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The Afterlife of the Body
!!DISCLAIMER!! This episode talks about death and body donations, which may be distressing to some. Please take care of yourself when listening. !!DISCLAIMER!!
In this episode of Anthro.mp3, we will dive into the world of body donation. Exploring its significance across different cultures and its role in medical education, research, and beyond. Joined by Dr. Pérez, a bio-archaeological anthropologist specializing in violence, the discussion covers the cultural and historical context of body donation, ethical considerations, and how cultural beliefs shape the decision to donate one’s body after death. Dr. Pérez also shares unique rituals associated with body donation from various cultures, offering insights that could inform medical practices and policies. Tune in for an enlightening conversation that bridges science, ethics, and culture.
Sources:
- https://optn.transplant.hrsa.gov/professionals/by-topic/ethical-considerations/ethical-principles-in
-the-allocation-of-human-organs/
Other:
UMass Conflict and Violence Laboratory: https://www.umass.edu/bioarchaeology/
UMass Chan Medical School Anatomical Gift Program: https://www.umassmed.edu/agp/
Transcript:
Lily: Welcome to anthro.mp3, where we attempt to explore the intricate tapestry of both human culture and evolution. I’m your host, Lily for this episode today. Today we are diving into the fascinating world of body donation, a practice that bridges the realms of science, ethics and culture, from medical education to artistic expression. The donation of bodies after death serves various purposes across different societies. Joining us is Dr Pérez, a bioarchaeological anthropologist who specializes in interpersonal and institutional forms of violence. Welcome, Dr Pérez, and thank you for joining us today.
Dr. Pérez: Thank you for having me. I’m excited to be here.
Lily: Yeah, me too, so let’s get into it. So Dr Pérez, do you mind taking a moment and sharing with the audience about your work in anthropology?
Dr. Pérez: I’d love to. I am a biological archeologist by training. And what that means is, in addition to my archeological skills, I also focus on human remains in an archeological context, and I also look at human remains in an ethnographic context, sometimes forensics, sometimes just working with extant populations around the subject of violence.
Lily: Yeah, wow, that’s, that’s very interesting, and now we can kind of just like, dive right into the topic, because we have the introduction. Could you give us an overview of the cultural and historical context of body donation?
Dr. Pérez: Well, I think we have to start by the fact that for both med schools and anthropology departments, specifically, the body donation was almost nonexistent. The way we acquired human remains, and we’ll start with anthropology, was usually through individual research collections, and these were almost always of from folks who had gone out excavated material, usually people of color, and brought that material back to their labs and after they had completed their research, those individuals who had not granted consent would then be used to train undergraduate and graduate students in biological anthropology. The same was done for a very long time in med school the grave robbing aspect of providing cadavers for medical students has a very long and very dark history, both in Europe and in the United States, medical students were required to bring their own cadaver as like you would purchase books for their medical school training. So there’s this very sordid history with regards to human remains and the way that we acquired them for teaching purposes. I realized, I guess it was a few months ago when I had to give a talk at the, uh, at the Med School at the University of Massachusetts, Chan Medical School, that all of my training had been on non-consented people of color. I had never worked with a European skeleton, and I had never been trained or worked with someone who had specifically consented for me to do that, or for a student or a researcher to do that.
Lily: Wow, and that was a common practice?
Dr. Pérez: Still is, unfortunately, and that’s something that the discipline has — well, starting in 1990, with the Native American Graves Protection and Repatriation Act, there became, um, there was a shift enforced by the federal government for institutions receiving federal funding to step back and look at their collections, inventory those collections, and make a concerted effort to return them to the indigenous people that they belong to. With one caveat: the people had to be from a federally recognized tribe. So it’s an imperfect law, and that law has been amended many times since 1990 but that doesn’t help individuals who are not of native descent and are not covered by the law. So there are a lot of institutions that have what are commonly referred to as “legacy collections”. They’re simply part of the collections of that institution that have no legal standing, and it’s not illegal to have them. It’s just not ethically… it’s a morally gray area to use them.
Lily: And I bet that’s tricky when it comes to research, and, like, balancing it.
