03 October 2012

Bullies and Bodies

'Schools, Cyberbullies, and the Surveillance State' by Deborah Ahrens in American Criminal Law Review (2012) comments that
In recent years, parents, educators, and the media have expressed a rising concern about the prevalence of bullying in our schools. In particular, this concern has been brought to the forefront with the emergence of “cyberbullying” and “sexting”. In response to this perceived epidemic of poor student behavior, legislatures and school officials have adopted a variety of new laws and search policies. Most notably, they have adopted policies that give school officials the authority to search students’ electronic communication devices. This article narrates these developments, assesses their impact on the lives of students and the culture of our schools and then locates them in broader trends in schooling, parenting, and policing. More specifically, this article explores the degree to which our sharp spike in concern over traditional bullying, cyberbullying, and sexting, and our resort to the surveillance of student devices as a response to such a concern, reflects important lessons about our collective conception of student privacy, about the expectations that parents have of the role that school will play in their children’s lives, and about the transformation of public schools into public institutions focused on criminal law and criminal-law-like approaches to perceived social problems. When analyzed in cultural context, our schools’ initial response to concerns about cyberbullying and sexting is disquieting. Though understandable — indeed even predictable — the approaches we have thus far chosen do not reflect considered policy supported by empirical evidence, but, rather, one more step in the reorientation of American institutions generally, and public schools specifically, towards the reflexive adoption of surveillance and punishment as the response to any potentially serious problem.
'Anatomy's use of unclaimed bodies: Reasons Against Continued Dependence on an Ethically Dubious Practice' by D. Gareth Jones and Maja I. Whitaker in (2012) 25(2) Clinical Anatomy 246 comments that
The use of unclaimed bodies has been one of the distinguishing features of the anatomy profession since the passing of nineteenth century legislation aimed at solving the problem of grave robbing. Only in more recent years has the use of bequeathed bodies supplanted dependence upon unclaimed bodies in many (but not all) countries. We argue that this dependence has opened the profession to a range of questionable ethical practices. Starting with contraventions of the early Anatomy Acts, we trace the manner in which the legitimacy of using unclaimed bodies has exposed vulnerable groups to dissection without their consent. These groups have included the impoverished, the mentally ill, African Americans, slaves, and stigmatized groups during the Nazi era. Unfortunately, ethical constraints have not been imposed on the use of unclaimed bodies. The major public plastination exhibitions of recent years invite us to revisit these issues, even though some like Body Worlds claim to use bequeathed bodies. The widespread use of unclaimed bodies in institutional settings has lent to these public exhibitions a modicum of legitimacy that is needed even when donated bodies are employed. This is because the notion of donation has changed as demonstrated by consideration of the principles of beneficence and non-maleficence. We conclude that anatomists should cease using unclaimed bodies. Difficult as this will be in some cultures, the challenge for anatomists is to establish relationships of trust with their local communities and show how body donation can assist both the community and the profession.
The authors note that
A clear trend is emerging from the history of anatomy, whereby use of the bodies of criminals morphed into illegal grave robbing, and this in turn morphed into legal use of unclaimed bodies. The move to reliance on unclaimed bodies was devoid of serious ethical reflection concerning any justification for acting in this way, nor did it face up to any of its implications, such as the significance of these people when alive, let alone of their bodies after death. The result was that unclaimed bodies rapidly came to be recognized not only as a legitimate source of bodies for dissection, but also the normal source (Jones, in press). In other words, dependence upon unclaimed bodies became normalized within the world of anatomy; their legal legitimacy transitioned into their ethical legitimacy. 
Quite apart from any legal nicety, the bodies being used had one thing in common: they were the bodies of those regarded as having had little value during life. They were the bodies of the poor, the marginalized, and those disadvantaged on cultural and/or racial grounds. The powerful drive for dissection-based learning trumped most other considerations. At one stage this allowed anatomists to support grave robbing and even on occasion murder in the interests of anatomy and medicine (Dasgupta, 2004). If transitions of this magnitude elicit little ethical reflection, there is nothing to hinder further transitions from occurring—such as the bodies of the homeless, the illegal immigrant, or the political prisoner being funneled to anatomy departments. 
Even when such atrocities lay largely in the past, the uncritical acceptance of the legitimacy of using unclaimed bodies was only made possible by ignoring the cultural inequities of their societies. Sadly, anatomists by and large operated within a heuristic atmosphere in which their scientific and medical aspirations overruled a host of relevant social, economic, and moral considerations. They appear to have been content to reflect the social mores of the privileged strata they occupied within society, and they failed to look beyond their own immediate interests or those of their profession. 
The rationale behind the use of unclaimed bodies was that since burying them used the state’s resources, passing them on to medical schools for dissec- tion benefitted both the state and the medical school. An allied argument was that this would compensate society for the burden these people had been during their lives. The Washington Post in an 1887 editorial asked: ‘‘Why would those who have made war on society or have been a burden to it be permitted to say what shall be done with their remains? Why should they not be compelled to be of some use after death, having failed to be of value to the world during life’’ (quoted in Garment et al., 2007). 
