Improper Procurement and Retention
Taking organs of dead children without parental permission at Alder Hey is a practice The Economist (2001) dubbed the ‘return of the body-snatchers’. There is a historical affinity between the practice of body-snatching in the Georgian period and ‘organ snatching’ at Alder Hey some two hundred or so years later.
As regards the law both body and organ ‘snatching’ were illicit rather than straightforwardly illegal practices. The removal of corpses from graves by the ‘resurrection men’ was not illegal before the Anatomy Act. Although stealing from the corpse and or ‘knowingly’ dissecting the corpse was. It would be more precise to say that body-snatching was an ‘extra-legal’ activity. (Richardson 2006: 155)
The removal of organs at Alder Hey for the most part was also not (straightforwardly at least) illegal. The pathology team at Alder Hey seemingly went through the legal motions of securing consent for post-mortems from parents of dead children. After the scandal broke the retention issue was deemed unlawful and parents secured a successful legal challenge against the removal of their children’s organs.
Even though ‘organ-snatching’ did not involve anything as dramatic as stealing a corpse from a grave in the dead of night, it did under the cloak of seeming medical respectability, amount to something similar to body-snatching.
From the perspective of family and friends the removal of organs without parental permission was experienced as an act of theft. In the case of body-snatching, bodies of the recently deceased were stolen out of graves to the chagrin of those watching over them. In the Alder Hey case organs and tissue was stolen from dead children during post-mortems and retained without the permission of parents.
The Commodity Value of the Cadaver
Another strong historical affinity between body snatching and organ-snatching is its motivation: human material post-mortem has had a strong commodity value over time (even though precisely what has been deemed valuable about human remains post-mortem has changed over time).
The transformation of the cadaver to an object of trade – commodification – took off in the body-snatching era, where the gallows provided nowhere near enough bodies required for teaching and research purposes. Demand outstripped supply and opened up a lucrative market for human remains to anatomy schools. (Richardson, 2001; 52-72)
The corpse to the body-snatcher represented monetary value. From the perspective of the anatomist the corpse is a cadaver, meaning a dead body intended for dissection. The change of signification of corpse to cadaver for dissection and anatomization is interesting and important to understand.
The corpse that had straightforward capital value to a body-snatcher, in the hands of the anatomists becomes a cadaver which has both cultural capital (Bourdieu, 1986) – the body as a resource for medical knowledge, education and skills – and symbolic capital (Bourdieu, 1986) – the body as resource that confers professional legitimization, recognition, honour and prestige. In sum, the transition of corpse to cadaver manifests as alternative forms of capital to different social actors in its commodification.
There are some interesting historical affinities to the procurement of organs at the end of the twentieth century.
The establishment of the NHS in 1948 coincided with altruistic donation where demand and supply levelled out for the first time. (Richardson, 2006) However, the commodity value of human material repeats with a difference, in the second half of twentieth century as organ donation takes off. By the end of twentieth century once organ donation and transplantation surgery become fairly routine, the demand for human organs from recipients needing transplantation surgery outstrips the supply of those willing to donate. This pattern, to some extent at least, is replicated in pathology where the demand to take organs from the dead for research purposes was voracious, especially at institutions like Alder Hey. During Van Velzen’s tenure the culture of ‘taking every organ in every case’ (Redfern, 2001a, 2001b) was partly driven by the promise of cultural and symbolic capital gained through research. More surprisingly still, at Alder Hey there were echoes to the earlier culture of body-snatching for straight profit. Alder Hey sold cadavers for five pounds apiece to a pharmaceutical company for their pituitary glands in order synthesise human growth hormone. (Hurren, 2002)
Finally the improper retention of organs was not isolated to the one institution, Alder Hey. Improper retention was a UK wide occurrence. (Donaldson, 2000) This also resonates with the Georgian period where body-snatching was a widespread phenomenon potentially affecting all classes, although actually affecting mainly the poor who could ill afford to secure the grave from the body-snatchers.
The Moral Ambivalence of the Collectors of Human Material Over Time
Another historical affinity lies in the morally ambivalent character of medical men such as John Hunter and Dick van Velzen who were keen to profit from the improper removal of human remains.
