Bodyworlds and the ethics of using human remains: A preliminary discussion

Bioethics

Volumn 20, Issue 5, 2006, Pages 233-247

  Barilan, Y Michael ^a,b,c  

^a MEIR MEDICAL CENTER   (Israel)

^b Israeli Palestinian Division   (Palestine)

^c TEL AVIV UNIVERSITY   (Israel)

Author keywords

Anatomy; Art and medicine; Bodyworlds (Kropperwelten); Ethics; Human remains; Posthumous interests and rights

Indexed keywords

ACETONE; RESIN;

ANATOMY; ATTITUDE; CADAVER; ETHICS; HUMAN; INFORMED CONSENT; ORGAN DONOR; PLASTINATION; RELIGION; REVIEW;

ANALYTICAL APPROACH; BIOMEDICAL AND BEHAVIORAL RESEARCH; DEATH AND EUTHANASIA; PHILOSOPHICAL APPROACH;

ANATOMY, ARTISTIC; ATTITUDE TO DEATH; CADAVER; COMMODIFICATION; DEHUMANIZATION; DISSECTION; EXHIBITS; EXHIBITS AS TOPIC; HUMAN BODY; HUMANS; INFORMED CONSENT; MORAL OBLIGATIONS; OWNERSHIP; PLASTIC EMBEDDING; TISSUE DONORS;

EID: 23244455717     PISSN: 02699702     EISSN: 14678519     Source Type: Journal    
DOI: 10.1111/j.1467-8519.2006.00500.x     Document Type: Review

References (74)

