Working with cadavers in an anatomy lab it is often a humbling and monumental moment in a doctor’s career. Students spend hours laboring over the corpses with gratitude and reverence for the donation that allows them to practice and learn about human anatomy on their journey to become healers. But sometimes these bodies aren’t actually donated—and the deceased never consented to having their body dismembered.

When a deceased person’s next of kin cannot be located or their family cannot afford a funeral, the responsibility of what to do with the remains rests with the state or county. In these cases, unclaimed bodies are sometimes sent and accepted by medical schoolsbut several experts in the field oppose the practice, raising ethical concerns that these people never consented to being dissected alive.

Writing in New England Journal of Medicine in 2020, a medical student shared her experience discovering that her first patient was actually an unclaimed body after she had already cut it open with a scalpel.

“I still deal with the guilt of dissecting a man who wanted to rest in peace,” she wrote.

There is no central database that counts how many unclaimed bodies are reported each year nationally, and practices vary by state or county in question. Some states—including Hawaii, Minnesota, Vermont, Rhode Island, and New York—have banned the use of unclaimed cadavers in medical education. But schools in other states continue to use them. In Texas, the proportion of unclaimed cadavers accepted by medical schools rose from 2 percent to 14 percent between 2017 and 2021, according to a 2023 study in JAMA.

Eli Shupe, a medical ethicist at the University of Texas at Arlington and the paper’s author, said she was shocked to learn about the practice.

“Using someone’s body, even after their death, without their consent is in tension with many of our commonly accepted norms of best ethical practice in medicine,” Shupe told Salon in a phone interview.

Many in the field are concerned that medical facilities using unclaimed bodies violate the deceased’s fundamental right to consent. Additionally, without being able to identify any of their relatives, there is no way for those performing the dissection to know if the person came from a religious background or had spiritual beliefs that directly contradicted or prohibited body donation, Joy said. Y. Balta, president. of the Human Body Donation Committee of the American Anatomical Association (AAA).

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“Body donation is a noble and altruistic gift, and a person makes that decision themselves,” Balta told Salon in a phone interview. “It’s not something that someone else is imposing on them.”

In addition to the ethical concerns that directly affect unclaimed people, the practice also harms families, Shupe said, citing a recent NBC investigation that found unclaimed bodies were not only sent to the North Texas Health Sciences Center without a family’s consent, but also sold to various other institutions for training purposes. Some families were still searching for their deceased relatives when the media contacted them for the story.

“In some cases, the deceased have relatives who have not been located, either because they were very difficult to find or because whoever was responsible for finding them did a bad job or was careless,” Shupe said. “Sometimes relatives come forward later and learn that a loved one’s remains have been donated without their knowledge, and that can and has caused really serious emotional distress.”

Many programs have reduced this practice in recent years. In 2007, for example, Oregon stopped taking unclaimed bodies after the sister and friends of a dead man – who were not notified of his death and never consented to donate his body to the institution – found his body at Oregon Health Sciences University. In Texas, the county under NBC’s investigation changed its mind POLICY to ensure the burial or cremation of unclaimed bodies. The North Texas Health Science Center did not respond to a request for comment by the time this story was published, but told NBC it will close its lab that accepts these bodies.

However, other data suggest that the practice continues to occur in various institutions across the country. In a 2018 study published in the journal of Anatomical science education12% of 146 medical schools that responded to a survey said they used unclaimed bodies in medical education, with many program leaders reporting that they were neutral on the question of whether it is important to tell students about the origins the body, said study author Dr. Matthew DeCamp, a general internist at John Hopkins University.

“We certainly looked at the whole spectrum in our research,” DeCamp told Salon in a phone interview. “Everything from institutions that knew they were using unclaimed bodies and decided not to tell students at all, to institutions that used it as a learning opportunity to help students develop what we would call their professional identity formation and … to learn about social justice and inequality in our country.”