John Hunter gained cultural and symbolic capital from the cadaver. Respected in his time he became a fellow of the Royal Society in 1767 and today is lauded as being the ‘father of modern surgery’ where he is recognised for his careful observation and scientific method in medicine. As an army surgeon Hunter contributed to an understanding of gun-shot wounds and their early treatment. Post-army, Hunter became an acclaimed pioneer of early transplantation surgery where he worked on the transplantation of human teeth. (Moore, 2010)
Hunter is a morally ambivalent character. On the one hand he is lauded for his skills and pioneering work in medicine. On the other hand he can be rightly criticised for his morally questionable methods. Hunter employed agents to obtain stolen human bodies and body parts. He financially induced living donors (often minors) to secure living teeth, which he would implant into rich paying adults. Hunter continued his work despite many set-backs where it was clear that he was harming his patients. Perhaps most worryingly, he was blind to such failures and seemingly impervious to ethical criticism (Richardson, 2006: 159, Moore, 2010)
If we look at Dick van Velzen – who became the villain at the heart of retention scandal at Alder Hey – there is scope for comparison.
Both Hunter and van Velzen were prominent social actors in historically conjoined, yet distinctive disciplines (pathology evolved from ‘morbid anatomy’).
Hunter was a practitioner of morbid anatomy and a surgeon whilst Van Velzen was a professor of paediatric pathology. Like Hunter van Velzen was actively involved in the improper removal of human material. Hunter paid agents to illicitly procure bodies. Van Velzen directly participated in ‘organ theft’ by flagrantly abusing consent procedures and lying to parents about the extent of his post-mortems. Again, like Hunter, his motivation seems to have been research led.
Unlike Hunter van Velzen’s research ambitions came to nothing as human materials remained in storage unused. Van Velzen will be remembered as a notorious nonentity. By contrast Hunter is also understandably acclaimed as a pioneer because of his contribution to anatomy and ‘the birth of modern surgery.’ (Moore, 2010)
Perhaps the most interesting similarity between the two men is their moral blindness. In the transplantation of teeth to live donors, Richardson refers to ‘Hunter blindness’; that is, ‘the ability to focus so narrowly on recipient benefit as to excise the humanity of the donor from contemplation.’ (Richardson, 2006, 159) Van Velzen also seems to have developed a similar form of blindness, dogmatically defending his virtue as a researcher and consistently maintaining that he had done ‘nothing wrong’ in removing and retaining organs from the dead children of distraught parents post-mortem, despite overwhelming evidence to the contrary. (Dickson, 2001)
Reaction to the Improper Removal of Human Material
Richardson states that ‘like grave-robbery for dissection, organ procurement necessarily impinges upon the fresh grief of bereaved relatives and friends’ (Richardson, 2001; 413). However, in her afterword to Death Dissection and the Destitute there is no space for further explanation.
Some clues are provided in the parental oral evidence to Redfern (2001) as to why such posthumous harm was so heartfelt and psychologically damaging. Inferences here may be drawn to body-snatching in earlier times. In this evidence parents challenge the fact that personal identity ends at death. The mother of Sam who died at eighteen months puzzles at the fact that Alder Hey understood an ‘individual’s identity’ to end ‘at a post-mortem examination, if not death.’ (Redfern, 2001: 425) In other words, this is puzzling because from a perspective within parental grief the narrative identity of a loved one continues on.
For the parents of the child victims of improper retention their capacity to remember their dead was deeply affected by dismemberment. This is illustrated in the oral evidence by the Mother of Kenneth who died at five and a half weeks. She ‘says the memory of her child has been ruined by living under the illusion that he was buried in tact when in fact his heart was missing.’ (Redfern, 2001: 410-411) In short, in certain cases, improper dismemberment affects remembering.
It is highly likely that body-snatching, some two hundred years earlier, would also have complicated grief in some way or other. Exactly how is difficult to ascertain as the historical evidence of the internal lives of ordinary people is, more often than not, unavailable to historians.
The more evidentially obvious comparison to be made between body-snatching and organ-snatching is in the high-emotion and public furore that both caused.
