After We Die: The Life and Times of the Human Cadaver

7. The Cadaver as Supplier of Used Body Parts

143 Don’t take your organs to heaven; Heaven knows we need them here Bumper sticker, circa 2002 Every hour another person dies waiting for an organ transplant. Despite significant technological improvements and numerous publicity campaigns over the past several decades, the substantial shortage of organs, tissues, and eyes for life-saving or lifeimproving transplants continues. This shortage persists despite efforts by the federal government and every state legislature to improve the system. National Conference of Commissioners on Uniform State Laws, Comments to the Uniform Anatomical Gift Act (UAGA) (2006) Chapter 7 The Cadaver as Supplier of Used Body Parts A host of uses can be made of a human cadaver. Some of them are utilitarian , such as using ground-up human remains for crop fertilizer or for filler in artificial reefs. Other uses are more humanitarian, as in education and research for the advancement of medicine and science. Corpses or parts of corpses are used beneficially as teaching tools in medical education or as practice tools for health care providers. Preserved human remains appear in museums and exhibitions that teach about human evolution and anatomy. Corpses as subjects of scientific research contribute to therapeutic advances in medical knowledge. A basic autopsy, for example, may help identify sources of fatal afflictions—a first step in leading to a cure. Or an autopsy may determine how effective various drugs or prostheses have been within the deceased’s body. Research using cadavers examines how the human body responds to various traumas and tests the effectiveness of related protective devices. No use of a cadaver is as immediately beneficial and appealing as transplanting a needed body part to a fatally afflicted or seriously ailing 144 | The Cadaver as Supplier of Used Body Parts person. For decades, health care organizations and government agencies have sought to encourage cadaveric organ transplantation. Successful tissue transplant techniques in the United States date to the 1940s, when orthopedic surgeons began using bone taken from one patient (a live donor) to repair fractures in another patient. Within a few years, surgeons discovered that cadavers could be a useful supply source for such bones.1 In 1951 a naval surgeon set up a body-donation program, and his Naval Tissue Bank became a source of tissue for civilian as well as military hospitals. The first successful kidney transplant occurred in 1954, using a live donor.2 Successful kidney transplants from cadavers started in 1962. By the late 1960s surgeons were using cadavers as a source not only of kidneys but of corneas, pituitary glands (to obtain human growth hormone), skin, and hearts as well. The development of immunosuppressive drugs enormously increased the success and scope of organ harvesting, making human cadavers a true “potential source of life [and well-being] for others.”3 Progress in tissue transplantation extended well beyond lifesaving organs like kidneys and hearts. By the 1980s nonprofit tissue banks were regularly supplying bone, ligaments, and tendons for repair of injuries. Also in the 1980s profit-making companies founded a “tissue-processing” industry to supply certain body parts for both transplantation and teaching purposes .4 By 2000 at least twenty-five different types of tissue or organs were transplantable, including liver, lungs, pancreas, veins, heart valves, cartilage, blood products, and collagen.5 In theory a single corpse can now benefit as many as one hundred tissue recipients. In 2004 a million tissue transplants were performed annually in the United States; today the total is close to a million and a half. Authority to Retrieve Cadaveric Organs—Informed Consent Any legal framework governing organ transplantation from cadavers must reconcile the enormous potential benefits of organ and tissue recovery for living recipients with traditional concern for the integrity and dignity of the human cadaver. American social and legal traditions have established that human remains should not be disturbed or violated except for very good reasons. A cadaver itself ordinarily has rights to be decently disposed of and to quiet repose. Removal of body parts could Authority to Retrieve Cadaveric Organs—Informed Consent | 145 easily qualify as unlawful abuse. At the same time, virtually no one disputes that salvaging the lives and restoring the health of stricken humans can, upon appropriate authorization, furnish a good reason to disrupt the normal tranquility of a cadaver. The question is who weighs the competing interests and decides whether a particular cadaver’s repose should be preceded by removal of one or more...