Whole body donation to medical science

What whole body donation is

Whole body donation is the gift of an entire body, after death, for anatomical education, medical research or surgical training. It is not the same as organ donation and it is not arranged through a funeral home. The body is collected directly by the programme, usually within a day, and the family does not typically see the person again.

Medical schools depend on it. So do the courses where an orthopaedic surgeon practises a new joint replacement, where a trauma team rehearses an airway technique, and where a device is tested before it reaches a living patient. Almost every clinician a family will ever meet learned part of their craft this way.

How it differs from organ donation

The two are separate systems with separate paperwork, and the most common misunderstanding in the whole subject is that ticking the donor box on a driving licence enrols somebody in body donation. It does not. That register covers organs and tissue for transplant into living people, and nothing else.

The two kinds of programme

University and state anatomical programmes are run by medical schools and by state anatomical boards. They exist to teach anatomy to students, they are answerable to a university, and many hold an annual memorial service at which students thank donor families by name.

Private non transplant tissue organisations are companies that supply body parts to medical device firms, research organisations and surgical training courses. Many are entirely reputable and some are accredited by an independent body. They also operate in a part of the sector with far lighter federal oversight than transplantation has, because the federal law governing transplant does not apply to bodies given for education and research. Investigative reporting and several prosecutions over the last decade concerned this sector.

The point is not to avoid one and choose the other. The point is that the questions further down this page are worth asking of either, and that a family should know which of the two they are dealing with before they sign.

What it costs the family

In most cases nothing, or close to it. A typical programme covers collection within its own service area, the cremation at the end, and the return of the remains to the family. Where a cost appears it is usually transport, when the death happens outside the radius the programme covers, and it is charged at the going rate for a long distance transfer.

Set against the alternatives, that is a real saving. A direct cremation runs a national median of $2,202, a cremation with a service $6,280, and a typical burial once the cemetery has billed around $15,395. Families do choose donation partly for that reason and there is nothing dishonourable in it.

Two costs remain in every case. Certified copies of the death certificate, and any memorial service the family decides to hold, which is entirely up to them and can be held whenever they like. Donation removes the funeral home bill, not the death certificate and not the gathering.

What comes back, and when

Cremated remains, if the family has asked for them, and the timing is the part families find hardest. A university anatomical programme keeps a body for the length of a teaching course and its associated study, which commonly runs somewhere between one and three years. Private research programmes are often much faster, frequently returning remains within a few weeks to a few months.

Ask for the expected timeframe in writing and ask what happens if it runs over. Ask also whether the programme will notify the family when the remains are ready, and to whom, because two years is long enough for an address and a phone number to change.

Families who do not want the remains back can usually ask the programme to inter or scatter them, and many universities maintain a donor plot or a memorial garden for exactly this. Several hold an annual service of thanks that donor families are invited to attend, which a surprising number describe afterwards as the most meaningful part of the whole process.

Why a donation can be refused on the day

This is the single most important practical point on the page. A programme can decline a donation at the time of death even where the person registered years earlier, and the family then has to arrange and pay for a funeral at a few hours notice with no plan.

Common reasons for refusal include certain infectious diseases, notably HIV, hepatitis B and C, active tuberculosis and prion disease. Extensive trauma, an autopsy, prior embalming or recent major surgery can also disqualify a body. Body weight at either extreme is a frequent reason, since the anatomical tables and the handling equipment have limits. Death too far from the programme, or too long before it is notified, will end it. And a programme that has simply reached capacity may decline a perfectly eligible donation.

The answer is not to abandon the idea. The answer is to name a second programme and to have a direct cremation provider identified and a way to pay for it, so the fallback is a phone call rather than a crisis. The planning checklist has a place to write both down.

How to register

1. Choose a programme and read its conditions. Start with the medical schools and the state anatomical board in your own state, because proximity is one of the things most likely to disqualify a donation later.
2. Complete the donor forms while the person is alive and able to sign. A documented gift made by the donor is the strongest form it can take, and under the anatomical gift laws adopted across the states it generally cannot be overridden afterwards.
3. Tell the family, in plain terms, and give them the paperwork. Registration is worthless if nobody can find it or knows to ring.
4. Register a backup programme. There is no rule against being registered with two.
5. Write down the fallback. Which cremation provider, and where the money comes from.
6. At the time of death, ring the programme first, before a funeral home collects the person. Its 24 hour number should be with the paperwork.

Where nobody registered in advance, the next of kin can usually make an anatomical gift at the time of death under the same laws, in the order the state sets out. It has to be quick.

What to ask before you sign

What the family gives up

A viewing, in almost every case, because the body is collected quickly and is not embalmed for a public viewing. A graveside, at least for a year or more. A body to sit with. For some families none of that matters. For others it matters a great deal, and it is better said out loud in advance than discovered on the day.

A memorial service is entirely available and needs no body present. Families who donate very often hold one within a fortnight, exactly as families who choose direct cremation do, then hold a second small gathering when the remains come home. If the environmental motive is part of the reason for considering donation, green burial is the other route worth reading about.