When the dead teach: Exploring the postvital life of cadavers in Danish dissection labs

Abstract

This article follows the postvital lives of bodies donated to science, exploring their continuing material and social lives after the donor has died. I explore how the postmortem wishes of those who decide to donate their bodies to science intersect with the pedagogical aims of anatomical dissection. Using ethnographic fieldwork in three dissection labs in Denmark, I attend to the encounter between medical cadavers and medical students, asking how this encounter unfolds and what kind of enduring effects it might have. This is done through two steps. First I pay attention to the unresolvable ambiguity of medical cadavers, detailing three dimensions of ambiguity that have significant implications for the encounter between cadaver and student. Second I describe how medical students engage with this ambiguity, attempting to strike a balance between the inherent violence of dissection and the respect for the deceased that they are told to maintain. On the basis of this ethnographic attention to the rhythms and negotiations of the dissection lab, I argue that we may understand what goes on in dissection labs as a kind of ethics training in practice, where students are given a chance by donors to learn how to deal with the uncertainty and ambiguity that will characterize their future engagements with human bodies, life, and death.

Consent in body donation

“…These stewards would then try to make optimal decisions taking all relevant factors into consideration, including protecting the best interests of the deceased in light of all the information at their disposal. One advantage of consensus rather than individual proxy decisions is that the former may help avoid decisions being too heavily weighted by particular points of view, e.g., that of donors who registered their consent long in the past, relatives with strong but perhaps excessively self-serving views, or experienced anatomists whose training and practice have altered the ways that they think about bodies and what it is appropriate to do to them ;Segal, 1988;O'Neill, 1988;Joralemon, 1995;Delaney et al, 1996;Sanner, 1997;Moreton, 1999;Corrigan, 2003;Şehirli̇ et al, 2004;O'Neill, 2013;Boyd, 2015;Winkelmann, 2016;Hall & van Niekerk, 2017;Olejaz, 2017;Shaw, 2017;Champney et al, 2018;Cooper, 2018).…”

The “difficult” cadaver: weight bias in the gross anatomy lab

“…Gross anatomy is an important early site of professionalism education. Cutting into a deceased human body challenges students' previously held moral beliefs and evokes fears about illness and mortality [24,39]; how they reconcile these existential and moral dilemmas is thought to shape their cognitive and emotional responses to future dilemmas in patient care [28,29,40]. Gross anatomy courses have the potential to teach ethical reasoning and professional virtues [28,41], but the dissection experience may alternatively foster unwanted attitudes and behavior, ranging from depersonalization, to jokes at the donors' expense or disrespectful handling of dead bodies [26,42,43].…”

“…All body donations are anonymous. PSOM's gross anatomy course is comprised of lectures, dissections, and examinations focused on anatomy, without accompanying reflective sessions, lessons on humanism or ethics [28], or interaction with donors' families [29,30], course elements utilized at some other medical schools in an attempt to teach humanism and professionalism through the gross anatomy experience.…”

Anatomy as a Model Environment for Acquiring Professional Competencies in Medicine: Experiences at Harvard Medical School

“…Starting with the body donor, ethical procurement is considered (FICEM, 2012) and contrasted with the abusive and often persistent history of anatomical body procurement in the United States and elsewhere (Halperin, 2007; Jones and Whitaker, 2016; Champney et al, 2019). Also discussed is the ambiguity of the dead body in the perceptive tension between “former person” and learning “object” (Winkelmann and Schagen, 2009; Jones and Whitaker, 2016; Olejaz, 2017). Explaining the ethical procurement process and sharing letters of motivations written by family members of donors emphasizes the empowerment, voice, and choice of those who choose to become anatomical donors – one of the core principles of TIC.…”

“…D. Gareth Jones, a pioneer in the study of ethics in anatomy, has recently described an “ethical awakening of human anatomy” and connects the often abusive history of the discipline to the currently increasing interest in humanizing the practice of anatomy education (Jones, 2019). Danish anthropologist Maria Olejaz concluded from her field study of medical students in the anatomy course that students were receiving “a kind of ethics training in practice” (Olejaz, 2017). Evidence for the influence of the dissection course on medical students' perceptions of ethics has been documented in a recent longitudinal qualitative study (Stephens et al, 2019).…”