Whole Body Donation for Research and Education.

There are several types of donations that can occur after death. Organ donation, this occurs primarily occurs for the purposes of life saving transplantation. Tissue and eye donation for the purposes of transplantation, which is primarily, considered life enhancing. In some cases it could be considered life saving but for the most part a person would survive without the transplantation. This includes things such as bone grafts for accident or cancer victims, or eye (cornea) donation. They would likely live without it but might otherwise be significantly impaired i.e. blind, or crippled. Organ eye and tissue donation for transplantation is one of the most highly regulated areas in healthcare. Multiple regulatory agencies at the federal level such as CMS (Center for Medicare Services), FDA (Federal Drug Association), UNOS (United Network for Organ Sharing) have oversight. These areas of donation are also regulated in many, but not all cases by state oversight. This regulation while adding cost and complication helps assure the safety of the public.

The next area of donation is done for the purposes of education or research. This area is completely unregulated in most states. The bodies donated to unregulated programs can be used for a variety of purposes. Often they are used as cadavers for training medical students. The remains could also be used as anatomical models for a chiropractor’s office, be processed to make a mold of the bone structure of a foot, or even be plasticized and used as a body in an exhibit. Other uses include research for the possible application in the treatment of disease like diabetes, Parkinson’s or arthritis. Many of these uses are beneficial to society and may be absolutely fine with the person or the family who donated the deceased body.

The problem is that while many in the field act responsibly some do not. In an area such as this abuses are traumatic to hear about and they hurt the cause of donation in general due to the fear they tend to elicit. Every time a story breaks in the press reputable donation agencies receive phone calls from concerned or angry donor families, who need reassurances that their loved ones were not misused. Since there is no regulation there is no need to report to an authority that there were proper testing completed to make sure the remains are free from disease. No need to document the use or eventual disposal of the bodies, no need to even prove there was consent in any of the cases. The last mentioned point has allowed some of the worst offenses to occur; essentially “grave robbing” is alive and profitable if you will excuse the pun.

The lack of oversight allowed an unscrupulous funeral home director to easily misuse corpses they were supposed to have buried or cremated. If they were forced to provide proof of consent the following would have been unlikely to have occurred. In Philadelphia brothers who ran a funeral home allowed at least 244 corpses to be carved up without family’s permission and without medical tests. Skin, bones and other parts- some of them diseased – were then sold around the country for dental implants, knee and hip replacements and other procedures. The head of this scheme may go to prison for life.

In another case bodies were essentially parted out for whatever purpose a buyer choose. A crematorium in California was raided recently, “partial remains of roughly 300 bodies were found. Only 80 of these decedents could be identified. Bodies that came to this facility for cremation were instead dismembered by handsaws on embalming tables”. It was reported that the owner Mr. Brown “would go to the “meatlocker” pull out the requested part accept payment and send the buyer on his way.” Nothing was tracked these remains could have been infected and no one would know as no serological testing was done or if it was known prior to the person’s death there was no record of it because they did not even know who the remains came from.

The lack of regulation also allows the buyers “off the hook” so to speak as they are not required to ask any questions about whether there was consent for the donation or use and do not have to report back about the final disposition or use of the remains.

These remains are often used for training for example a manufacturer may be trying to sell physicians on a seminar where they learn new surgical procedures. The vendor will rent space in a hotel say in the Bahamas get 25 surgeons to come to the seminar. There would be human torsos on tables the physicians then get to practice this procedure. Not that this is completely a bad thing. I would like a physician to have at least tried a new procedure on a cadaver instead of learning on me. The issue is that these donors or their families should know that this is what is going to be done. There should also be oversight for how these remains are tested used and finally disposed of so that the public safety is protected. Since these body brokers are not regulated there is no need to “prove” there was consent for donation.

Why is regulation necessary? First regulation in needed to assure transparency of the use of deceased individuals. The second reason is to help maintain public trust. All donation agencies suffer from bad publicity, “guilt by association”. Regulation is needed in order to take the excessive monetary incentive out of the plundering of human remains. Finally and very important is the prevention of possible disease transmission.

Resulting regulation.

Despite heavy lobbying by some of these organizations New Jersey enacted the “Anatomical Research Recovery Organization Act”. This act requires each organization to be federally listed as a non-profit organization. They must be registered with the Department of Health, have a state licensed medical director. They must keep complete records of all uses and disposition of all remains. Finally they must keep complete consent records! Minnesota has adopted similar but much less restrictive legislation. While government regulation is not always seen to be a beneficial thing, this is one case where I believe it is. We are still early in the process but I hope that all states will follow New Jersey’s lead. An even better solution would be to federally regulate the use of all human remains, much like Organ eye and tissue banks for transplantation. This would stop an unscrupulous business from merely setting up shop in a state where no regulation existed.

A Positive Example

To contrast some of the above negative examples I will tell you how OHSU treats human remains donated to the medical school. OHSU receives between 150-200 whole body donations per year. Consents for the process are required and documentation preserved. All donations are tracked as well as use and the remains are eventually returned for proper disposal. The medical students offer an additional memorial service for the donor families after course work is completed. This is an example of professional safe and respectful treatment of human remains that other organizations would do well to emulate.

Works Cited

Bennett, Sherrie. "Organ & Body Donation." Understand Your Legal Issue. Lawyers.com. 2 Nov. 2008 .

"Body Donation Programs in the United States." Body Donation Programs in the United States. University of Florida State Anatomical Board. 5 Nov. 2008 .

Boggs, Robert. "CTS interview." Personal interview. 6 Oct. 2008.

Crow, Barbara. "CEBT Executive Director Lions Eye Bank of Oregon." Personal interview. 3 Nov. 2008.

Elsworth, Catherine. "Brothers admit to selling Alistair Cooke's corpse from Philadelphia funeral home." Telegraph.co.uk. 3 Sept. 2008. 4 Nov. 2008 .

Hester, Tom. "Bill promoting organ donation wins Senate approval." Real-Time News New Jersey news 24 hours, every day. 17 Mar. 2008. The Star-Ledger. 1 Nov. 2008 .

Modie, Jonathan. "OHSU Surgeon Improves Patient Care By Providing New Access To Oregon Tissue Donations." OHSU News Releases. 12 Apr. 2007. Oregon Health Sciences University. 4 Nov. 2008 .

Seely, Michael. "Legislation Whole Body Donation." Personal interview. 1 Nov. 2008.

Soto, Onell R. "Business illegally sold bodies to researchers." Union Tribune 29 Nov. 2004: 1+.