impact that mass fatality disasters bring on U.S. cities large and small. The recent H1N1 outbreak, with its 1918 predecessor, the Great Pandemic Influenza, created a 21st century reminder of the potential catastrophic impact an influenza pandemic could have on the nation and across the world. These pivotal events, and the anticipation of what may come, require emergency managers, public health preparedness planners, and elected officials to assess what has been accomplished in our national efforts to plan for and respond to mass fatality incidents and to prioritize the development of a comprehensive and coordinated approach to address such incidents in the future.

This country’s modern-day efforts to address and respond to the potential impact of mass fatality incidents began in the 1980s, when a committee was formed within the National Funeral Director’s Association to address disaster situations and, more specifically, incidents involving simultaneous multiple deaths. A multifaceted nonprofit organization was eventually formed by this committee to support the concept of a national-level response protocol for all related professions. Led by Tom Shepherdson, the Disaster Mortuary Operational Response Team (DMORT) gained federal recognition in 1992 and became incorporated into the federal disaster response system within the National Disaster Medical System. This initiative resulted in the formation of 10 DMORTs representing each federal region of the country. Two specialty teams—the Weapons of Mass Destruction Team and the Family Assistance Core Team—were added later.

While the early years of mass fatalities planning and response focused essentially on the identification and release of decedents, this focus has greatly broadened in light of our country’s experience with such events. The Department of Homeland Security’s Target Capabilities List (2007) defines fatalities management as “…the capacity to effectively perform scene documentation, the complete collection and recovery of the dead, victim’s personal effects and items of evidence; decontamination of remains and personal effects (if required); transportation, storage, documentation, and recovery of forensic and physical evidence; determination of the nature and extent of injury; identification of the fatalities using scientific means; certification of the cause and manner of death; processing and returning of human remains and personal effects of the victims to the legally authorized person(s) (if possible); and interaction with and provision of legal, customary, compassionate, and culturally competent required services to the families of the deceased within the context of the family assistance center.” 1 This expanded way of thinking



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