1. The eighteenth century French artist Honore Fragonand injected a metal alloy into the blood vessels of the corpses of a man and a horse, left the tissue to dry and covered it with varnish. The end product, which is on public display in the National School of Veterinary in Paris, is very much like the plastinized horseman, a combination of desiccated tissue and artificial materials. In 1521 Berengario published an anatomical image of a flailed man clad with a skin of a tiger. R. Herrlinger. 1970. History of medical illustration from antiquity to 1600. Munich. Graham Fulton-Smith: 80.
2. Perhaps this is linked to the fall of the Aztec empire in 1519 since Aztec priests used to wear skin removed from their sacrificial victims, human or animal. It is notable that opponents to Jenner's vaccination also invoked the argument of blurring the boundaries between the human and the animal. R. Porter 2001. Bodies politic: disease, death and doctors in Britain, 1650-1900. London. Reaktion: 217.
3. G. Von Hagens. 2002. Anatomy and Plastination. In Bodyworlds, the anatomical exhibition of real human bodies: catalogue on the exhibition. in G. von Hagens and A. Whalley, eds. Heidelberg. Institut für Plastination: 9-36.
4. K. Vogel. 1999. The transparent man - some comments on the history of a symbol. in Manifesting medicine: bodies and machines. R. Bud and B. Fin and H. Trischler, eds. Amsterdam. Harwood: 31-62.
5. L.B. Nelkin & L.B. Andreas. 1998. Do the dead have interests: policy issues for research after life. Am J Law Med 1998; 24: 261-291.
6. D. Price. From Cosmas and Damian to Van Velzen, the human tissue saga continues. Med Law Rev 2003; 11: 1-47 p. 43.
7. th, 2002. I have no personal information about Bodyworlds' methods of procuring cadavers, a sensitive issue that bears on confidentiality and privacy of both Bodyworlds and its sources.
8. Von Hagens only asserts that he uses donations from (1) the deceased (2) family (3) 'unclaimed bodies' and (4) bodies already in the possession of anatomical institutes, some of which are very old. P. Harris & K. Connolly. The Observer op. cit. p. 30.
9. The laws in many countries refer to the 'closest kin', not indicating how far the search for a blood relation should go. At a deeper level, I wish we had never regarded a human being 'lonely', since a spirit of fraternity should make us claim the unclaimed.
10. st, 1999; 153(21): 33.
11. T. Mulgan. The place of the dead in liberal political society. J Political Phil 1999; 7: 52-70.
12. See also M. Ridge. Giving the dead their due. Ethics 2003; 114: 38-59.
13. Nelkin and Andrews Ethics op. cit.
14. P.D.G. Skegg. Criminal liability for the unauthorized use of corpses for medical education and research. Med Sci Law 1992; 32: 51-54.
15. J. Feinberg. The mistreatment of dead bodies. Hastings Cent Rep 1985; 15(1): 31-37.
16. M.C. Pouchelle. 1990. The body and surgery in the Middle Ages. Oxford. Polity Press.
17. R. Richardson. 1987. Death dissection and the destitute. London. Routledge and Kegan Paul: Ch. 6.
18. M. Roach. 2003. Stiff: the curious lives of human cadavers. New York, Norton: 50.
19. S.M. Shultz. 1992. Body snatching: the robbing of graves for the education of physicians. London. MacFarland & co.
20. M. Sappol. 2001. A traffic of dead bodies: anatomy and embodied Social identity in nineteenth-century America. Princeton. Princeton University Press.
21. J. Bondeson. 2002. Buried alive: the terrifying mystery of our most primal fear. New York. W. W. Norton. Even if it is unlikely that anatomists accidentally cut up people who were still alive, the populace certainly tended to believe in this possibility.
22. Besides, the notion of a 'moment of death' is a cultural construct that does not easily fit with the gradual dying of separate organs. Today biomedical law equates 'brain death' with 'death'. But many people feel differently and accuse transplantation doctors of murdering patients. M. Lock. 2002. Twice dead: organ transplantation and the reinvention of death. Berkeley. University of California Press: ch. 3. I wonder what people and Bodyworlds enthusiasts would say if - having given their consent during their lifetime - brain-dead patients were to be assigned for public display of the circulatory system in action, instead of for harvesting organs for transplantation. Is death a stable concept throughout all domains of our lives?
23. One such situation was possibly obstructed labour. The church fought against embryotomy (destroying the fetus) and cesarean surgery performed on hopeless and dying birthing women. Cesareans were mostly fatal in pre-modern settings. If the surgeons wanted to save lives, they had to make a tough choice: to cut the mother or to cut the baby. Labour was the only setting in which caregivers dissected live patients, often with sacrificial intentions. Elsewhere I dwell on the historical significance of this situation and on how it bears on the formation of medical ethics. Y.M. Barilan. Abortion in Jewish religious law: neighbourly love, imago Dei and the Medieval blood libel. Review of Rabbinic Judaism 2005; 8: 1-34.