Dr. Pérez: It can be for some folks, and this is the, this is the difficult part. There are some folks that believe that, because there are no legal constraints, that they have the right to teach with the skeletons and do research with the skeletons, and they don’t see the, um, they don’t see the moral problem of engaging with that. Fortunately, this institution and many other institutions are quickly coming to terms with how problematic that is, and how we don’t want to train the next generation of biological anthropology students in such a morally questionable way.
Lily: Yeah, it seems like we’re in a time of, like, evolving the practice.
Dr. Pérez: I think that people are, are stepping back and saying, “Should we actually be doing this?” Even though we can legally do this, should we be doing this? And as such, there’s been a shift to, trying to acquire individuals that have consented to being part of a research collection or a teaching collection.
Lily: Yeah, so like, body donations?
Dr. Pérez: Body donations. And, the body donation program varies from state to state, and it also varies from institution to institution. So, what’s been a challenge and what people really haven’t thought about — and why the program here at UMass Amherst is so exciting — is trying to, trying to collaborate with an existing body donation program in which Community Outreach is the centerpiece of the program hasn’t been hasn’t been attempted before. So there are body donation programs, for example, at University of Tennessee is probably the most famous, and that program has been around for 60 years. It was started by a biological anthropologist by the name of Bill Bass, and they are, it’s an amazing program. They have over 2000 individuals that have donated their bodies to be skeletonized. Currently, they have another 7000 on their waiting list.
Lily: Wow, so it’s very successful?
Dr. Pérez: Very, very successful program, but it has some limitations. The individuals that donate their bodies, uh donate their bodies, but they don’t have their medical records aren’t part of that process, for example. So you get the individual body, but you don’t get the life history, the medical life history of the individual. The other thing that Tennessee, where Tennessee is different than Massachusetts, and I should say this before going any further: body donation, there are no federal laws surrounding body donation, it is all generated by the state. Every state is different. In Massachusetts, the individual has to fill out paperwork while they’re of sound mind and sound body. The application process is pretty rigorous. It’s about 48 pages long, and it’s very specific on what they can and cannot do, or what we can or cannot do, I should say. So the individual could say, “I would like to permanently donate my body as a skeleton”. That would be one possibility. And during the filling out of the form for that particular track, we will ask questions that range from “How do you want to use, how would you like us to use your body?” And that the individual may say “Only for teaching”, they may also say “For teaching and research”, and if that then opens up a new series of questions, what kind of destructive analysis, if any, can we use your body for, with regard to research? And it’s very specific. We talk about ballistic trauma, we talk about potential burning. We talk about sharp force trauma, so it’s, there are, um, there’s, there’s no ambiguity, and that’s what makes the program that we’re developing here so special. Not only do we have consent, but we have specific consent. So 50 years from now, if somebody wanted to do a particular… wanted to develop a particular research design, that researcher would approach the individuals curating the donor population here, run through the database, ask the question, and we might have, um, let’s make up some numbers, 1000 individuals. And of that 1000 individuals, 375 have indicated that they would be willing to have their bodies used in such a manner. This is, this is revolutionary. This makes it so that there’s no possibility of conducting research that is morally or ethically gray.
Lily: Wow. And, I really like how you talked about the differences between Tennessee and Massachusetts, because that kind of leads to another question that I wanted to ask you is: How do different cultures perceive the act of body donation, and what factors influence these perceptions?
Dr. Pérez: That is a terrific question, and it is not one that I readily have an easy answer for. Everybody thinks about body donation differently. We tend to see, and it’s not uncommon to see, that the majority of people who choose the option of body donation, at least in Massachusetts, and again, this varies from state to state and population to population, but in Massachusetts, there’s a wide range of individuals who choose to do this. The majority of them are college educated, have always been interested in science, or have had a family member or friend who has been in or around or involved with science, so nurses and doctors, researchers, um, but not always. I mean, so that’s one segment of the population. Interestingly enough, at, at the Anatomical Gift program for UMass Chan, there’s a disproportionately high number of veterans who have donated their bodies, and we’re not sure why, to be honest, because we haven’t had an opportunity to do ethnographic research on the, uh, on the donor population. That’s something that we’re going to start doing within the next couple of years. But it’s, it’s a fascinating caveat of the program that so many men and women who have served have chosen to continue that service through body donation. So, and that’s, that’s really hard to explain. A lot of these folks don’t have a degree, they, they simply have a high school education, went off and served their nation and as a continuation of that service, have decided to do body donation.
