THE HISTORY ISSUE
The first great bioethics debate began 2,000 years ago with a clash between the scalpel and the cross.
Scientists and physicians say it will add to the storehouse of human knowledge and improve our ability to tackle disease. Conservatives and ethicists argue that it violates the sanctity of the human body.
Sound familiar? We've been there before. From the advent of anesthesia to the original organ transplantation, medical advancements have quickly become ensnared in religion, cultural mores, and politics. But it's the centuries-long tumult over cutting up cadavers that, more than anything, echoes in today's biotech debates.
Like the stem cell controversy, dissection raised questions about where the body and soul begin and end. The ethical firestorm got under way as far back as the fourth century BC - the era of Aristotle and Hippocrates. The prevailing religious attitudes of the period considered the body and soul to be separate entities, making dissection acceptable. But during the time of the Romans, the practice was banned. For the next 1,000 years, scientists were reduced to dissecting animals. The famous Greek anatomist Galen, whose work in the second century was the basis for all anatomical assumptions for nearly 1,400 years, relied almost entirely on pigs and monkeys for scientific research.
By the Renaissance, attitudes had begun to shift again. In the late 15th century, Leonardo da Vinci secretly made use of human cadavers for his anatomical drawings, detailing the human skeletal, muscular, and vascular systems as never before. In 1543, Andreas Vesalius, considered to be the father of modern anatomy, published his anatomical treatise De Humani Corporis Fabrica, a series of detailed woodcuts of dissected corpses.
Overcoming social taboos was a problem; dealing with a dearth of corpses quite another. Just as today's stem cell researchers face a shortage of embryos, physicians for centuries have had to scrounge for cadavers.
By cultural consensus, treatment of the body following death was linked to the soul's fate. At a time when scores of post-death rituals were performed to prepare the soul for the afterlife - such as carrying the corpse from the house feetfirst, or singing before traveling across water - who would want their body violated after death? (Or worse, while presumed dead. According to legend, a very surprised Vesalius, conducting a dissection in Spain, was met with a cry of "Ouch!" from the supposedly dead corpse.) "In the recesses even of the rational mind," writes British historian Ruth Richardson in her book Death, Dissection, and the Destitute, "there lurked the fear that mutilation of the corpse might have eschatological implications."
In their quest for bodies, scientists in Europe and the US soon found themselves brushing up against all sorts of shady characters in a sordid cadaver pipeline. Britain's Henry VIII endorsed a policy to donate the bodies of executed criminals to med schools. That produced cadavers - but it also created a fresh set of problems. As med schools grew dependent on corpses from the gallows, dissection came to be considered the ultimate punishment.
And still the shortage continued - so much so that a black market developed. In Scotland, William Burke and William Hare ran a boardinghouse as a front for what was really a cadaver factory. They murdered tenants and delivered the bodies to anatomy schools for as much as £10 each - nearly five months' wages for the average working man. A gruesome twist of poetic justice: Burke was eventually hanged and his body subjected to a public dissection; Hare testified against his co-conspirator and was spared. According to another tale from the era, a student recognized the cadaver on the table in front of him as that of a prostitute who had been alive and well the night before.
Similar scenes played out across the ocean into the 19th century. In New York, a young boy stood transfixed outside a hospital window as a student taunted him with a dismembered arm, shouting that it belonged to the child's mother. By coincidence, the boy's mother was in fact dead - and a check of her grave revealed that her body was missing. Her outraged widower spurred a protest that escalated into a riot.
Finally, the government stepped in. By the mid-1830s, many US states and the UK had passed the Anatomy Act. The act ended the practice of ushering criminal corpses - replacing them with the bodies of people too poor to afford a proper burial. Unfortunately, this did little to stop the grave robbing, and incited the poor to protest.
Over time, as consent became necessary for dissection, the public gradually lost some of its disdain for the practice. Attitudes toward death also shifted. With so many soldiers failing to return home from World War I, society learned to separate the whereabouts of a dead body from a soul's fate in the afterlife. Slowly, med schools began to receive a steady supply of legitimately donated corpses.
Today, dissecting cadavers is a critical component of every medical education. "Without the anatomical understanding of the human body that is afforded by dissection," says Joel Howell, a professor of history and internal medicine at the University of Michigan, "much of modern medicine would simply not exist."
Will science prevail in the stem cell debate just as it has with cadaver dissection? History says yes. "Eventually the public comes to a consensus about how to deal with these medical and ethical issues," says Myron Weisfeldt, chair of the department of medicine at Johns Hopkins University. "That's what's going to happen with stem cells."
And this time it won't take 2,000 years.