A comparable argument today could support a willingness to use the bodies of those who have suffered from chronic medical conditions throughout their lives. Having been supported by the state’s resources throughout life, why not get something back by freely using their bodies after death? One would hope that anatomists would find such a rationale ethically objectionable. 
The primary concern of anatomists has been the education of medical students, and in some cases the commercial success of their medical schools (Savitt, 1982). It is this unbalanced emphasis on anatomical education that has proved so problematic, both in the early twentieth century and subsequently. 
Consequently, elements of the historical trends traced in the previous sections are also evident today. In one medical school in South Africa unclaimed bodies sourced from government mortuaries provided 77.8% of all bodies used for dissection between 1956 and 1996 (Labuschagne and Mathey, 2000). Almost all of the black and coloured (mixed heritage) bodies were received from government mortuaries (99% and 95.8%, respectively), whereas only 34.1% of the white bodies were unclaimed bodies. The practice continues across Africa today (Gangata et al., 2010). At one Nigerian medical school, for example, there were no bequests at all; all the cadavers were supplied from the state hospital as unclaimed bodies (presumably of homeless people), accident victims, or suspected bandits shot by police (Osuagwu et al., 2004). The situation is similar in Bangladesh (Chakraborty et al., 2010), Brazil (de Melo and Pinheiro, 2010), and India (Ajita and Singh, 2007). 
By comparison, the use of unclaimed bodies is much less frequent in the United States, but the prevalence of the presence of the bodies of the poor and blacks continues a historic inequity. This is not a marginal issue, since they still constitute the source of cadavers in about 20% of United States and Canadian medical schools (Dasgupta, 2004). Some states, including Maryland, Pennsylvania, North Carolina, Michigan, and Texas, automatically pass on unclaimed bodies to state anatomy boards (Dasgupta, 2004; Harrington and Sayre, 2006; Cunningham, 2009; Funk, 2010). For instance, in 2002, 40% of bodies used for study in Maryland were unclaimed bodies. The Maryland Body Donation Program has even boasted of making money for the state by charging medical schools a nominal fee for the cadavers provided (Cunningham, 2009). In some other states unclaimed bodies are accumulating in state mortuaries as more families find themselves unable to afford funerals and states cut funding for public burials (Funk, 2010). In contrast, medical schools in Kansas and Oregon have recently decided to refuse to accept unclaimed bodies despite their legality (Saker, 2009; Koranda, 2010). 
This raises the question of what qualifies as an unclaimed body in the United States. According to Coelho and Caplan (1997), this is usually the body of an individual who has died in a hospital or nursing home but which has not been claimed by family. Homeless or indigent people found on the street are rarely used these days, unlike the past, since these are no longer considered suitable for anatomical study. The result is that the number of unclaimed cadavers received by medical schools is relatively small (Davidson, 1995), although in some larger cities they may constitute a major source of cadavers for dissection. 
Anatomists should not hide behind the claim that the practices in which they engage are legal; for instance, they were legal in Nazi Germany. What should have been queried was whether practices considered legal are ethical by any generally accepted notion of what constitutes ethical practice. In other words, anatomists have a responsibility to be both ethically aware and ethically astute, and not blindly accept the standards imposed by their political masters (Jones, 2011a). However, when the use of unclaimed bodies is accepted, and when this is legal, there is little in place, beyond the moral char- acter of individual anatomists, to stem unethical practices. 
The use of unclaimed bodies does not, of course, lead inevitably to the ethical catastrophes encountered in the anatomical practices undertaken in Nazi Germany, but it may provide an environment that makes possible such activities. If anatomists had stipulated that they would limit their use of bodies to those bequeathed following free and fully informed consent, the consequences for the practice of anatomy would probably have been major. However, this was never tested.
The article is usefully read in conjunction with 'Dissecting the history of anatomy in the Third Reich — 1989–2010: A personal account' by William E. Seidelman in (2012) 194(3) Annals of Anatomy - Anatomischer Anzeiger 228
a personal narrative of involvement with the revelations of the use of anatomical and pathological specimens of victims of Nazi terror. The narrative documents responses to the question of the retention and use of anatomical and pathological specimens from victims of Nazi terror by leading academic and scientific institutions and organizations in Germany and Austria including the government of the Federal Republic of (West) Germany, the University of Tübingen, the University of Vienna, the Max Planck Society and the Anatomische Gesellschaft. It begins with the public revelations of 1989 and concludes with the September 2010 Symposium on the History of Anatomy during the Third Reich at the University of Würzburg. The narrative documents a 22-year transition in attitude and responses to the investigation and documentation of the history of anatomy and pathology during the Third Reich. The chronicle includes the 1989 proposed “Call for an International Commemoration” by the author, together with the bioethicist Professor Arthur Caplan, on the occasion of the planned burial of the misbegotten specimens and the responses to that proposal.