24. A. Cunningham. 1997. The anatomical renaissance: the resurrection of the anatomical projects of the ancients. Brookfield, VT. Scholar Press: 147-160.
25. T. Marshal. 1995. Murdering to dissect: grave-robbing, Frankenstein and the anatomy literature. Manchester. Manchester University Press.
26. K.V. Iserson. 2001. Death to dust: what happens to dead bodies? 2nd ed. Tucson. Galen Press: 471-473.
27. M. Ardagh. May we practice endotracheal intubation on the newly dead? J Med Ethics 1997; 23: 289-294.
28. D.G. Benfield et al. 1991. Teaching intubating skills using newly deceased infants. JAMA 1991; 266: 1649-1651.
29. E. Westermarck. 1908. The origin and development of the moral ideas. Vol II. London. MacMillan: ch. 45. Neglect and utilization are often the reality behind an ideology of respect.
30. See, for example, J. Baines and P. Lacovara. Burial of the dead in ancient Egyptian society: respect, formalism, neglect. J Social Archeology 2002; 2: 5-32.
31. D.E. Brown. 1991. Human Universals. New York. McGraw Hill: 139.
32. Only a few societies trash aborted fetuses. G. Devereux. 1951. A study of abortion in primitive societies. New York. International Universities Press: 44.
33. Respona Hatham Sofer, Yoreh Da'a, #336, #353. (Slovekia, early 19th cent.). The same rabbi also employs the metaphor of the sheath.
34. Y.M. Barilan & G. Seigal. 2004. Stem cell research Jewish and Israeli perspectives. in Grenzueberschreitungen. Kulturelle, religioese und politische Differenzen in der Stammzellforschung. edited W. Bender, C. Hauskeller & A. Manzei Munster: Agenda verlag: 293-323.
35. Price, Grenzueberschreitungen. Kulturelle, religioese und politische Differenzen in der Stammzellforschung. op. cit.
36. J. Harris. Organ procurement: dead interests, living needs. J Med Ethics 2003; 29: 130-134.
37. Skegg J Med Ethics op. cit. notes that Common Law does not prohibit such acts.
38. In 1990 a British court convicted an artist and a gallery owner for the public display of earrings made from human fetuses. Whether art is an 'ordinary' business or a privileged public pursuit similar to science and education is a question beyond the scope of this paper. The exhibition of art made from human cadavers is common in contemporary Chinese Art (see Art in America, July, 2001, p. 35
39. and W. Nanming. How to deal with rights - criticism of the violent trend in Chinese contemporary art. Chinese-art.com 2001; 4(2) http://www.chinese-art. com/Contemporary/volumefourissue2/nanming1.htm [Accessed 01 June 2002]). It is notable that von Hagens holds a professorship in a Chinese university and that he produces his plastinized objects in China as well.
40. E. Partridge. Posthumous interests and posthumous respect. Ethics 1981: 91: 243-264.
41. Feinberg 1984. Harm to others. Oxford: Oxford University Press.
42. B. Baum Levenbook. Harming someone after his death. 1984; Ethics 94: 407-419.
43. T.M. Wilkinson. Last rights: the ethics of research on the dead. J Applied Phil 2002; 19: 31-41.
44. Von Hagens, J Applied Phil op. cit. p. 34.
45. D.G. Jones. Reinventing anatomy: the impact of plastination on how we see the human body. Clin Anat 2002; 15: 436-440.
46. C.F.A. Marmoy. The 'Auto-Icon' of Jeremy Bentham at University College London. Med Hist 1958; 2: 77-86. From a Bethamian point of view, the College should trash his auto-icon when the costs of its upkeep exceed benefits. I wonder whether such an act is respectful or disrespectful of his memory, ideology and personal wishes.
47. Von Hagens, Med Hist op. cit.
48. K. Park. The life of the corpse: division and dissection in Late Medieval Europe. J Hist Med Allied Sci 1995; 50: 111-132.
49. Roach J Hist Med Allied Sci op. cit. ch. 3.
50. S. Lindenbaum. 1979. Kuru society: disease and danger in New Guinea Highlands. Palo Alto, Ca. Mayfield.
51. J. Sawday. 1995. The body emblazoned: dissection and the human body in Renaissance culture. London: Routledge.
52. A. Carlino 1999. Books of the body: anatomical ritual and Renaissance learning. Chicago. University of Chicago Press:188ff.
53. The ethics of anatomical museums is far from innocent. As a matter of fact, some museums exhibit human remains against the explicit wishes of their late persons. C. Fforde. The Royal College of Surgeons of England: a brief history of its collection and a catalogue of some current holdings. World Archeology Bulletin 1992; 6: 22-25.
