People who donate their bodies to science are the first and most important patients that medical students will have. But what motivates people to make that choice, asks FIONOLA MEREDITH
FOR MOST people, leaving their body to science is something that has never crossed their minds. To some, the idea of their remains being dissected as a teaching aid for medical students is a chilling, unnatural or alien prospect. But others, such as 78-year-old Alma Elders, from Chapelizod in Dublin, take a far more pragmatic approach.
“To be perfectly blunt, someone who is six feet down is not doing anybody any good,” Elders says briskly. “I have a practical view of life, I don’t shudder at things. As a child I wanted to be a nurse, but that never happened. This is another way for me to give something back.” Alma’s husband, Ron, died in 2005, aged 77, and donated his remains to the Royal College of Surgeons. Two years prior to his death, both Ron and Alma decided that they would commit to leaving their bodies to science.
“We were watching a television programme about donating your remains, and almost immediately we agreed that it was something we wanted to do. Ron was quite ill in his latter years, and we had both spent time in hospital throughout our lives. We realised how much illness there is, and how important it is to learn more about it. So that’s why we decided to register as donors,” she says.
For centuries, human bodies have been the cornerstone of training in anatomy, providing an essential learning tool unobtainable by any other means. “All our medical students need to use real human donated material,” says Siobhan Ward of the Trinity College Dublin anatomy department. Together with her colleague Philomena McAteer, she organises the process of remains donation at Trinity, from taking initial phone calls of inquiry to preparing and embalming the bodies. “If students didn’t have remains to work on, it would be like a trainee mechanic looking under the car bonnet and never actually touching anything,” says Ward. “There is nothing like looking at and feeling the real thing.”
Clive Lee, professor of anatomy in the Royal College of Surgeons, says that the decision to donate is a public-spirited thing to do. “It’s the best way to teach the next generation of doctors and surgeons, providing a three-dimensional map of the body. If you know where everything is, what’s under the skin, what you can expect to find there, the chances of doing damage to the patient are much less. It’s the difference between walking across the room with the lights on, or with the lights off.”
And it’s not just would-be surgeons who benefit from close work on human remains: those studying dentistry, physiotherapy, pharmacy and sports medicine all rely on donors as part of their training in the systems and structures of the human body. “Only quite a small number of people decide to donate – less than a hundred people a year,” says Lee. “It’s something we want to encourage.”
From a medical point of view, it’s clear that a steady supply of bodies is absolutely vital. But why would an individual choose to offer their remains to science after they die? What would motivate them to make such an unusual and challenging decision? After all, there is no financial benefit to the donor’s family: while medical colleges might cover burial costs when the remains are eventually released, they do not pay a fee for the body.
Siobhan Ward says that, like Alma Elders and her husband, many donors see it as a way to show their gratitude for treatment they have received. “Others do it because they are anti-religious, or even because they believe in the idea of recycling. A lady who called us today wanted to help to educate the next generation. If a mother or father did it, often you find that the son or daughter will do it too. Some people have told us that it’s because they couldn’t get into medical college, and they see this as another way to benefit science. One person decided to donate, rather than be cremated, because she was frightened of fire. But most people are quite upbeat when they call, not morose or sad.”
Ward says that prospective donors tend to leave it to later in life to register: the TCD anatomy office has many calls from people in their 80s and 90s.
While donating one’s body to medical research is an intensely personal decision, it’s bound to have a profound effect on those who are closest. “It’s vital for the family to understand what the person is doing,” says Lee. “It can be a challenge for them. There may be a longer period of mourning, because the time scale for donation is short, and there may not be an opportunity for a service with the body in the coffin. On the other hand, when the remains are released , this gives the opportunity for a family reunion and memorial service, which can be beneficial.”
“It used to be something that people never talked about, or if it was mentioned it was spoken about in hushed terms, and the family had no connection with the process,” says Ward. Times have changed, but as Philomena McAteer points out, while most donor families feel proud of their loved one’s decision, they miss having a grave or other place to go to remember them. “One woman came in regularly to have lunch in the college, just as a way to feel close to her loved one,” says McAteer.
Last September, in recognition of this need, a Relatives’ Room was opened at the Biomedical Sciences Institute at Trinity. When a donor is received, the next of kin can accompany the coffin to the room, and family and friends are welcome to visit and talk to anatomy staff while the donor’s remains are with the department. There is also a special book of remembrance, recording the names and details of donors. “One lady phoned up and said that her father had donated back in 1971, but she didn’t know much about why he had done it,” says Ward. “She was able to come in and find his name and details in the book of remembrance. She was absolutely delighted, it really meant something to her.”
When Ron’s remains were returned in March 2007, the Elders family had a thanksgiving service, and Alma still remembers the words of a young medical student, called Jennifer, who spoke at the ceremony: “I was so taken by what she said. Jennifer described the donors as their first and most important patients; extraordinary people, who had made a difficult choice in the name of science. She said they were like silent teachers. It’s good to think that Jennifer must be a qualified doctor by now. Her speech really meant a lot to me.”
It’s not only the bereaved family who must come to terms with their loved one’s remains being used for educational purposes. “We do see the impact of death on the young student population too,” says Siobhan Ward. “It can be quite intense for them: it may be their first encounter with a dead body. We now have a scheduled induction process, where we explain why people donate, what the bodies will look like, and how to speak about the remains.”
“It’s a great honour to be custodians of the donor programme,” says Philomena McAteer. “We’ve been doing this for many years now, and we still think it a special privilege to be working with donors and donor families.” Since 1832, many donor bodies have been interred at the Dublin Medical Colleges plot at Glasnevin cemetery. The inscription reads: “here lie those who have assisted us in the study of man . . . pray o traveller for their souls . . . that they rest in the peace of God”. While it may not be a comfortable or easy choice for individuals or their families, it’s clear that donating one’s remains is part of a noble tradition, invaluable to medical education and research.
Donating your body to science
The donation of remains to medical science is governed by the Anatomy Act 1832. Prospective donors should contact their nearest medical college: Trinity College Dublin, University College Dublin, Royal College of Surgeons Dublin, University College Galway, or University College Cork. Those resident in Northern Ireland can donate to Queen's University, Belfast.
Donors must complete a registration form; it is not sufficient to record your intention to donate in your will. Its recommended that your next of kin, a close family member or your executor acts as your witness.
The remains are usually held for one to three years, and are then interred in accordance with the wishes of the donor and in consultation with the family.
