Dignity In Death

Dignity In Death

"Say you want to leave your body to us, we may get it almost straight away, within a couple of months, or we may wait several decades for it” says the friendly operator at the anatomy museum on Tuesday morning.

Chris Smith is responsible for the operation, maintenance, and guided tours of the museum. He shows me around– the plaster casts of bodies, the delicate membranes encasing a bottled digestive system, and a plastinated female torso. He lifts off the front of her abdomen to show me how the guts fit inside, and explains how they squash up during pregnancy in answer to my question of whether your organs can move around inside you. I’m agog at this ex-person. Is it a “she” or an “it”? How can he just touch her like that? Why have they chosen to leave the body hair on her? How long will she be around for?

Chris kindly shows me into the dissecting room. 32 body bags are lying on tables in the meticulously clean, tidy, brightly-lit space. There is a distinct but not overwhelming odour. It’s different to what I thought it would be – neither chemical nor fleshy, more of a sour smell. An old smell. I wonder what the people inside the bags look like after half a year of dissection. We exchanged some hushed words about the careful respect with which the students treat the cadavers. Many choose to reassemble the bodies they have dissected before they go to be cremated after a year on the students’ slabs. Overhead speakers play The Red Hot Chilli Peppers.

“If I wanted to examine your body after you died, of course the quicker I could get it the better” says the delightful old anatomist to me on Tuesday over coffee. “Nice and fresh, and then I could do whatever I wanted with it quickly, you know.”

But he may not be able to get my body as fresh as he would want it. “You would have to act in some pretty unethical ways to get it that quickly. Whereas, if someone has donated their body, you get it pretty quickly and there are limits. But sometimes you’ve got to accept it will not be ideal.” Scientists who use human tissue are aware of the tension between sourcing ideal material to do the research they would like to and the necessary ethical constraints around doing that.

Emeritus Professor D. Gareth Jones is an anatomist, neuroscientist, and bioethicist. He spoke to me about the “bleak and questionable past” of anatomists, particularly in the eighteenth and nineteenth centuries. He has devoted a lot of effort to improve the relationship between anatomists and the communities they rely on for bequeathed bodies.  As an anatomist, he says, “One of the things that you realise is that you are doing things to bodies which no one else can do in this society.” He gives the example of an ordinary person keeping a dead body at home for a long time, and even cutting them up. “Now, we look upon that as being deeply pathological and not the sort of thing normal people will do. But when you think about what happens in an anatomy department, in the dissecting room, you are doing these sorts of things –things that are not allowed to be done by anyone else within the society at large. You can only do this because of the goodwill of that society.”

Gareth has worked passionately to encourage anatomists around the world to cultivate a trusted relationship with the people in their community. He told me about the yearly thanksgiving ceremony put on by Otago medical students to honour the donors whose bodies they work with, the work of anatomists and biological anthropologists to deal with ancient remains respectfully, and the ethical conundrums surrounding some of the older specimens in the anatomy and pathology museums. Gareth is strongly opposed to the use of unclaimed bodies in anatomy departments, a practise that still exists in some countries. “Obviously that person has never given his or her consent for their body to be used in this way.”

Plastination is a fairly new process in preserving animal tissue, and has presented bioethicists with a new set of ethical concerns. In 1977, pathologist Gunther von Hagens developed the technique of replacing water and fat in animal tissue with certain plastics, creating specimens that can be touched, do not smell or decay, and retain most properties of the original sample. Gareth and his co-author Maja I. Whitaker explain how plastinated human specimens are far superior to anatomical models “because they illustrate real human material with its considerable anatomical variability mirroring what is found in the more traditional dissecting room.” The plastinates are virtually indestructible, a quality von Hagens believes is a form of immortality for his donors.

Von Hagens has perfected his techniques and used them to create whole human plastinates for public display in what he calls the “democratisation of anatomy.” In his infamous Body Worlds exhibitions, plastinated people are posed to resemble athletes: a basketball player, a ballet dancer, and a gymnast to name a few. Some of the more controversial exhibits portray plastinates having sex, a pregnant woman reclining placidly with her abdomen gaping open to reveal a foetus, and various whimsical scenes of plastinates playing games or instruments. The exhibits show off, as Gareth and his co-author write, “skill of a level that cannot truly be appreciated by those without dissecting experience.”  But some anatomists find the displays distasteful, and even unethical, as they push the limits of what is educational anatomy into the realm of sensational, shocking entertainment.

Gareth is one of these anatomists. He is struck by the way the plastinated people are shown as though they are alive, when “they’re as dead as anyone. They’re shown with serene looks on their faces. They seem almost happy, enjoying themselves.” The ballerina, he says, was almost certainly not a ballerina when she was alive. In fact most of the corpses used would have been very old people, made to look young. Actual anatomical information on the plastinates is scant and a minor part of why most people would go to see the exhibitions. “There’s this entertainment element to it, which is not necessarily bad, and I suppose we like to be entertained by a lot of things, and we can learn from them, but a lot of people feel uneasy about the actual tension here.”

Why do we care so much about what happens to our dead bodies, and the remains of other humans? Why does human dignity continue to be important after we have died, when our bodies are, technically, inanimate objects?

