Bill Would Require Relatives’ Consent for Schools to Use Cadavers
Article originally published by: NYTimes
Ever since grave robbers haunted American cemeteries and medical students paid for fresh corpses, New York State law has appropriated unclaimed bodies on behalf of medical schools that teach anatomical dissection.
But on the last day of the legislative session this month, lawmakers voted overwhelmingly to end that 162-year-old system by requiring written consent from a spouse or next of kin before city officials can release an unclaimed body to a school, unless the deceased is already registered as a body donor.
Though the new measure applies only to New York City and still needs the governor’s signature to become law, its passage in both houses on June 16 showed a significant shift in public attitudes toward human remains and the dead the city considers unclaimed.
The vote — 61 to 1 in the State Senate, 107 to 32 in the Assembly — came a month after a New York Times investigation highlighted provisions in the current law that give families as little as 48 hours to claim a relative’s body before the city must make it available for dissection or embalming practice. The city has offered at least 4,000 bodies to medical or mortuary programs in the past decade, records show, and among these, more than 1,877 were selected for use before burial in the city’s mass graves on Hart Island.
In practice, with the rise of body donations, few medical schools in New York still collect unclaimed corpses from city morgues. Officials at the Albert Einstein College of Medicine in the Bronx, one of the few that have continued to rely on significant numbers of unclaimed cadavers, decided to stop after The Times’s article was published.
Still, an association of the 16 medical schools in the state strongly opposed the measure, which had failed to pass the Assembly last year after similar opposition. In a memo to legislators, the association, the Associated Medical Schools of New York, was especially critical of a provision that makes the schools responsible for obtaining consent, pointing out they lack access to the records that public administrators use to identify the dead and their next of kin.
The memo also warned that the consent requirement would essentially mean the end of the educational use of bodies without known survivors. It cited a current shortfall of 38 cadavers out of about 800 typically used to teach future doctors each year.
But Brandi Schmitt, the director of the anatomical donation program at the University of California and a leading member of the American Association of Clinical Anatomists, provided a different perspective.
“I think the general modern opinion in the modern world is that consent should be obtained,” she said, citing the evolution of medical ethics and a growing recognition that unclaimed bodies, like unwitting subjects of medical research, have often been people marginalized or exploited in life.
Practices in the United States regarding the unclaimed dead vary widely from state to state and even from county to county, experts say, with many jurisdictions still governed by laws rooted, like New York’s, in 19th–century efforts to curtail grave robbery. Even amid a booming international marketin donated bodies, in countries where dissection clashes with prevailing funeral rites, as in the Middle East and parts of India, a trade in unclaimed bodies has often arisen to fill demand.
The background to the new bill echoes the same clash of interests and climate of scandal that made New York’s first cadaver law controversial in 1854, when medical professionals won despite vehement protests from representatives of working-class and immigrant New Yorkers. The new bill’s co-sponsors were Senator Simcha Felder, a Democrat who caucuses with the Republicans and represents a Brooklyn district that includes neighborhoods that are heavily populated with Orthodox Jews or people of Chinese descent; and Assemblyman Michael Simanowitz, a Democrat from an equally diverse district in Queens.
“Our current laws do not protect the religious or personal rights of New Yorkers,” Mr. Simanowitz said. “We have seen repeated cases of unclaimed bodies delivered for dissection without consideration of religious or personal wishes.”
Robert T. Farley, counsel to Mr. Felder, said that the bill’s original impetus came not only from traditional religious and cultural objections to dissection and embalming, but also from recurrent complaints and lawsuits by aggrieved relatives over bodies mishandled, lost or mixed up at morgues operated by the New York City Office of the Chief Medical Examiner.
In a 2014 case reported by The Daily News, for example, the body of Aura Ballesteros, an 85-year-old Bronx woman who had died at a nursing home, was mistakenly passed by city morgue workers to Einstein medical school despite the city’s agreement to store it while her children made funeral arrangements. By the time her son located the body three days later, he said, it had undergone a type of medical school embalming that left it unrecognizable. The city ended up paying a $115,000 settlement for emotional distress.
Many cases never come to light because the city declines to publicly identify bodies waiting in the morgue or to name those transferred as cadavers, citing privacy for the dead. One of the cases discovered by The Times concerned Milton Weinstein, a disabled Jewish typographer whose mentally ill widow was given no say over what would happen to his body after he died in a Bronx nursing home at age 67. His corpse was swiftly passed from a city morgue to a medical school; it was still serving as a cadaver two years later when his long-estranged sons finally learned that he was dead and tried to find out where he was buried.
In 2014, after being caught in a series of blunders, the medical examiner’s office stopped supplying bodies altogether, and supported the Felder-Simanowitz bill. But the city was forced to resume the flow of corpses last year when it was sued by the state’s leading mortuary school, the American Academy McAllister Institute of Funeral Services.
A century-old institution, McAllister is the only mortuary school in the city. The state requires embalmment training on real bodies for a funeral director’s license and for a school’s accreditation, and unlike medical schools, McAllister has no body donors.
“The bill is a disaster for the school,” its lawyer, Brian Sokoloff, said, adding that the changes threaten to put it out of business. “It makes no sense.”
The school is asking the governor to veto the bill, one of 542 pieces of legislation awaiting his review before year’s end.
McAllister now signs out corpses at the Queens morgue, drives them to embalming classes in Midtown Manhattan and returns them after mortuary students have practiced incisions, drainage and chemical infusion — a process that leaves the cadavers unfit for medical schools’ purposes, and which, absent consent, is seen by some as a bodily desecration.
“The societal good is now being jettisoned because there are a couple of stories of the city not doing what the city should have done,” Mr. Sokoloff contended. “These are people who have nobody. So now to expect the school to go out and become a private detective to try to figure out where are the person’s relatives — how in the world is a mortuary school supposed to do that?”
But the New York State Funeral Directors’ Association remained neutral on the bill, Bonnie McCullough, its executive director, said, out of respect for the wishes and beliefs of the families its members serve.
Transparency and informed consent are now seen as the gold standard in medical ethics, Ms. Schmitt said, citing the University of California’s overhaul of its anatomical donation program in 2005. Over all, its program now receives 1,200 to 1,500 bodies a year, has 30,000 body donors registered statewide, and requires a nine-page consent form that even lists mortuary students among the beneficiaries of an anatomical gift.
“Steadily, the donation rate has increased,” she said.
Photo: The building housing the anatomy department at Albert Einstein College of Medicine in the Bronx. Officials there recently decided to stop collecting unclaimed corpses from city morgues.
Credit: Joshua Bright for The New York Times
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