54. Body parts of victims of the holocaust are still in use by some anatomy laboratories. K. Holubar. The Pernkopf story: the Austrian perspective of 1998, 60 years after it all began. Perspect Biol Med 2000; 43: 382-388.
55. The 'Irish Giant', Charles O'Brien (d. 1783), made special efforts to protect his body from the anatomists. John Hunter bribed the undertakers, took the body and put the skeleton in his collection, where it is still on display. Historian and bioethicist Alice Dreger has recently campaigned for the burial of the Irish Giant. A.D. Dreger. 2004. One of us: conjoined twins and the future of normal. Cambridge, MA. Harvard University Press: ch. 4.
56. Hunter unabashedly belabored his own 'ethos' of anatomy in his voluminous diaries. S.T. Asma. 2001. Stuffed animals and pickled heads. Oxford. Oxford University Press: ch. 2.
57. Admittedly, Bodyworlds appropriates quite a lot from the heritage of the Christian West and its unique cultures of relic veneration and scientific anatomy. The Christian West broke away from taboos of purity and impurity. All aspects of earthly material existence were regarded as a whole. The veneration of the life of Jesus encompasses birth, masculinity, suffering and even the death of his human body. The Christian dead are buried inside churches and human remains of saints, relics, are placed under the altars and displayed for veneration on high holidays. Renaissance art regarded the natural yet idealized human body as the most accurate visual manifestation of the imago dei. Sawday, Stuffed animals and pickled heads. op. cit. p. 96.
58. The notion of the idealized human body parallels the anatomists' search for the canonical human body from the times of Vesalius. N.G. Siraisi. Vesalius and human diversity in De Humani Corporis Fabrica. J Warbourg Courtauld Inst 1994; 57: 60-88: 68. up to the 'visible human project' sponsored lately by the NIH (http://www.nlm.nih.gov/research/visible/visible_human.html [Accessed 9th June 2006]).
59. The life-like corpse of Renaissance anatomy also expresses a 'resistance to death' and a yearning for immortality and eternity J. Elkins. 1999. Pictures of the Body. Berkeley. University of California Press: 134.
60. In opposition to the now widely accepted pathological tradition, Vesalius and other anatomists believed it was possible to understand the human body only when reconstructed so as to mimic the ways in which it is animated by the soul. G. Harcourt. Andreas Vesalius and the anatomy of antique sculpture. Representations 1987; 17: 28-61.
61. The life like corpse was instrumental in helping doctors understand the workings of the human body as a living whole. J.S. Ackerman. 1991. Early Renaissance naturalism and scientific illustration in Distance points. Cambridge, Cambridge University Press.
62. Hunter's brother, William, also laid the foundations of fusing art and anatomy for the sake of holistic clinical thinking that reaches beyond the scope of concrete findings M. Kemp and M. Wallace 2000. Spectacular Bodies: The Art and Science of The Human Body from Leonardo to Now. London, Hayward Gallery: 44.
63. G. Dworkin. 1988. The theory and practice of autonomy. Cambridge, UK. Cambridge University Press: 90-99.
64. Possibly Melville's Bartleby the scrivener, is a living character to whom there are no formal duties. D. Meindl. 1996. American fiction and the metaphysics of the grotesque. Columbia, MO. Missouri University Press: CH. 3.
65. Worshippers of relics use dead body parts in the sense that the relics are trafficked according to perceived needs for supernatural protection and benediction. The cult of the relics, however, intends to benefit from a piece from the body as part and parcel of venerating the person and his values. It does not entail the non-personal consumption of otherwise useless tissues.
66. S. Levine. 2000. The anatomy of anatomy in images and words. New York. Third Rail Press: 124.
67. The universality is at the social and cultural levels. Among the billions of people alive, there are possibly some who feel and behave differently.
68. Y.M. Barilan. Speciesism as a precondition to justice. Politics Life Sciences 2004; 23: 22-33.
69. Von Hagens, Politics Life Sciences op. cit. p. 34.
70. D. Singh. Scientist or showman? BMJ 2003; 326: 468.
71. A. Giddens. 1991. Modernity and self identity. Cambridge, UK. Polity Press: 47.
72. G. Ferrari, 'Public anatomy lessons and the carnival: the anatomy theatre of Bologna' Past Present 2004; 117: 50-106.
73. Y.M. Barilan. The story of the body and the story of the person: towards an ethics of representing human bodies and body parts. Medicine Heathcare and Philosophy 2005; 8: 193-205.
74. Y.M. Barilan. Contemporary art and the ethics of anatomy. Perspect Biol Med 2007; 50: 1.