Lily: That’s, that’s interesting. And I was wondering, have you found any correlation between the demographics that choose to donate in the research that is found through their bodies?
Dr. Pérez: Well, this is, this is all for us. For the department here, and for Anthropology, this is… we’re really breaking new ground. So in a couple of years, if you ask me that question, I would be able to, I think I’d be able to give you a more insightful and knowledgeable breakdown of the demographic. We are, we are attempting to do several outreaches to the community, because we want the community to play a large role in the body donation. So it’s not like we’re out, we’re out trying to drum up interest in the program. And it’s really quite the contrary. It’s… we attend different functions, sometimes regional mortuary conferences, sometimes educational, just educational conferences, academic conferences, and we’re just now talking about this as, as a possibility. What we’re discovering is a lot of people are looking for green options for burial that they don’t want to contribute to climate change and they don’t want to put massive amounts of toxic chemicals into the ground. And this form of body donation, which is, is unique to our collaboration, is 100% green there. There are no chemicals involved. So it’s for many, for many of the donors, that’s one of the really appealing things, is that they’re leaving a minimal footprint once they die, and for the next several hundred years, their skeletons will be used to, to help train the next generation of Biological anthropologists and medical students.
Lily: It’s so cool how it ties in climate change and all these different ethical and moral issues. I know you already discussed this, but I wanted to ask, do you want to discuss the ethical considerations surrounding body donation, particularly in the realm of Medical Education and Research?
Dr. Pérez: Yeah, I think that body donation is the purest form of gift giving that can exist in education. I think it is. It’s one of the most sacred gifts someone can bequeath an institution. You know, it is, it’s not a… it’s not necessarily an easy thing to do, and what I mean by that is it’s easy to donate your body, but not every person who donates their body has a family that’s supportive in that decision making process, particularly in the skeletonization process, because the family does not get any of the, of the remains back. So if, for example, if we were talking about body donation for gross anatomy at the med school, what happens is an individual makes that decision. The students have that particular donor through gross anatomy. At the end of, at the end of the year, the family has the option of receiving the donor back, in cremated form, or just the rest, the remains in their current state, for burial. Or, they can choose to have the remains cremated by the med school. It’s amazing for the, for the donor and the donor’s family, when they come together on this in consensus, it can be a really powerful moment, particularly for the family, both the med school and eventually the program here, is going to create a system. Well, the med school has already done this. They’ve created a system where the students can leave messages to the donor’s family, thanking them for the donation and the sacrifice that the donor made, and telling them what it meant for them as a medical student to have this opportunity. The students… all the identifiers are stripped away, so the student is anonymous and the donor’s family is anonymous, and this is to protect both groups of individuals, but they get these incredible messages, and they mean so much to the donor’s family. I had the privilege of closing the memorial service and doing, doing the closing remarks for this, the most recent memorial service, the 2024 memorial service. And there were 400 people there. And afterwards, I can’t even tell you the number of people that stopped me in the auditorium while we were getting lunch, while I was walking to my truck, in the, in the, in the deck, all these family members were coming up to me and thanking me for the work that I do and for the work that my students do, and saying just how important it was for the donors, and how important it is for the family members to know that their loved one was having such a significant, playing such a significant contribution in the education of these students and in the research that we’re doing.
Lily: I love how thoughtful the process is and how it takes into account everyone, like the donor, the family, the researchers. And I was wondering, have you noticed that culture, beliefs and traditions and the influence that they have? Do they influence the decision to donate one’s body after death?
