statingthat “the COVID-19 crisis poses a structural challenge to human rights that goes beyond
the increased risk to certain rights, in this case above all the right to life and health. They
are linked to the abuse of power in the name of the fight against the pandemic and to thelimited access to justice.”6 Such a Statement, although silent to address cultural rights
issues of the deceased and the families, is important as it guards against the ‘abuse of
power by the state’. Another document produced by the United Nations also issued in2

Sriprapha Petcharamesree: Between Medical Precaution and Religious/Cultural Rights

April 2020 put the spotlight on three rights considered as at the frontline in the time ofpandemic, including the right to life and duty to protect life, the right to health and accessto health care, and the central challenge to freedom of movement.7 As protecting the rightto life is the priority, everywhere restrictions are imposed including the organization of
ceremonies of the deaths for fear that disease could be contacted from the dead bodies.

3. Restrictions and Rights in Performing the Cultural Rights ofPostmortem
On 24 March 2020, the World Health Organization (WHO) released its guideline on“Infection Prevention and Control for the safe management of a dead body in the context
of COVID-19.”8 The guidelines offer recommendations on the ‘safe and dignified burial
procedures of deceased persons’ with suspected or confirmed COVID-19. These include,
among others: (1) the lack of evidence of human transmission to subjects having become
infected from exposure to the bodies of persons who died with/from COVID-19; (2) the
option for decedents with confirmed or suspected COVID-19 to be buried or cremated;(3) respect of customs, with family's chance to view the body after it has been preparedfor burials, using standard precautions at all times including hand hygiene; (4) bodywrapping in cloth and deceased transfer as soon as possible to the mortuary area.9 How
do some countries deal with the bodies of persons who died or suspected to die with/from
COVID-19?

4. Case Studies
Italy
On 9 March 2020, Italy passed the Prime Minister's Decree n. 648, establishingurgent measures to contain the transmission of COVID-19 and prevent biologicalhazards, including very restrictive interventions on public Holy Masses andfunerals. Italy banned burial procedures based (i) on the recent acknowledgment
about the virus environmental stability as well as (ii) its national civil
contingency plan. Hence, only the cremation process is admitted for COVID-19
deaths. Viewing of the body is permitted only for mourners, which are allowed toperform the prayer at the closing of the coffin and the prayer at the tomb (cf. Rite

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Project COVID-19: Cremation or Burialof Succession, first part n. 3 and n. 5). The dead cannot be buried in their personal
clothes; however, priests have been authorized to put the family clothes on top of
the corpse, as if they were dressed. Burying personal items is also illegal.10
Due to a very high number of deaths in Italy, the government adopted the highest level of
precaution. Strict measures that entail restrictions on freedoms, including freedom of
movement and association inevitably affect the right to decent burials which can be
distressing for families as funeral gatherings were not permitted and family members were
either denied to participate at the burial as they themselves were, most of time, underquarantine; visiting to the body was equally forbidden.11 In addition, since burial which
is a cultural and religious practice in Italy is banned, only the cremation process was
permitted for COVID-19 deaths. In order to minimize delays between time of death andcremation, deceased were taken straight to the cemetery where a brief rite of burial wascelebrated. The time frame set by law from the death to the burial was up to 48 h. However,
due to the unprecedented number of deaths, certain areas experienced a 30 minutes
turnover procedure because of the pressure created by the number of corpses.12
Sri Lanka
Sri Lanka is the country with largest population of adherents to Theravada Buddhism,
which is the official religion, while Islam is a minority religion in the country. Sri Lanka
is now facing the second wave of the virus and the Sri Lankan government has intensified
its crackdown on Sri Lankan Muslims by forcing larger numbers of families into thecremation of their dead relatives. In fact, soon after the outbreak of COVID-19, the Sri
Lankan government issued, on 31 March 2020, the fourth amendment of the Provisional
Clinical Practice Guidelines on COVID-19 suspected and confirmed patients. The
decision to make cremation mandatory followed alleged expert advice, including by thechief epidemiologist who claimed that burials could contaminate ground drinking water.13
As of 21 January 2021, 274 COVID-19 related deaths have been reported in Sri Lanka,
with a significant number of the deaths belonging to Muslim minorities.14 Information
indicates “that cremation often takes place immediately upon the notification of the test
results without granting family members reasonable time or the opportunity to cross checkor receive the final test results. There have been several cases of cremations based onerroneous information about COVID-19 test results.”15 In Islam, it is important that oncea person dies, they are buried as part of their religious obligations. As a matter of fact, not4

