Who donates their bodies for anatomical dissection?
Anonymity serves as a cornerstone of the institution of whole body donation. While donors agree to relinquish autonomy of their remains for the purpose of medical dissection and study, the maintenance of anonymity throughout the process acts as a way to preserve the integrity of their humanness long after the departure of their human form. For first-year medical students, the anonymity of the donors functions to preserve a part of them as well—an emotional shield to ease the feelings that come with confronting the deceased, often for the first time.
Age, sex, occupation, cause of death: that is all we know. For some, even this superficial disclosure is too much. Others must accept it as enough, despite feeling compelled to know more. With four students assigned to each body, a first-year student at Alpert Medical School will encounter the remains and demographic information of about 30 donors. With such a small sample from which to glean data, it becomes difficult to characterize the donors as a population and to explore their humanity within the boundaries of their established anonymity. Inspired to know more about the individuals who so generously gifted their bodies to us, I gathered demographic and occupational data from the records of the 491 people who donated their bodies to Brown through the Anatomical Gift Program during the last decade. I hoped to provide an opportunity to learn more about the posthumous community that contributes to our medical knowledge and to enhance our understanding of what remains.
In the past 10 years, individuals who have donated their body to Brown have self-identified predominately as white (98 percent), without any discrimination to sex. As donation programs are often advertised in assisted living facilities, this may reflect a lack of diversity within the resident populations of these facilities. The absence of ethnic minorities in the donor population also may suggest a culture of distrust toward the medical community acquired through generations of health disparity and marginalization.
More than half of all donors opted for the return of their cremated remains to their families, a practice normally carried out upon request no more than three years after donation of the body. Civil status did not seem to influence whether or not donors wanted their remains returned. While it might seem as though only donors with congenial and robust family relations would request that their remains be returned, one donor explicitly documented his decision not to do so because he “did not want [his] family to mourn [him] twice.”
As for occupational histories, the largest contribution came from working-class individuals representing industry (23 percent) and office work, hospitality, and retail employment (24 percent). Individuals from health care-related professions comprised 7 percent of the donor population, with nurses accounting for 49 percent of donations from this sector. Of the 491 individuals who donated their bodies, two were physicians.
In addition to characterizing Brown’s donor population, I sought to assess the attitudes of medical students toward whole body donation. When I surveyed my colleagues to ask whether they believed that cadaver dissection has benefited their medical education, their average response was overwhelmingly positive. Moreover, they affirmed that cadaver dissection had benefited their medical education in such a way that models, animal specimens, or electronic applications could not have replaced it.
The positive light in which Alpert medical students viewed whole-body dissection made me reconsider the representation of physicians in the donor population data. While the number of physicians in the donor population is proportional to the number of physicians in the US population, one might anticipate greater participation from a constituency that intimately appreciates the value of donors’ gifts. Ideally, the characterization of Brown’s whole-body donor population in the last decade and the affirmation of students’ positive attitude toward the value of cadaver dissection will provoke further discussion about the context in which we practice anatomical dissection and reflection on the population of human beings who make this medical rite of passage possible.
