No Skeletons in the Closet

No Skeletons in the Closet

Writing about dead bodies almost as ethically challenging as collecting them

Although they’re careful not to advertise it, Otago Uni’s Anatomy Department curates a fascinating and rare collection of human cadavers.

The collection is an invaluable teaching tool for the medical professionals of tomorrow, and what began as an investigation into a purportedly dubious medical history quickly became an appreciation for the Department's compassion and diligence.

There are lots of helpful humans in the Anatomy Department. Most of them are alive - we call them “staff” - but a number of them reside in the Department’s carefully maintained collection of cadavers and museum specimens.

Despite its world-class quality, the collection is not advertised to potential international students. It’s a welcome surprise for those who enter the Department. While some students were a bit shocked to be presented with the rather grizzly nature of human dissection, every student Critic spoke to stressed the value of the resource.

Most of these specimens are used for dissection, but some are on display in the University’s W. D. Trotter Anatomy Museum. Here you can see muscles you’ve pulled, the organs you rely on, and the bones you’ve broken. If you’re not too squeamish, you can go layer-by-layer, from skin to skeleton, and confront the fact you’re basically just a very complicated biological machine.

As fascinating as the displays are, they’re not there for you to gawk at. Every department collects specimens of its trade, but things start to get understandably complicated when those specimens are cadavers. The Anatomy Department therefore takes great pains to stress that the bodies and body parts are “not exhibits, [but] rather, valued educational resources”.

This got me thinking, though. The Geology Museum also houses several hundred “valuable educational resources'', but you’re allowed to look at those without any ethical complications. Obviously, the difference here is that one museum collects rocks while the other houses the bodies or body parts of dead people. So how exactly does a university get its hands on human bodies? Critic consulted Anatomy’s Head of Department as well as a recent Honours thesis discussing the collection of foetal remains to answer this question.

Medical ethics have come a long way since the collection began. The Human Tissues Act of 2008 sets the current ground rules for handling human remains and ensures a great deal of respect for any bodies acquired by the Department, but these rules weren’t always in place.

When the Medical School was founded in 1875, Kiwi anatomists acquired cadavers in a similarly shady way to their colleagues in the UK: in addition to donations, they received unclaimed bodies from places like the Dunedin Lunatic Asylum and the public hospital. Today, we would call this a “no-no”, perhaps a “breach of moral decency”, even though they were legitimately trying to further medical research in line with the law of the day: the Anatomy Act of 1875.

Originally, the fact that these cadavers were collected in 1875 seemed to be a red flag. We did a lot of things in 1875 that wouldn’t be okay today, and Critic suspected that perhaps there was some murky history here to uncover. Instead, the history was found to be of compassion and excellence. The resource is an honest academic treasure surrounded by a particularly fascinating bit of bioethics.

Since the early days of the Medical School, the Department has instituted many changes to the way they source their bodies. No longer following the Anatomy Act of 1875, the Department now relies on the Body Bequest Programme (BBP) to supply cadavers.

Like all good things, the BBP relies on informed consent. If someone wishes to leave their body to the Department, both the donor and their family sign off on the process. By the 60s, voluntary bequeathment of bodies provided the majority of human specimens. Today, this rigorous process for body acquisition is strictly followed, and most bodies or body parts end up used in dissections, not on display.

The Department holds onto the pre-BBP museum specimens because they are “unique, valuable and irreplaceable resources for anatomical education”. Many of the bodies with a “sensitive nature” are those of infants and children who - even under modern regulations - would not be legally viable for body acquisition, as according to the Human Tissues Act of 2008, all donors must be over the age of 16.

Megan Southorn’s BSc Honours thesis tells us that most of these foetal remains passed away during the last month of pregnancy, and offer important insight into a critical phase of human development. Hospitals were a more dangerous but more affordable way to give birth in the late 1800s, and in the case of poor mothers, donating their child’s body could have been seen as a way to avoid burial costs. The deceased child obviously couldn’t consent to this.

You can see the moral dilemma: our current Department must now reconcile the importance of these specimens with the ethical implications of holding them. While we can tear down statues or rename buildings in the name of accounting for past injustices, we cannot discard these bodies without losing something valuable. They are making a unique, tangible, scientific contribution in a way that a statue or building cannot.

Southorn also notes that only some of the children’s bodies were unclaimed. Records show that at least five were purchased, possibly from India, where grave-robbing was prevalent at the time. The remaining 27 foetal specimens may or may not have been donated by the parents. There’s no explicit record of donation, though that doesn’t mean they were “stolen”. We just don’t know.

What we do know is that they have made an invaluable contribution to medical research. Professor D. G. Jones* suggested in a ‘94 paper that no matter the sourcing of human remains, once in a medical collection, their current use must be for good. This is undeniably the case in the University of Otago’s Anatomy Department.

You wouldn’t trust an electrician who’d never wired a circuit, or a painter who’d never touched a brush, so it’s similarly important to give medical professionals firsthand experience with the body before they begin treating living patients. Our department has access to the resources necessary to give this essential experience.

Some skeletal remains and preserved tissue document the critical early phases of life, and these foetal specimens are used for educational purposes only. Many other anatomy departments cannot offer this valuable resource, but it just so happens that our Department has been legally handed some of these specimens by their predecessors.

A child’s body is not the same as an adult’s, and studying how the body develops or mis-develops during this period of life is a crucial part of an anatomical education. Physical specimens are the most direct way of doing this, though technologies like VR and digital rendering are raising questions about the presence of human remains in the classroom.

To preserve the “sensitive” bodies with as much respect as possible, the Department does not make them publicly available. Some are kept purely out of historical significance and some are used in the classroom, but to the Department, the use of any of these specimens remains “a complex question that we continue to ask ourselves”.

The Anatomy Department takes the handling of human remains extremely seriously. These are not the same people that staffed the Medical School in 1875. Organised tours of the Museum (which is separate from the BBP) are available and certain students have access to its halls, but disrespect from anyone is swiftly penalized.

The Anatomy Department finds itself at a complicated moral crossroads, but seems to have taken every possible measure to preserve the importance of these specimens while acknowledging their sometimes unfortunate history, and for that, there are no bones to pick with them.


*Professor D. G. Jones is an emeritus Professor and former Head of the Anatomy Department, specializing in bioethics.

This article first appeared in Issue 16, 2020.
Posted 9:20pm Thursday 27th August 2020 by Fox Meyer.