Sriprapha Petcharamesree: Between Medical Precaution and Religious/Cultural Rights

only Muslims but also Christians, and even a section of the majority Sinhala-Buddhist
community bury their dead; however, there is no hard and fast rule among them, as is thecase with the other two religious denominations.16
Indonesia
Indonesia hosts the largest Muslim population in the world with almost 90% of the
population adhering to Islam. Among ASEAN Member States and Southeast Asia,
Indonesia also has the highest number of COVID-19 infections and death toll in the region.
Since the outbreak of the pandemic, there have been clashes between the relatives of thedeceased and health personnel over the dead bodies. The country finds itself at odds with
protocols put in place by the government to handle the bodies of victims of the pandemic.
This has led to increasing incidents of bodies being taken from hospitals, rejection of
COVID-19 health and safety procedures. The most publicized case is that of Muhammad
Yunus, the 49-year-old Islamic preacher, whose cadaver was taken away less than 30
minutes after his death by force by over 150 people from a hospital in eastern Indonesia
who thought it was impossible that he could have died from the coronavirus.17 He had
always washed his hands, worn a mask, and followed health protocols issued by thegovernment. After his death, his followers were determined to retrieve his body for what
they considered a proper Muslim burial, saying, “What we have done is noble in God’seyes, but despicable in the eyes of the law.” 18 There have been reports of bodies ofcoronavirus victims stolen in places across Indonesia.19
In Islamic rituals which are commonplace in Indonesia, when someone dies, religion
dictates that those practicing must usually bury their dead within 24 hours, with the bodies
interred without a casket so they can lie on their right side facing the holy city of Mecca.
Before the burial, the body is washed by family with soap and scented water, then wrappedin a seamless cloth that is tied at the head and feet. Cremation and embalming are
forbidden. A wake is usually not held because prayers for the forgiveness of the dead aresaid at the gravesite.20 But with corpses of coronavirus victims thought to possibly becontagious, government protocols for handling bodies have meant that rituals typically
performed by families have fallen on the shoulders of those handling the country’s dead.
While graves are dug, families must keep their distance, preventing them from performing
burial rituals.21

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5. Conclusions: Human Rights Dimensions of Handling the Deaths
Victims of COVID-19
On 25 January 2021, a group of the UN experts on human rights issued a joint statement
urging the Sri Lankan Government to end its policy of forced cremation of the COVID19 deceased as it ran contrary to the beliefs of Muslims and other minorities in the country,
and could foment existing prejudices, intolerance, and violence. 22 The UN experts
confirm that “While we must be alert to the serious public health challenges posed by the
pandemic, COVID-19 measures must respect and protect the dignity of the dead, theircultural and religious traditions or beliefs, and their families throughout.” 23 The
statement makes it clear that the imposition of cremation as the only option for handlingthe bodies confirmed or suspected of COVID-19 amounts to a human rights violation.24
This also infers that the practice as imposed in Italy is also incompatible with human rights
principles. In many cases, where issues of religious minorities are there, the practiceamounts to violations of the right of religious minorities to carry out “the final rites”
according to their own traditions.
Right to freedom of thought, conscience, and religion and beliefs is recognized by
Article 18 of the International Covenant on Civil and Political Rights,25 whilst culturalright is enshrined by the International Covenant on Economic, Social and Cultural Rights
in its Article 15 which prescribes obligation of the state to recognize the right of everyone
to take part in cultural life. 26 In addition, the Declaration on the Rights of Persons
Belonging to National or Ethnic, Religious and Linguistic Minorities27 recognizes in its
Article 2 that these peoples have the right to enjoy their own culture, to profess andpractice their own religion…, in private and in public, freely and without interference or
any form of discrimination. They also have rights to participate effectively in cultural,religious, social, economic, and public life.
Whilst the WHO recognizes that there is no clear evidence of persons having become
infected from exposure to the bodies of persons who died from COVID-19, as alreadymentioned, the interim guidance issued on 24 March 2020 states that the safety and wellbeing of everyone who tends to bodies should be the first priority. It further emphasizes,
though, that “it is a common myth that persons who have died of a communicable disease
should be cremated, but this is not true. Cremation is a matter of cultural choice andavailable resources.”28 The guidance further prescribes that the dignity of the dead, theircultural and religious traditions, and their families should be respected and protected
throughout; and that authorities should manage each situation on a case-by-case basis,

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Sriprapha Petcharamesree: Between Medical Precaution and Religious/Cultural Rights

balancing the rights of the family, the need to investigate the cause of death, and the risksof exposure to infection.29
While rituals regarding death have traditionally been a private matter in most if not all
countries around the globe, the pandemic has caused the government to intervene with thistradition using health and safety as reasons. The division between private and public is nolonger clear. There is an intrinsic link between the measures and the fight against the
pandemic and various intrusive measures in the lives and rights of the population. But theright principles prevail as stated by the WHO, in the sense that the dignity of the dead,their cultural and religious traditions, and their families should be always respected andprotected. The three cases in Italy, Sri Lanka, and Indonesia reveal the fragility not onlyof life but also of rights of human beings under “enforced isolation and the painfuldeprivation of families to accompany their loved ones to the last farewell.”30