The use of unclaimed corpses in medical schools was legalized in the 1800s as an attempt to stop grave robbing, in which so-called “resurrectionists” exhumed corpses and sold them to the schools. However, some have argument this simply created a new avenue for medical schools to continue to use bodies from disenfranchised communities.

There isn’t much research on the demographics of the unclaimed, but one in 2020 study Looking at trends in Los Angeles County, it found they were more likely to be poor, unemployed, male and black. However, black people are less likely to donate their bodies consensually at medical schools. This may be due in part to the fact that the medical establishment has a long and fraught history of exploiting black bodies to “advance” science, from The Tuskegee Syphilis Study to the doctor who was once known as the “Father of Gynecology” practicing experimental medical procedures on enslaved black women.

“If we know that unclaimed bodies come from mostly black people, and we know that very few black people donate their bodies or want to donate their bodies, that’s all the more reason for us not to send unclaimed bodies, especially from black people, to dissect,” Balta told Salon in a telephone interview.

Many institutions justify the use of unclaimed cadavers by saying they are needed to cover the need for missing cadavers, according to a short on this topic from the American Medical Association released in May.

However, while some localities have reported not having enough donors to meet the needs of their medical facilities, others reported more than enough. For-profit body brokers even collect enough bodies to ships thousands of body parts internationally each year. This industry requires consent, although family members reported being unaware of the extreme distances the deceased would travel or their bodies would be put through. Some family members, for example, have reported they donate the bodies of their loved ones to these body agents, believing they will be used by medical facilities, and are instead sent to the US Army to test explosives.

“The lack of oversight is a problem here, because if there was an entity that oversees this, then there could be a bank of donors, and people could be sent from one county to another, or from one state to another . , rather than having to step out of those ethical practices,” Balta said.

Other than the Uniform Anatomical Gift Act passed in 1968, there is no federal law governing what is done with unclaimed bodies, said Thomas Champney, a professor of anatomy at the University of Miami Miller School of Medicine. In states that regulate unclaimed bodies, it is simply up to the agency and county to decide what to do with them.

“I really wish there was federal legislation that said all unclaimed people’s data had to be uploaded to a national database where families could search to find their loved ones,” Champney told Salon in a telephone interview. “But currently, there are few regulations and no laws at all.”

Other countries have more centralized mechanisms for regulating unclaimed people, Balta said. In the UK, for example, HM Inspector of Anatomy has the authority to close programs if they do not comply with federal body donation regulations.

AAA creator a task force to establish best practices for body donation in 2019, which Balta said should be published before the end of the year.

“We specifically say (in the guidance) that body donation programs should not accept unclaimed or unidentified people into their programs as a matter of justice,” Balta said.

Even close relatives who choose to donate their deceased loved ones to medical schools may not do so out of a desire to further science. One 2022 study found that the application process for organ donation is highly variable across the country, with many places accepting donors not informing families of everything the process entails. Unfortunately for some families, it may be the only affordable option for dealing with their relatives’ remains, said Lauren K. Bagian, a body donation researcher at Georgetown University School of Medicine.

“He can just donate, because as part of the donation, most of the time institutions will cover the costs of embalming, burial, preparation of the death certificate or transportation of the body, which can be thousands of dollars.” Bagian told Salon in a telephone interview. “That’s another interesting ethical question: Do we accept these donations from next of kin, even though they might be financially motivated, when we don’t need proof that this is what the individual would have wanted?”

It is cheaper for the county or state handling the remains to donate the body to science as well. Each funeral or cremation can cost thousands of dollars, and the new policy in one county in Texas, for example, will cost her $675,000 a year. That, Shupe said, is the price to pay for the county to support its constituents in death — as much as in life.

“These are unclaimed bodies, so it’s easy for them to be overlooked and forgotten,” Shupe said. “It’s nice to see that people are finally paying attention to what’s going on and wondering whether or not they owe stronger obligations to these dying people.”