Dr. Pérez: Oh absolutely. One of the things that we’re working on right now is outreach to different community members and trying to expand the donor population and eliminate some of the fear that exists, particularly in minority populations. With medical institutions, the highest percentage of donors are of European descent, but there are still a significant number of African American donors, fewer Latino donors, and even fewer indigenous donors. Our goal is to, is to begin to change that, to show that there, why that might be a consideration for folks. We do our best to recognize and honor the donors, belief systems. And for example, one of the things that we’re doing right now is, trans folks: We are recognizing their sexual identity and not the biological sexual identity of the donor. So there’s a biological sexual reality that the students will see on the skeletal material, but we’re also going to present that individual as they wanted to be presented in life, and we’re now allowing the donors to talk about why that’s important to them, and that information is being shared with the students, which I think is going to have a profound impact on the way they begin to think about skeletonized human beings, because some of those cultural markers aren’t present on the hard tissue. And this will be one of the first times that students will be able to get trained on what is visible, and actually know what is invisible. We can always speculate about the invisible aspect of culture on a body, but now we’ll have narratives from the donors themselves.
Lily: I think that’s so fascinating, because combining multiple areas of anthropology, like biological, cultural I just think that’s so cool, to fully understand the human experience. I wanted to ask a question. I’m not sure if you know about this, but do you have any examples you’d like to share of unique rituals or ceremonies associated with body donation and different cultures?
Dr. Pérez: I actually don’t. I, and the reason this is, um, it’s a fascinating question, and I’m sure somebody somewhere is doing research on this, but oftentimes, with regard to the body, a decision for body donation: it’s such a personal experience. So it’s part of Western culture, now, body donation is, it has become more mainstream than it was even 20 years ago, less taboo to talk about it. And it’s… it is a process in which the individual who’s made that decision shares that with their loved ones, and then, of course, it’s shared with the institution they’ve chosen to do the body donation program, which one, whichever one they’ve chosen. I’m sure that every family has its own set of ceremonies. I think that how they choose to spend their final moments with their loved one is, is a, is personal and unique, and that variability is interculturally and, and, and cross culturally going to be unique. So it’s a, it’s a, it’s a death and dying moment. And I don’t think there’s anything more personal in our lives than the final moments before we pass.
Lily: Exactly, and I wanted to ask an overarching question that kind of combines everything we talked about, how can greater understanding of cultural perspectives on body donation inform medical practices and policies?
Dr. Pérez: Well, I think first and foremost, we have to be transparent. We need to talk about the programs, talk about the research, and most importantly, talk about the teaching and the necessity of using human remains and why this is so important. If you have that level of transparency, then it opens up possibilities for folks to ask questions. They’re no longer afraid of this, they no longer see it as… as ghoulish. So, this podcast is really important because it’s allowing us to talk about a really serious topic without sensationalizing it and leaving space for conversation. And hopefully leaving, or making it possible for individuals to say, “Oh, I’d never thought about that. Or maybe I could, maybe this is something that, that I would like to do”, and it allows them to look into it further.
Lily: That’s awesome. I think podcasts like this… like that’s why we’re here. To talk about these topics in an educational format so people can learn about anthropology. And before we wrap up today’s episode, is there anything else you would like to share, Dr. Pérez?
Dr. Pérez: I would just say that I’m really, I’m really excited about this program. I’m very proud of the fact that it’s happening here at UMass. UMass is also my alma mater, so I received my MA and my PhD here, and we’re going to be at the forefront of significantly changing the discipline and and I think it’s, it’s, it’s long overdue, and so seeing the university takes time to invest in the laboratory and equipment, and seeing my students in particular, being able to do the research and present thoughtfully to a wider audience on why it’s important that we have human remains and why it’s important that we have these particular human remains. I think all of these things are going to lead to more ethical teaching and more ethically sound practice of biological anthropology, moving forward.
Lily: It’s amazing that UMass Amherst is at the forefront of this evolutionary like practice. That’s awesome. Thank you, Dr Pérez, for illuminating this episode with your expertise and knowledge, and thank you to our listeners for joining us on this enlightening journey into the world of body donation. Lastly, a huge shout out to our tech crew and the individual who made this all possible: Sarah Reedy, until next time, remember to stay curious and keep exploring the diverse understanding of anthropology. And one last thank you to Dr. Pérez.
Dr. Pérez: Thank you very much, it’s been my pleasure to be here.