Why more Californians are becoming body donors for medical teaching
Sharon Williams never thought twice when she and her husband decided to donate their bodies for medical research at UC Davis. Her parents, both 99 when they died, had done the same thing years ago in Tuscon, Ariz.
“It just made sense. Rather than just being buried, if there’s an inkling of a chance of solving a (medical) problem by donating, we wanted to do it,” said Williams, sitting recently in her sunny Davis duplex. When her husband, Hibbard Williams, a former dean of the UC Davis medical school, died in July at age 83, his body began a new life as a medical donor.
Williams and her late husband are two of about 11,000 individuals registered with the UC Davis body-donation program, one of five at University of California campuses.
Despite recent headlines of careless handling of donor remains in other states and a rash of lawsuits over illegal activities in UC donor programs a decade ago, more individuals like the Williamses choose to donate.
“It’s a way for people to give back,” said Aron Davis, director of the UC Davis body-donation program, who said about 35 to 40 new donors sign up every month. “Each donor body touches a countless number of individuals, from a fledgling medical student to their future patients and the families of those patients.”
“The need is fantastic” from medical schools, community colleges, researchers and university classes, the former funeral director said. “I don’t see demand decreasing, ever.”
While some parts of the country have reported shortages of body donors, the UC body-donation program has seen “modest but consistent” increases statewide, roughly 3 percent a year in the past decade, said Brandi Schmitt, executive director of the University of California’s Anatomical Donation Program, which covers five medical school campuses in Irvine, Los Angeles, Sacramento, San Diego and San Francisco.
The uptick, she said in an email, is likely due to “a combination of (older) population demographics, outreach efforts and knowledge of the program.”
Another factor may be financial: Aside from altruistic motivations to further medical science, body donation avoids the expense of a funeral, cremation or burial.
“The majority of people donate because they want to make a contribution to mankind and advance science and education,” said anatomy professor Richard Drake, an industry expert who heads the body-donor program at Cleveland Clinic in Ohio. “But there’s also a financial aspect. Some people don’t want to put that debt on their family.”
Upon death, most donor programs will transport the body to a medical morgue, handle arrangements for research or medical use, then provide cremation – all at no cost. Some programs will return ashes to loved ones; the UC program does not but scatters the ashes at sea, either off San Francisco or Southern California.
California’s body-donation programs are thriving despite a rocky past.
In 1999, the director of UC Irvine’s program was fired for allegedly selling six spines to a Phoenix research company for $5,000, according to news reports. In 2004, the former director and a middleman with UCLA’s program were arrested for selling hundreds of body parts to pharmaceutical and medical firms, allegedly raking in as much as $1 million; the pair were later sentenced to prison terms. And in 2005, a UC Davis autopsy assistant, David Lawrence Beale, was sentenced to 32 months in prison for stealing about 150 pounds of body parts from the campus body donor lab.
In February, George Washington University’s medical school in Washington, D.C., suspended its body-donation program after officials acknowledged they had lost the individual identifications of about 50 sets of cremated remains, which were unable to be returned to families as promised, according to The Washington Post.
Those rare but unsettling cases apparently haven’t hurt overall donations, according to the UC donor program and others.
“When stories like that come out, we’d get more requests for donor registration forms,” said Drake, who is co-editor of the American Association of Anatomists journal. “It is kind of weird. Those stories haven’t really hurt things.”
But, he said, those cases are constant reminders of the need for vigilance.
In 2005, following the scandals at its Davis, Irvine and Los Angeles campuses, the UC donor program adopted more stringent procedures, record-keeping and centralized operations, with even a program director in the UC president’s headquarters in Oakland. Each campus program undergoes quarterly inventory and regular audits, tracking every donor from arrival at a UC morgue to cremation and scattering at sea.
The past problems were caused by lone individuals acting without oversight, said UC Davis anatomy professor Richard Tucker. Starting in 2005, “there was a systemwide response to prevent anything like that from happening again,” he said.
There is no federal oversight of body-donor programs, although the 1987 Uniform Anatomical Gift Act prohibits the sale of body parts.
