There’s a provocative piece in a recent New Scientist about what happens to unclaimed bodies after death – about, specifically, the practice of coopting them for research purposes.
Gareth Jones, who wrote it, points out that the practice has been going on for centuries – but that a consequence of the way it’s done is that it tends to be the poor and disenfranchised whose corpses are used:
[T]he probably unintended and unforeseen result [of most policies] was to make poverty the sole criterion for dissection. [… U]nclaimed bodies are still used in countries including South Africa, Nigeria, Bangladesh, Brazil and India. While their use is far less in North America, they continue to constitute the source of cadavers in around 20 per cent of medical schools in the US and Canada. In some states in the US, unclaimed bodies are passed to state anatomy boards.
For Jones, the practice of cooption ought to be stopped. His main bone of contention is the lack of consent – it’s a problem that’s made more acute by the fact that the bodies of the disenfranchised are more likely to be unclaimed, but I take it that the basic concern would be there for all.
One question that we might want to ask right from the off is why informed consent is important. In a clinical setting, that’s quite easily answered: it’s a way of ensuring proper respect for persons, or for liberty, or for interests, or for something along those lines. But corpses are neither persons nor free, and quite possibly don’t have any interests; and so none of those good things is going to be eroded by a lack of consent. That is: we might think that informed consent really only matters in respect of the living person, not the post-person; if that’s correct, then there shouldn’t be too much of a worry when it comes to deciding what to do with post-persons. What moral statements there are to make have to do with the person acting upon the corpse, rather than with the ex-person whose corpse it is or the corpse itself. If it’s wrong to play football with Uncle Bill’s head, the argument would go, then that’s not really because Uncle Bill is harmed or wronged; it’s because of (say) a Kantian indirect duty in relation to brute nature, or maybe an Aristotelian what-kind-of-person-would-even-consider-that claim. Analogously, if it’s wrong to throw a stone at your greenhouse, that isn’t because we care about the greenhouse.
Others think that dead persons do have persisting interests; but the question we need to ask here is how long they persist. There’s an interesting suggestion in a 1997 paper by Stan Godlovich in the Journal of Applied Philosophy called “Forbidding Nasty Knowledge” that there’s a period of “decent delay” when it comes to, say, making use of Nazi data in research, but that in the end we are talking about delay rather than veto.
This, of course, provides no reason at all for using any nasty knowledge. It provides no warrant. We have here consolation, not argument. It simply says this: whatever bothers us now will not bother our successors or even us later in life. We uncomplicatedly admire the Pyramids. Our successors will appreciate and benefit fully from that which we cannot now abide. Should it be so? Should the sun rise?
Could something similar be said in respect of enlisting unclaimed cadavers? That the interests of persons do persist, but not forever? It might – but that wouldn’t always tell us a great deal about cadaver use, since their research value is likely to have a fairly short half-life. (Not always, though – it might help us figure out the best attitude to have about ancient bodies: see Søren Holm’s 2011 New Scientist piece for more on this.)
On the other hand, we might think that if there is a persisting interest, and the point of consent is to protect that interest, then consent would be required as a sine qua non. We might not know how to identify the ex-person’s interests, but that simply means that we have to assume that there is no consent, rather than that there’s blanket consent to do anything whatsoever. No consent would mean no research.
But the problem there is obvious: if a body is unclaimed and we have no record of consent being given for it to be used for research, it’s hard to believe that we’d have any record of consent for it to be buried or cremated either. And yet we must do something with and to such bodies. We have to make a decision on behalf of the person whose body it is. If we’re willing to decide to bury on their behalf, then why not decide to anatomise? There might be limits on what we’d consider – during the Renaissance, the bodies of executed criminals were used to provide models for écorché studies: I don’t think many would go for that – but the point would stand that we’d have to consider something, and consent would be neither here nor there.
Even if the persisting interests are strong and do count against cooption, they aren’t necessarily going to be trumps. We might think that the value of research is such that persisting interests are more than matched by the interests that society has in conducting research. This line of argument may be particularly attractive if you think research to be a moral duty, though it’s possible to hold that research is not a duty but still more important, in the grand scheme of things, than the interests of ex-persons. The argument here is related to the arguments about routine harvesting of cadaveric organs, although the imperative to research is almost certainly weaker than any imperative to find organs for transplant. We might find ourselves thinking that a lack of consent is worth noting, but not the clincher: if you think that there should be an opt-out system for organ donation, then you might easily think that there doesn’t need to be consent for cadaveric recruitment here: the reason to research is sufficient to obviate the merely apparent need for consent.
I don’t want to suggest a response to the problem that Jones raises, or that I’ve raised with Jones’ piece. What matters here is that a moral decision is being made. We have two things that have prima facie arguments in their favour – a research mandate, and a persisting interests mandate – and we have to decide which is the more important, and what we should do on the basis of that decision.
The decision isn’t, as Jones says it is, between “scientific and ethical ideals”. The scientific ideal is an ethical one, after all – if you think that science is important, that’s an ethical claim. There might be a conflict between doing research and respect for the dead (whatever that turns out to mean); but it’s not a conflict between science and ethics. It’s an ethical conflict.
Indeed, when Jones says that “acceptable compromises can only be reached if sufficient attention is paid to both the science and the ethics”, he not only mischaracterises the nature of the problem, but also suppresses the fact that the desirability of compromise rests on an unargued moral claim, and the measure by which we’re to measure its acceptability is a moral measure.