 “So if you died and you’d said “I want you to do x and y to my body”” says the enthusiastic bioethicist to me on Tuesday afternoon, “If we don’t do that or we do something different, we’re not carrying out your wishes, it seems like we’re doing something wrong. But, given that you’re dead, how can anything be bad for you now?”

I spoke to bioethicist Dr Mike King about the special concern we as people have for the treatment of human bodies. He has co-written work with Gareth and Maja on Gunther von Hagens’ plastinates. “There seem to be a lot of contradictions around these bodies. They seem very lifelike, and yet they’re dead. Their internal organs are put on the outside and exposed. They are both real and artificial. There are ways in which people relate to them, in some sense, as a future “them”, yet it seems somehow other than them. All these kind of dualities around them.”

When it comes to carrying out the wishes of people who want certain things done to their bodies, there seems to be a natural intuition surrounding what we should and should not be allowed to do. “Human dignity” is a term used by some philosophers to describe the sense that by being human we all possess a special value that can be destroyed or desecrated by certain acts performed on our bodies. So when someone like Gunther von Hagens offers the option of plastinating, posing, and displaying dead human bodies, many people are offended by what seems to be a lack of respect for dignity in the treatment of human remains. 

Human dignity permeates the thought behind the socially accepted treatment of corpses. The New Zealand law against necrophilia explicitly mentions “indignity to any dead human body or human remains ” as a reason to make it illegal. Some philosophers back dignity, or an innate respect and reverence for any human body, because it seems instinctual and universally important.

Mike questions the concept of innate dignity with regard to dead bodies: “To say all humans have a dignity is one thing. But more needs to be said. What is this special value or quality, and what properties does it depend on? Is it another word for our autonomy, or is it some other value, that can conflict with our autonomous wishes? Crucially, do our bodies continue to have it after we die?” We can’t make sense of the “interests” of a corpse in the same way we can with a living person, who can experience benefits and harms. But there continue to be strong arguments for and against “posthumous harms.” Perhaps some interests persist after we die, but it is a complicated area and not universally agreed upon.

The concept of human dignity seems to limit what people can have done to their own bodies. “Say I wanted – I don’t really want to give an example – but something really undignified done to my body after I died, that any reasonable person would think was undignified, then human dignity could give a reason for someone to say that my wishes ought not to be carried out. Rather than respectful treatment being the carrying out of my wishes, in fact it’s a constraint on what wishes I can have that can be carried out.”

The acceptable treatment of human bodies varies so widely in different cultures that if somebody from one society were to look at another’s funeral customs they may assault our sense of “dignity” for corpses to the point of offence. “Sky burials” in Tibet involve leaving a corpse in the mountains to decompose and be eaten by vultures and other animals. Some cultures still practise ritual cannibalism of the recently deceased as part of the grieving process. We in New Zealand tend to embalm our dead, a strange thing to happen to a “person” if you stop to think about it.

What is the harm in allowing people to choose their own, perhaps unconventional treatment? Keith Richards said recently that he would like his children to snort some of his ashes when he’s cremated, just like he did to his father’s. Some tattoo artists are offering a service where human ashes are mixed into ink and tattooed into loved a one’s flesh. Australia’s first “body farm” opened in April, where people can donate their bodies to be left to decay in different outdoor environments for homicide investigators and students of anatomy and other sciences to study.  More extreme, what about the case of Armin Meiwes, a German who found somebody to agree to be killed and cannibalised by him? If two people enthusiastically consent to Gunther von Hagens arranging their corpses so they are copulating for perhaps centuries to come, who are we to stop them?

When people bequeath their bodies to the medical school, they expect strict codes of dignity to be mandatory. So if the medical school were to offer to fulfil the wishes of anybody who wanted to have their dead body mounted on a horse or skinned for display, many potential donors could be put off in the name of human dignity. That’s where Gunther von Hagens comes in. If you want your body to be playing a Stratocaster or pole-vaulting into mid-air for the foreseeable future, he may be able to make that wish come true.

Mike is curious rather than uneasy about some aspects of these exhibitions.  He believes the cadavers used in the displays have an interesting aesthetic element, and they are “often given the same fantastic qualities as fictional monsters.” The exhibits’ uncanny contradictions of life and death, animation and in-animation, real and fake, and the incredible technical skill of the displays can have legitimate value aesthetically, a continuing topic of debate among anatomists. 

I think back to the dissection room, the altruism of the donors, the good intentions of the medical students, and the things done to the cadavers that would be pathological in any other setting. Respect for dignity can be a confusing idea for treatment of dead bodies. Reminding medical students that they should respect the dead body seems like the right thing to do, but this requires some work to make sense of, since it seems to conflict with the way we show respect for dead bodies in other areas of our life. “That means these situations can be quite demanding and go against what you would normally do in any other part of your life. Dead body? You’d be sad, you’d be at a funeral. Now you’re in a room, you’re cutting it open, you’re sawing it, you’re skinning it, all kinds of difficult things to do. The way you overcome that is you remind yourself this person wanted it done.” 

So if you were dead, and I had your body, what would you want me to do with it?

This article first appeared in Issue 25, 2015.
Posted 1:12pm Sunday 20th September 2015 by Lucy Hunter.