Anatomy: ANATOMY Bodies by Bequest

When Grace Metalious, author of Peyton Place, died in Boston’s Beth Israel Hospital last year, she left a written statement donating her body “in the interests of medical science” to Dartmouth or Harvard Medical School. But Novelist Metalious’ daughter said no.And since in Massachusetts, as in about half of the 50 states, a bequest of one’s own body is not legally binding, the daughter’s objection prevailed. Even without it, Dartmouth would have lost out for another reason: like most states, Massachusetts forbids shipment of bodies for dissection across its borders, and Dartmouth is in New Hampshire.

The Metalious case highlighted a situation that has caused every U.S. medical and dental school a vast amount of trouble and anxiety for most of the past 25 years, and is still afflicting about half of them. Professors say medical students learn anatomy best if only two of them share in dissecting a body; with 8,800 freshmen entering medical schools this year, that would mean 4,400 bodies, plus 1,000 for dental students* and at least 2,000 for research surgeons anxious to practice advanced techniques. By best estimates, U.S. schools are now getting 3,000 bodies a year, only 20% of them by bequest.

No Man’s Property. Under English law, which has filtered through the colonies to the states, a man’s body is not his own property to “devise and bequeath.” Nor is it technically the property of surviving kin, but since they are responsible for giving it decent burial, they have won the right to decide what shall not be done with a relative’s body.

Until recently, the schools relied largely on state laws, which provided that the body of anyone who died with no known relatives, and whose burial would have to be at public expense, should be sent to a medical school. Such arrangements worked reasonably well until World War II, when prosperity, Social Security and VA funeral benefits drastically reduced the number of indigent dead. The schools’ crisis became particularly acute in the 1950s. Today, the situation has vastly improved in a few states.

Closed Seasons. In California, body bequest is not only legal but so generally accepted that the medical schools have been forced to set specific “open seasons” during which prospective donors can bequeath their bodies. U.C.L.A. now has 3,500 donation forms, filed by the living in anticipation of death.

Illinois has set up what it calls the Demonstrators Association to serve sev en medical schools, under the motto, “Let the dead teach the living.” The association gets upwards of 200 bodies a year by bequest, and 300 from state institutions−still far short of the 1,200 that are needed by all the state’s medical and dental schools and research hospitals. In New York, famed private schools Columbia University’s College of Physicians and Surgeons and Cornell University Medical College get many bodies by bequest, but like other schools they must still rely mainly on indigents. Florida resembles California in abundance of body bequests.

Carried with Credit Cards. Some schools used to refuse a body if any surgery at all−even as routine as an appendectomy−had ever been performed on it. Now most insist only that the body be intact (not mutilated, as after many accidents). Post-mortem subjects and commercially embalmed bodies are also unsuitable. The schools themselves use special embalming techniques for preservation. Most schools have developed what they call “bequeathal kits” of legally valid forms: several issue a wallet card (see cut), to be carried at all times along with the driver’s license and credit cards.

Boston’s three medical schools are still hard up for bodies, and Harvard University’s Dr. Benjamin Spector has enlisted the support of Richard Cardinal Cushing, Rabbi Roland Gittelsohn and Episcopal Bishop Anson Phelps Stokes Jr. “The clergy are behind this now,” says Dr. Spector. Most people who donate their bodies feel they are doing something useful for society as well as saving funeral expenses.

* Though dental training emphasizes the head and neck, students are required to dissect the entire body.