Notes
1WHO, WHO Coronavirus Disease (COVID-19) Dashboard, 29 January 2021, https://covi
d19.who.int/?gclid=CjwKCAiAgc-ABhA7EiwAjev-jys8R7kSbmXjqUurYc3vP09RYXloILmH
mIjiMAszPpNTq8GlpkdJiRoCssYQAvD_BwE [accessed 30 January 2021].
2
Shahzadi Zain, Mulazim Hussain Bukhari, and Khalid Mahmood, Medical and Cultural Ethics
for Deceased with COVID-19 for Performing the Postmortem or Religious Rituals and Burial
in any Graveyard, Biomedica, Vol 36, COVID19-S2,2020, https://www.researchgate.net/p
ublication/342819655_Medical_and_Cultural_Ethics_for_Deceased_with_COVID-19_for_Per
forming_the_Postmortem_or_Religious_Rituals_and_Burial_in_any_Graveyard, [accessed 26
January 2021].
3
See Statement made by the UN ESCRs Committee, n.6.
4Council of Europe, Directorate General Human Rights and Rule of Law, Coronavirus: guidance
to governments on respecting human rights, democracy and the rule of law, 4 August 2020,
https://www.coe.int/en/web/human-rights-rule-of-law/-/coronavirus-guidance-to-governmentson-respecting-human-rights-democracy-and-the-rule-of-law, [accessed 26 January 2021]
5
Ibid.
6
Global Campus of Human Rights, COVID-19 and Economic, Social and Cultural Rights, posted
on 30 June 2020, https://gchumanrights.org/preparedness/article-on/covid-19-and-economicsocial-and-cultural-rights.html, [accessed 26 January 2021].
7
United Nations, COVID-19 and Human Rights: We are all in this together, April 2020,
https://www.un.org/victimsofterrorism/sites/www.un.org.victimsofterrorism/files/un_-_human_rights_and_covid_april_2020.pdf, [accessed 26 January 2021].
8
WHO, Infection Prevention and Control for Dead Body Management in the Context of COVID19: Interim Guidance cited by Silvia Ussai et al, Hazard Prevention, Death and Dignity During
COVID-19 Pandemic in Italy, Front. Public Health, 18 September 2020, https://www.fro
ntiersin.org/articles/10.3389/fpubh.2020.00509/full, [accessed 28 January 2021].

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10

11
12
13

14
15
16

17

18
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20
21
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26

27

28

29
30

Ibid.
Silvia Ussai et al, Hazard Prevention, Death and Dignity During COVID-19 Pandemic in
Italy, Front. Public Health, 18 September 2020, https://www.frontiersin.org/articles/10.338
9/fpubh.2020.00509/full, [accessed 28 January 2021].
Ibid.
Ibid.
OHCHR, Sri Lanka: Compulsory cremation of COVID-19 bodies cannot continue, say
UN experts, https://www.ohchr.org/EN/NewsEvents/Pages/DisplayNews.aspx?NewsID=2668
6&LangID=E,25 January 2021, [accessed 28 January 2021].
Ibid.
Ibid.
N Sathiya Morrthy, Maldives: Discourse over burying Sri Lankan Covid dead turns Islamic, in
Observer Research Foundation, 20 December 2020, https://www.orfonline.org/expertspeak/maldives-discourse-burying-sri-lankan-covid-dead-turns-islamic/, [accessed 28 January2021].
Niniek Karmini and Victoria Milko, Burial traditions clash with coronavirus safety in Indonesia,
AP News, 9 July 2020, https://apnews.com/article/22764fc02d1974e78c844605a5170df1,[accessed 29 January 2021].
Ibid.
Ibid.
Ibid.
Ibid.
OHCHR, Op cit.
Ibid.
Ibid.
OHCHR, International Covenant on Civil and Political Rights, https://www.ohchr.org/EN/ProfessionalInterest/Pages/CCPR.aspx [ accessed 29 January 2021].
OHCHR, International Covenant on Economic, Social and Cultural Rights, https://www.
ohchr.org/EN/ProfessionalInterest/Pages/CESCR.aspx [ accessed 29 January 2021].
Refworld, Declaration on the Rights of Persons Belonging to National or Ethnic, Religious and
Linguistic Minorities , https://www.refworld.org/docid/3ae6b38d0.html [ accessed 29 January2021].
WHO, Infection Prevention and Control for the safe management of a dead bodyin the context
of COVID-19, 24 March 2020, https://apps.who.int/iris/bitstream/handle/10665/331538/WHOCOVID-19-lPC_DBMgmt-2020.1-eng.pdf, [accessed 29 January 2021].
Ibid.
Silvia Ussai et al, Op cit.

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