Using unclaimed bodies for dissection draws outcry

Illinois officials are handing them over to an anatomical gift association after two weeks to help cope with a cadaver shortage.

By — Posted Nov. 7, 2011

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A new law in Illinois is enabling use of unclaimed bodies in anatomical education to help combat a shortage of cadavers amid a growth in medical school enrollment. The move could signal a nationwide resurrection of the decades-old practice of giving medical schools first choice on unclaimed bodies before they are buried at public expense.

The medical examiner's office in Cook County, Ill., has so far given five bodies to the Anatomical Gift Assn. of Illinois under the policy. Two of the bodies have been shipped to medical schools for use in dissection.

The Cook County Board of Commissioners in Chicago voted the practice into law in September 2010, though an 1885 state law already gave coroners the power to give unclaimed bodies to medical schools. The matter came to broader public attention after a September medical examiner's office memo outlining the policy was reported in the Chicago Tribune. Critics argue that using the bodies without the consent of the decedents or families is wrong, and that the policy could exploit the poor.

The Anatomical Gift Assn. of Illinois approached the medical examiner's office in 2009 about making arrangements to obtain unclaimed bodies, said Paul J. Dudek, executive vice president of the association, which manages bodies donated for use by medical institutions in the state. The effort to revive the 126-year-old law came because of rising demand for cadavers from medical schools and other health profession schools, he said.

"In 2010, we received 483 useable cadavers," Dudek said. "We could have easily placed 600."

Illinois has seven allopathic medical schools and one college of osteopathic medicine.

Under the policy, the medical examiner's office keeps an unclaimed body for two weeks while police search for next of kin to notify. If no family is found and the body weighs less than 300 pounds and is free of any communicable diseases, it is shipped to the gift association. The body is embalmed and kept for 60 days before any medical school can use it. If at any time a relative claims the body, before or after dissection, it will be returned, Dudek said.

"We have every reason to respect the wishes of the family. There is no reason for us not to," he said. "And if they don't approve it, that's OK. ... It really creeps some people out."

The practice is not unique to Illinois. In New York, the medical examiner holds a body for 24 hours for claiming by relatives before making it available to medical schools. Bodies are held for 14 days before being sent to the Anatomy Board of Maryland.

About 200 unclaimed bodies annually are shipped to medical or dental schools for use in education, said Ronald S. Wade, director of the Maryland board.

"There has been more of an interest around the country in resurrecting these old 1800s laws as the number of unclaimed bodies seems to be growing," said Wade, who also directs the University of Maryland School of Medicine Anatomical Services Division.

Most states still have laws giving medical schools access to unclaimed bodies for anatomical education. Laws enacted in the 20th century made it easier for people to donate their bodies for anatomical education after death, and most bodies used in dissection are bequeathed by the decedents or their families. Yet experts say that as more people opt for cremation and plan ahead for funeral expenses, fewer are choosing to donate their bodies to science.

Many medical schools have shied away from accepting unclaimed bodies due to criticism. In January 2009, Oregon Health & Science University reversed its policy of accepting unclaimed bodies after controversy erupted over whether a 10-day period to notify families was long enough.

Ethical objections

No unclaimed bodies are used in anatomical education in Indiana, said Ernest F. Talarico Jr., PhD, assistant professor of anatomy and cell biology at Indiana University School of Medicine Northwest. He said interstate agreements should allow Illinois to get the cadavers it needs from other states. Medical schools also could adjust to fewer cadavers by letting students take shifts with the bodies or supplementing anatomical education with computer programs.

"I was surprised to learn about what Illinois is doing," Talarico said. "Actually, I think it's kind of revolting. It's professionally wrong and ethically wrong."

Families deserve at least a six-month waiting period before their loved ones are handed over for dissection, said Laurie Zoloth, PhD, director of the Center for Bioethics, Science and Society at Northwestern University Feinberg School of Medicine in Illinois. Officials should do much more to publicize the existence of unclaimed bodies, she said.

"A more robust search for family members should be done," Zoloth said. "It's tragic that people are so disconnected and so abandoned in their lives that no one close is there to bury the bodies of the dead, which is widely understood to be one of the fundamental obligations of a society and how a culture understands what it means to be human."

A U.S. House bill called the Help Find the Missing Act would direct the attorney general to maintain a nationwide database to share information on missing persons and unidentified human remains. The bill, HR 1300, has seven co-sponsors but has not moved out of the subcommittee on crime, terrorism and homeland security.

Dudek defended the Illinois initiative, saying the association had looked at the pros and cons before moving forward.

"There was some concern that this might be viewed as taking advantage of the indigent, but the consensus was that the overall good that could result from a program like this outweighed the potential negatives," he said.

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External links

Memorandum of understanding on unclaimed bodies between Cook County and the Anatomical Gift Assn. of Illinois (link)

Thomas, the federal legislative information service, for bill summary, status and full text of the Help Find the Missing Act, HR 1300 (link)

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