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The Left Atrium

Respect for the dead

Anne Andermann
CMAJ June 05, 2007 176 (12) 1738-1739; DOI: https://doi.org/10.1503/cmaj.070237
Anne Andermann
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  • © 2007 Canadian Medical Association

Human remains: dissection and its histories Helen MacDonald; Yale University Press; 2006 (Melbourne University Press; 2005) 224 pp US$35.00 ISBN 0–300–11699–3

At first glance, a history of dissection may appear morbid with little relevance for present-day health practitioners. However, Helen MacDonald has written a thought-provoking and readable book that raises important ethical considerations regarding the use and abuse of human remains, both in the past and in the present.

Figure

Figure. Photo by: Yale University Press

Most, if not all, physicians practising medicine in Canada, and around the world, have dissected a cadaver during their undergraduate medical training. The anatomy class has become a rite of passage, but few are aware of the important history regarding the procurement and use of dead bodies for the purpose of medical education. Stories of “resurectionists” and “body-snatchers,” who at one time ensured the supply of cadavers for dissection, are not simply anecdotal relics of the past. Learning about the history of dissection can help students and physicians reflect upon the use of human remains and foster a greater respect for the dead.

In the introduction to the book, MacDonald engages the reader with a graphic account of a human dissection carried out in 2002 as a form of performance art in the East End of London (also known as “Jack the Ripper” territory). She recounts, for instance, how the audience cheered when the artist–anatomist “pulled at the sternum with both hands and plunged into [the] thorax [of the deceased] to lift out his heart and lungs.” Using this rather gruesome event as a starting point, MacDonald weaves a complex narrative linking morally questionable historical practices, such as grave robbing and dissecting the dead bodies of poor and vulnerable people (e.g., prisoners, Aboriginal peoples, women, persons with mental illness), with controversial practices carried out in a modern context (e.g., harvesting organs without explicit consent to be used for transplant or research, human dissection as performance art).

The main focus of this book is 19th-century Tasmania, then known as Van Diemen's Land, an island off the southern coast of Australia that served as a penal colony during the British colonial era. MacDonald uses this setting to explore how the dead bodies of prisoners and Aboriginal peoples were used for medical dissection in the interest of advancing science, and how their remains were then sold for display in Victorian museums of natural history.

By describing in detail specific dissections documented in historical records, MacDonald provides a vivid account of how the bodies of individuals were used after death. Such accounts are at times unpleasant to read, particularly when they reveal a lack of professionalism and when human remains are treated with disrespect: “The dissecting room was a place in which gross indecencies were performed and not only by medical men. A porter at St. Bartholomew's was said to have raped the corpse of an attractive fifteen-year old girl in front of medical students.”

Through the examination of archival material, MacDonald seeks to demonstrate the relationships of power surrounding dissection and, in particular, how 19th-century anatomists developed a proprietary attitude toward human remains. MacDonald shows how these insights are useful in better understanding many of the unethical practices that occurred in relation to the dead, and how they can shed light on current-day abuses (such as the unauthorized collection of children's organs at Alder Hey Hospital in Liverpool during the 1980s and 1990s).

MacDonald does not argue for abolishing anatomy classes, organ transplantation or medical research on autopsy specimens and suggests that “there are, indeed, compelling reasons to dissect the dead.” She wants, however, to draw attention to the important ethical questions and concerns regarding the use of dead bodies. The main thesis of the book, for which MacDonald makes a strong case, is that “human remains matter” and should not be treated as mere objects or tools for the acquisition of medical knowledge, or for any other purposes, even if such activities may benefit humankind. Transparency, professionalism and respect for the dead (and their loved ones) should therefore guide our approach to the procurement and use of human remains.

Bodysnatching in 19th century Canada

Although the context in Canada in the 19th century was quite different from the penal colony off the southern coast of Australia that is the focus of Helen MacDonald's book, there were nonetheless concerns here with regard to the procurement and use of dead bodies for human dissection. Francis J. Shepherd, a close friend and colleague of Sir William Osler, wrote in his Reminiscences of Student Days and Dissecting Room:

When I was a medical student at McGill University, in 1869–73, nearly every subject for dissection was obtained illegally, by the old method of “body-snatching.” Although there was an Anatomy Act on the statutes of the Province of Quebec, and an Inspector of Anatomy, yet as no penalty was attached to the law it was never carried out…. On my return from Europe in the autumn of 1875, to assume the duties of Demonstrator of Anatomy, I found immediately that to provide subjects for the dissecting room I had to accept those obtained from “Ressurectionists.” The body snatchers were usually medical students … who by the process of their nefarious occupation paid their fees…. For some years I obtained subjects from the Cote des Neiges Catholic Cemetery, to the west of the Montreal mountain…. The dead poor, not being able to pay expenses of the vaults, were buried in winter in very shallow graves in a corner of the cemetery, and those freshly made graves were marked by the guardian (of the cemetery) and the students went up at night, disinterred the bodies, buried usually the previous morning, removed all clothing, wrapped them in blankets and tobogganed them down Cote des Neiges Hill. Many weird tales are told of accidents and the bodies rolling off the toboggan, and people who saw the accident thinking a death had occurred. They usually arrived at the College in the very early morning hours, and the janitor took in the bodies and gave a receipt on which they collected their money the next day…. I seldom knew who brought the bodies, and the janitor, strange to say, was never summoned as it was supposed to be all done by medical students for the love of anatomy and in the interests of their profession, and it was thought that they had the entrée to the dead house.1

Grave-robbing in Montréal, and elsewhere in Canada, has long since been abandoned.2 Present-day anatomy classes are conducted with propriety and respect thatincludes a memorial service for the dead that takes place annually at the end of the school year.

Footnotes

  • Dr. Andermann is a Rhodes Scholar (DPhil, Oxford) with an MPhil in the History of Medicine from Cambridge University.

    Acknowledgements: Anne Andermann would like to thank Christopher Lyons, Pamela Miller and Lily Szczygiel at the Osler Library of the History of Medicine at McGill University for their help in retrieving the document entitled Reminiscences of Student Days and Dissecting Room by Francis J. Shepherd.

REFERENCES

  1. 1.↵
    Shepherd FJ. Reminiscences of student days and dissecting room. Montréal: The Author; 1919.
  2. 2.↵
    Francis D. Bodysnatching in Canada. CMAJ 2001;164:530.
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Canadian Medical Association Journal: 176 (12)
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Respect for the dead
Anne Andermann
CMAJ Jun 2007, 176 (12) 1738-1739; DOI: 10.1503/cmaj.070237

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