>Death and Dying: The Sequel

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            I always knew I was a sick man.  I just wasn’t sure how to define the malady.  Was it urangst – a primal fear of death?  Or was it a milder syndrome described by Stephen Holden as “upper middle class angst as old age and death loom, and there is suddenly too much time to fill”?   
            The main symptom – a preternatural absorption with the process of dying – appeared decades ago.  Since 1973, I have been immersed in scholarship about the legal aspects of death and dying.  The object was to outline the best methodology – in both practical and legal terms – for dying with a modicum of dignity.  The product was dozens of articles in medical and legal journals and 3 books featuring titles like “Advance Directives and the Pursuit of Death with Dignity.”  By 2005, when I retired from law teaching, I had pretty much said all I cared to about end-of-life decisionmaking – the range of options open to dying medical patients and their families. 
              Then a new vista opened.  I realized that there’s a natural segue between absorption in the dying process and preoccupation with people’s post-mortem fate – the disposition of human remains.  Raw emotions, sharp disputes, and legal uncertainties are just as ripe and just as gripping in the post-mortem as pre-mortem context.  This revelation was spurred by an episode involving the remains of baseball great Ted Williams.  After Williams died in 2002, his daughter sought to fulfill his 1996 will dictating that his remains be cremated and his ashes scattered over the Florida Keys where he had spent many happy times fishing.  Ted’s son wanted to have his father’s corpse frozen and transferred to a cryonic storage facility in Arizona so it would be ready for restoration whenever science might master the technique of revivifying dead human beings.  The son contended that his father had, while hospitalized, changed his mind about cremation.
            Many things about the story of Ted Williams’ remains caught my attention.  From a legal perspective, which of the several interested parties really controlled the disposition of the corpse?  The executor responsible for implementing the will?  The son who believed that his father wanted to be frozen?  The daughter who believed that her father wanted to be cremated as stated in his will?  And even if someone could reliably discern Ted Williams’ wishes, would those wishes be binding on the responsible parties?  What if Ted Williams had indeed wanted cryonic disposition, but his descendants believed that such a disposition was a futile waste of money, or sacrilegious, or overly burdensome, or just plain undignified?   Would the responsible parties still be bound to implement his wishes?  In short, I wondered about the legal principles governing disposition of a human corpse, especially the question of self-determination concerning one’s earthly remains.  Can a corpse have legal rights?   Is a corpse legally entitled to have prior instructions carried out?  Or do the descendants of the deceased have their own right to govern disposition of the human remains?
            Thus was born the sequel to Death and Dying.  For the next several years, I researched my current manuscript “After We Die: The Life and Times of the Human Cadaver.”  This meant learning not just who legally controls the fate of a corpse, but also what range of dispositions is available for human remains.  I examined what physical consequences accompany each means of disposal, including sepulcher, cremation, cryonic freezing, or mummification.  Some people believe that the physical fate of human remains is irrelevant to a now-dead person, so they are indifferent about post-mortem bodily transformations.  I am not one of them.  Somehow it matters to me whether a buried corpse retains its shape and form or is transformed into a moldy, shapeless, shrunken mass.  I wanted to know whether corporeal disintegration is inevitable and at what pace it occurs.  I learned that a typical buried cadaver will deteriorate to a blackened hulk within two decades, and to a moldy skeleton within forty years.
One lesson of “After We Die” is that advance planning can be useful in the post-mortem context.  A deceased’s wishes usually govern the fate of their corpse.  (Once it was demonstrated that Ted Williams had indeed expressed a late wish for cryonic preservation, his corpse was transferred to Arizona to become a corpsicle).  It behooves a person to articulate his or her preferences for post-mortem disposal.  One’s conception of post-mortem dignity may diverge from that of one’s survivors.  Or survivors may differ among themselves in projecting what the deceased’s wishes would have been if they had only been expressed.  And if beneficence toward fellow humans is one of your inclinations, you might well consider, in formulating instructions, the continuing roles available to the human cadaver as teacher (anatomy lab), scientific research subject, and supplier of used body parts. 
Your good deeds can continue after you die.  Donation of cadaveric tissue benefits the needy recipient, prolongs the physical presence of the deceased, and adds a poignant memory about the late lamented one’s generosity.  Also, dissection of cadavers continues to serve as an important element of medical education.  A Boston University medical student recently expressed her gratitude to the body donor whose corpse provided a critical introduction to the wonders of human anatomy.  She labeled the donation “an exponential gift from one man to eight future doctors to hundreds of patients.”   Likewise, researchers in both academia and industry need cadavers or parts to help expand medical knowledge about bodily afflictions and cures as well as safety products.  Post-mortem examination of the body’s interior sometimes provides insights unavailable from live research subjects – as with brain research regarding dementia or the effects of concussive trauma.
The good news, then, is that a live person is entitled to shape their corpse’s fate in many constructive ways.  Post-mortem human dignity imposes only a few constraints.  For example, don’t try to extend your sexuality beyond your lifetime because necrophilia is an intrinsic violation of post-mortem human dignity even when based on consent. 
The bad news is that a corpse has extremely limited capacity to enforce its predecessor’s instructions.  Implementation of controversial wishes for cadaver disposal may depend on survivors’ willingness to overcome any qualms about the indignity or distaste of a chosen course.   It might help the implementation of disposal wishes if the probable survivors are alerted to any unconventional or controversial plans and their cooperation enlisted.  In November 2009, an 80 year-old Israeli, in failing health, sought a judicial declaration upholding his request to have his corpse thrown to wild animal scavengers on the Golan Heights.  The Israeli court rejected the petition, ruling that such disposal would constitute an intolerable offense to human dignity.  The result is not surprising given the religiously influenced cultural norms that prevail in Israel.  Putting aside practical objections like unsightly debris of skeletonized remains, the question remains whether a decedent’s wish to become fodder for wild animals really represents a debasement violative of post-mortem human dignity.  Is this route any more degrading than burial at sea to become food for the fishes?  Instead of turning to a court, wouldn’t the Israeli man have been better off soliciting advance cooperation from likely survivors?
All this background about “After We Die: The Life and Times of the Human Cadaver” is just to whet your appetite.  Don’t bother yet to look for it on the shelves at Barnes & Noble.  According to publisher Georgetown University Press, publication is scheduled for Fall 2010.  I will be happy to provide a timely reminder. 
 
          – Norman L. Cantor