The Economics of Everyday Things - 22. Cadavers - Part 1

Episode Date: October 23, 2023

In the first of two episodes, Zachary Crockett digs into the strange and discomfiting history of cadavers, and the industry that has emerged around them. RESOURCES:"From Grave Robbing to Giving Your Own Body to Science – A Short History of Where Medical Schools Get Cadavers," by Susan Lawrence and Susan E. Lederer (The Conversation, 2023)."Box of Human Heads Stolen From Truck in Denver," by Carly Moore (FOX4, 2022)."A Body Donated to Science - but Used to Test Bombs," by Rozina Sini (BBC News, 2019)."How an American Company Made a Fortune Selling Bodies Donated to Science," by John Shiffman and Brian Grow (Reuters, 2017)."From Sacrilege to Privilege: The Tale of Body Procurement for Anatomical Dissection in the United States," by Raphael Hulkower (The Einstein Journal of Biology and Medicine, 2011).The Anatomy Murders, by Lisa Rosner (2010).

This is an anatomy class at Georgetown University School of Medicine. It's not a morbid curiosity to learn of what was inside of us or to work with a dead person. A professor is briefing a classroom full of anxious students and blue scrubs. They are about to embark on a right of passage. Their first dissection of a human cadaver. If you hit that perfect layer, then it just pulls right back. See, there's kind of that little bit of weight there that connective tissue. We learn about how human bodies work by studying dead ones. And not just in the classroom, researchers use cadavers to study chronic illnesses.

Medical device makers use them to test out new tools. The military blows them up to measure its explosives. Science, education, and technology all rely on a steady stream of cadavers. And a lucrative for-profit industry has arisen to fill the demand. Last year alone, we placed more than 45,000 anatomical specimens for research, training, and education in 50 countries worldwide. For the Freakonomics Radio Network, this is the economics of everyday things. I'm Zachary Crockett.

Today, part one of a special two-part story, cadavers. To understand how cadavers became a commodity, you have to go back a few hundred years. To a time when the study of anatomy was still considered a taboo. In Western history, modern anatomy really begins in the 14th century. It is the first time that

humans have access to other humans to dissect. That's Susan Lawrence. She's a professor and head of the history department at the University of Tennessee Knoxville. She studies the history of cadavers. She has a book coming out on the topic with her fellow historian Susan Letterer. Lawrence says that in the late middle ages, being dissected was considered the ultimate punishment. The only bodies available were the bodies of executed murderers or other felons, but a lot of people believed in the literal physical resurrection of the body. people believed in the literal physical resurrection of the body. The idea that the body would be dismembered was particularly abhorrent. This would terrorize or deter other criminals from committing these heinous acts.

The dissections of those criminals were public spectacles with little educational value. But as interesting anatomy grew over the next few centuries, scholars began to realize that watching a demonstration wasn't enough. They needed to do hands-on training. So they started setting up cadaver labs, or places where students could come to dissect. And it's at this point where the supply of bodies of executed criminals is not enough

to deal with the number of students who want to do dissection and to really learn anatomy. In other words, they needed more bodies. And to get them, that's when grave robbing really takes off. It's the stuff of horror shows. It's the stuff of Frankenstein. There were basically gangs of men who would target the graves of the poor, because they would not have been guarded very well.

They would just dig one little hole. You didn't have to unearth the whole grave. You just got down to the head and then pulled the whole body out. By the early 1800s, robbing graves for cadavers was a big business. Bodies can be unearthed in less than an hour and sold to universities for the equivalent of around a thousand dollars in today's money. Some doctors and medical students dug up graves themselves. People got away with it for quite some time. Every once in a while somebody would get caught and then there

would be you know a ruckus. But pretty much people either didn't know what was happening or they turned a blind eye. A few suppliers of cadavers even prayed on the living. In Scotland, there were two grave robbers who decided that grave robbing was an awful lot of work. And so it would be much easier just to kill people to provide very fresh bodies to the anatomists.

And they got away with something like 16 murders over a period of 10 months, among the very poor and the vagrants and the down and outs, people that they thought wouldn't be missed. Around this period, American medical schools began teaching anatomy courses for the first time, and they too obtained their cadavers by nefarious means. They often used the bodies of slaves, and the bodies of poor, free African-Americans. And they, again, didn't raise a whole lot of political fuss. It was when the bodies of white people were involved that the community got more incensed.

Grave robbers eventually started going after wealthier citizens' graves. And only then did it become a hot button political issue in America. The result was a series of state laws that granted medical schools access to unclaimed bodies from prisons, hospitals, and city streets. The decision was driven by economics. If you died on the street or if you died in a public institution, the burial would be

done with taxpayer money. The medical school has to now pay for the body and the disposal. Cudavars were sourced this way for the next century. But in the 1950s, things began to shift. Americans had become less superstitious and more supportive of medicine, thanks to breakthroughs like the first human organ transplants. At the same time, there was a growing distrust in the modern funeral home industry, which

had made dying very expensive. The public began to rally around the idea of willingly donating their bodies to science. There was just one problem. Technically, it was illegal to donate your own body. So, in 1968, legislators enacted a federal framework called the Uniform Anatomical Gift Act. The Uniform Anatomical Gift Act of 1968 was designed to 1968 was designed to enable organ donation. The whole body donation part is simply kind of left over from that that you can donate your body not only for organs but also for research and for education. So it's kind of an umbrella act that allows multiple uses of the body.