Bodily theft and respect for the dead generated high emotion and visible public commotion in the Georgian period. For example catching a body-snatching gang at Lambeth in the district of London in 1795 was reported as:
“people of all descriptions, whose relatives had been buried… demanded to dig for them…in great numbers forced their way in, and in spight of every effort the parish Officers could use, began like Mad people to tear up the ground…” “Great distress and agitation of mind was manifest in every one, and some, in a kind of phrensy, ran away with their coffins of their deceased relations.” (First cited, Richardson, 2004; 935)
Furthermore in early January 1832 high emotion led to protest and public violence. A full scale riot erupted at an Anatomy school in Aberdeen which led to violence, looting, and the school’s eventual destruction by being burnt down to the ground. (Richardson, 2001: 90-91)
The events at Alder Hey also spawned high emotion and a public furore (though it did not lead to public disorder, violence and the burning down of a medical school). In the case of the organ- snatching anger was organised through an interest cum pressure group called Parents who Inter Their Young (PITY 2) that spoke truth to power. Parents talked of having their children ‘butchered’ and ‘desecrated’ post-mortem without their consent. Many also talked of the hospital having ‘betrayed their trust.’ (Redfern, 2001)
Another interesting comparison between the two cases is how public outrage finally leads to parliamentary intervention. In both cases parliament acted once medical personnel and medical institutions became implicated and incriminated.
An important factor that led from popular protest against the body-snatchers to the select committee that officially looked into the issue was the prosecution and conviction of an anatomist in 1828 for unlawfully conspiring to obtain and receive a body. The proven collusion between an anatomist and resurrectionists ‘effectively incriminated anatomical enquiry, and at last caused Parliamentary action to be taken.’ (Richardson, 2001b)
Likewise once a medical institution was implicated parliament was forced into a formal investigation of organ retention in the Alder Hey case. Once Ms. Rowlands, the Chief executive, could no longer reassure parents that the organ retention issue was neither unusual nor deviant in any way, the hospital as van Velzen were potentially incriminated forcing parliament to intervene with a Public Inquiry.
The final comparison worth drawing is that both body-snatching and organ snatching violated certain cultural and religious taboos.
In the eighteenth century body-snatching violated both cultural and religious taboos by running roughshod over complex funerary customs that existed in caring for the dead. The notion of a ‘decent’ funeral had strong cultural currency and was deeply entangled in how the dead needed to be treated in order to ensure safe passage in a life hereafter.
With the decline of religion and folkloric belief in the nineteenth and twentieth centuries comparisons may seem difficult to make. Nevertheless, even in the highly secular times where science supposedly outs belief and superstition about a life hereafter, Alder Hey demonstrates that dismembering the dead was still culturally and religiously taboo.
Many of the Alder Hey parents affected were Catholic and were intent on having a ‘decent’ funeral, even if it meant multiple funerals in order to bury their children whole. For example, from the parental evidence to Alder Hey the family of Philip (5 years 3 months):
“The first funeral was a Catholic burial. The Church was packed with friends, family and work colleagues. Their son should have been buried intact. His body was desecrated. The second funeral was very low key. Seven people attended. Their son could not face the second funeral. They feel that the first funeral was indecent. They were not sure what they were burying at the second funeral.” (Redfern, 2001b: 425-426, my italics)
The unauthorised removal of Philip’s organs was perceived as desecration of his body. This is significant because the word ‘desecration’ has a double meaning: the harming of ‘someone that is dear and loved’ and the harming of something that is ‘sacred and revered’. It is quite possible therefore, that the desecration of the dead at Alder Hey, in the eyes of Catholic families deeply contravened their religious belief, as well as complicated grief by affecting their capacity to truly remember them. The possible contravention of belief resonates in official Catholic teachings where integrity of the corpse is implicitly required for physical resurrection in the after-life at the Last Judgment. (Burke, 2016) While it is mistaken to think that parental beliefs were magically synonymous with the churches teaching, it is likely that Catholic parents were deeply worried that burying their children in pieces was sacrilegious in some sense or other.
— Floris Tomasini, Lighthouse Cottage
For the last twenty years, Floris has worked in applied philosophy, working on: belonging and sense of place; trust and health-care, bioethics, philosophical aspects of genomics, philosophy of mental health, philosophy of disability, vulnerability and death. Before turning to academia, Floris worked: as a deckhand on trawlers; as a ‘roadie’ for Queen and David Bowie; in prisons and secure mental health facilities and as a full-time volunteer in a night shelter for the homeless in London. He was also once a history teacher and military journalist.
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