Nationally, no one has precise numbers on how many Americans donate their bodies each year for medical classes and research. An estimated 120 to 140 body-donation programs – either state-run or university sponsored – bring in an estimated 10,000 to 15,000 bodies annually, according to the American Association of Anatomists. Another eight or so private donor companies, such as Science Care, which operates in California, also supply schools, pharmaceutical companies and medical firms.
Body-donor programs are not as widely known as organ donation, in which a person’s heart, liver or corneas, for instance, are donated for transplant into a living patient. But baby boomers may be particularly well-suited to donate their bodies, rather than individual organs.
“It’s a very different kind of donation when you’re a whole-body donor,” Tucker said. “As we get older and our bodies wear down, our tissues and organs may not be appropriate for donation. So Plan B, as a whole-body donor, is another option.”
Anyone over 18 can be a body donor, although some may be ineligible due to certain contagious illnesses, including Hepatitis B and C. “They’re communicable (diseases), so if a student cuts themselves while working (on a cadaver), it can be a health concern,” said UC program director Davis.
Other reasons that might prevent a body donation include obesity, trauma, extensive surgeries and some autopsies.
Body-donor shortages have been reported in some parts of the country, but in California, experts say, demand can be high, especially in regions such as Sacramento with a variety of medical training programs for doctors, nurses, emergency responders, physical therapists and others.
Bodies donated to UC Davis are used by instructors at community colleges, as well as private universities. William Jessup University in Rocklin, for instance, wants already-dissected cadavers for graduate and undergraduate classes. Community colleges from as far away as Humboldt and Butte counties request cadavers for anatomy courses. Doctors, nurses and others taking UC continuing-education classes use them to practice injections and emergency medicine procedures.
A sentimental bond often occurs with first-year medical students, who spend a semester intimately working with a donor body in their anatomy lab.
“It’s both their first patient and their instructor,” said Tucker, who’s taught anatomy and cell biology for 22 years. “It’s a profound experience.”
They spend 12 weeks painstakingly studying the arteries, veins, muscles and internal organs of the donor, who’s typically embalmed in formaldehyde solution and draped in cheesecloth. When the semester ends, students often hold impromptu farewells or leave behind flowers, notes and cards at their cadaver’s lab table as a silent goodbye. One year, a student left a red stocking cap to keep her patient’s head warm in his final days before cremation, Tucker said. Another medical student, who was a Buddhist monk, gathered with fellow students to chant prayers and burn incense.
Every fall, a memorial service is held on the Davis campus, where the name of every individual donor is read aloud. Medical students sing songs, express thanks. Family members of donors who are military veterans receive a U.S. flag. “Taps” is played.
“People want closure. This is the service where they can say their goodbyes,” Davis said. About 500 people attended this year’s ceremony, including families who flew in from Philadelphia for the occasion, he said. There’s also a permanent plaque on campus memorializing donors who have “gifted their earthly remains.”
While plastic anatomy models and virtual dissection are used in U.S. classrooms, working with a once-living human body, with all of its imperfections, is an invaluable research and teaching tool, say professors.
“If you’re just learning from pictures in a book, you might think that all your patients are the same,” said UC Davis’ Tucker. “But in a room with 24 (cadavers), students learn that we’re all as different on the inside as the outside.” Years later, as a practicing doctor, “those differences might be the reason why a patient just walked into your office.”
Being a body donor
Who’s eligible: Any adult 18 or older can register to become a body donor after death. If not registered, the surviving spouse or person holding power of attorney at time of death can sign a donor form.
Who’s not: Individuals with a contagious disease, including Hepatitis B or C, tuberculosis, HIV/AIDS, Creutzfeldt–Jakob disease (brain disease) or MRSA (staph infection) cannot be donors. In some cases, bodies cannot be accepted due to obesity (generally 250 pounds or more), trauma, organ donation, extensive surgery or autopsy.
How it works: With the UC Davis donor program, the donor’s body is transported to the medical school’s morgue, where it’s embalmed and “cured” for up to eight months, before being available for anatomy classes and medical research. After a semester or up to five years of donor service, the remains are cremated and scattered at sea, according to state regulations. Each campus holds a memorial service for individual donors and their families. For more information on the UC Davis program: Call 916-734-9560 or go to: ucdmc.ucdavis.edu/bodydonation