Versions of this act have been instituted by nearly every state in America. They generally define a human body as property and give Americans the right to donate that property to an organization of their choice. But those laws came with an unintended side effect, a new generation of four profit companies that can obtain and sell cadavers with very little oversight. That's coming up. Now that it's legal to donate your body to science, US medical schools have

their own body donation programs. If you bequeathed your body to Georgetown, for instance, the university will give you a donor card to put in your wallet, and when your time comes, you'll be frozen in a lab and put to use within 30 months. Georgetown receives around 120 donated cadavers every year, and it currently has 4,500 living donors signed up. University donor programs like this are strictly not for profit. But if you don't want to end up in a classroom, you have another option. You can give your body to one of America's many for-profit body donation companies who collect bodies and sell them to third parties. We are very transparent about being a for-profit organization, and we are also quick to remind people that funeral homes,

crematories, those entities are, in most cases, also, for-profit organizations. That's Kaelin Goodwin. She's the vice president of marketing at Science Care. We are the world's largest program that's dedicated to the facilitation of body donation for scientific purposes. Science Care opened its doors for business in Arizona 23 years ago. It was started by a funeral insurance salesman who saw an opportunity

to be a cadaver middleman. He'd seek out willing donors, then sell their bodies to businesses that had a need for them. The firm grew to around $30 million in annual sales before it was acquired by a private equity firm in 2016. Today, science care has seven donation facilities across the country, and it accepts bodies in most states. We have, as of yesterday, more than 257,000 people registered with us that intend to donate their body to science.

Science care attracts these donors by marketing body donation as an altruistic act. So one particular campaign that I've worked on this year is the concept of there's a hero in us all. And the idea is helping people understand that we all have this opportunity at the end of our lives to help our bodies go, to expand the knowledge and awareness of our inner workings for the benefit of our future generations. But like other body donation programs, they also offer material incentives.

All accepted donors in the science care program receive free cremation at the end of the program. Anything that's not collected for active projects, research opportunities, etc. is cremated and returned to the designated recipient. According to Susan Lawrence, companies like ScienceCare will often say that they provide a service, not a product. That's kind of the umbrella that these four profit companies are operating under is that they're not actually buying and selling body parts.

They're just selling that process. It is the reimbursement cost for the difficulty of securing the body, preparing the body, transporting the body, all of those things. The body is looked at as a whole and then matched with those different studies and educational opportunities at the time of their donation. But unlike live organ donation, which has strict federal oversight, bodies donated for education or research purposes are largely unregulated. There are no laws against selling them.

Sometimes bodies are sold fully intact to medical schools that have cadaver shortages, either in the US or abroad. But more commonly, the body is cut up into parts, forearms, torso, heads, knees, and sold to multiple entities. It's able to be separated in a way that honors their life and their decision, but also goes to the fullest extent, we collaborate with medical device manufacturers, research organizations, medical professional associations, pharmaceutical companies, and world renowned medical teaching and training organizations worldwide.

Kedava workshops or so-called wet labs are a particularly lucrative market for body parts. When medical device manufacturers design a new tool or when surgeons come up with a new procedure, it needs to be tested, often in bulk, which means the researchers need a specific body part in large quantities. Collectively, body parts from a single donor can generate anywhere from $5,000 to $10,000. A lot of good things come out of these partnerships. Science Care donors over the years have aided in cancer research, Alzheimer's research, the development of new drugs, biomechanical testing that helps us develop new medical devices. The research and development for patient care outside of surgical or emergency training

wouldn't be possible without the gift of body donation. But many donors aren't aware that their bodies will be parted out, and the company never says exactly where those parts are going. In 2022, concerns were raised when a box full of human heads from science care was stolen from a cargo truck in Denver. Even so, science care is one of the most trusted body donation firms in the country. It's one of only a handful of for-profit companies accredited by the American Association of Tissue Banks, the same organization that regulates live organization. It's not a requirement to operate, to be accredited through the AATB. We sought out voluntary accreditation solely to hold ourselves to that higher standard of regulatory compliance.

Goodwin says science care sees it as a moral obligation to take care of the cadavers entrusted to it. When you look at modern medicine and compare it to the medicine that was being practiced a century or even more ago, we really would not be in the position we're in today without the impact of body donation. So you know, at the end of the day, it's a really difficult to learn about the human body without the human body. Susan Lawrence is thinking about donating her own body to science someday.

But when the time comes, she'd prefer to give it to an educational institution, rather than a for-profit company. She's looking at a program at the University of Tennessee that runs a body farm where forensic anthropologists use cadavers to study the decomposition of human remains. Herpologists use cadavers to study the decomposition of human remains. It doesn't bother me at all to think of my body being used for, you know, how did bodies decay in the back of a car or something like that. But she's also worried that the future of body donation could be called into question. It's a delicate social contract that I think could be easily broken if there were enough scandals and Abuse of body parts in a market as unregulated as human cadavers that fear may have some merit

Next week in part two of this story We talk to a man who spent more than a decade in the underbelly of the trade. And he says that the cadaver market can get pretty wild. I didn't have to have any type of medical degree or licensing to take possession of a human body. Do not pay in for a fine cut. You know, we use home depot tools. You know, stuff like that. I don't always say there's zero regulation, but yeah, we use home depot tools. You know, stuff like that.

I don't wanna say there's zero regulation, but yeah, but there is really no regulation. For the economics of everyday things, I'm Zachary Crocket. This episode was produced by Sarah Lilly and mixed by Jeremy Johnston. We had help from Lyric Boutich and Daniel Moritz Rapson. After a while you just get numb. You know, you get this request and you don't think twice about it and then somebody else hears it over the phone and they're like, what the hell?

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