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Getting into a university as a corpse is easier than getting in alive. All you have to do is fill out a consent form stating your wish to donate. When you die, your family notifies school officials and your body is transported to the university, where you are embalmed and refrigerated until they need you.

After students finish their anatomical studies on you, your remains are cremated and disposed of at an appropriate site. Or, for a fee of a few hundred bucks, your family can have your ashes delivered to them. Body-donation programs follow the guidelines spelled out in the Uniform Anatomical Gifts Act, the legislation that governs disposition of bodies and body parts for dissection, research and transplantation in all 50 states and the District of Columbia.

But what really happens to your body? You've heard stories of medical students goofing around with cadavers -- dressing them up for Halloween and drag-racing corpses on gurneys down the corridors. Are these merely urban legends? Or do the recent bouts of mischief in California and Texas point to larger problem of cadaver mismanagement?

"Those are extremely isolated cases," says Dr. Dwight Phillips, a professor of anatomy at Montana State University and associate director of WWAMI, the body-donation program serving Washington, Wyoming, Alaska, Montana and Idaho.

"There is no widespread problem," says Dr. Richard Drake, director of the body-donation program at the University of Cincinnati. Cincinnati's program is one of the largest in the country, accepting up to 300 bodies a year, compared to the 70 that UC-Irvine accepts annually. "It comes down to one question: How good are the people working in the program?"

Phillips says, "Most schools go out of their way not to offend the families of donors. Most of us feel a certain obligation."

Indeed, most universities do take a kinder, gentler approach to the bodies. Some programs hold annual memorial services for cadavers used throughout the year. In a particularly scenic ritual, officials at the University of Hawaii gather the friends and families of donors along with the medical students who studied the bodies. They pay tribute to the departed, and then the students paddle canoes a mile out from Honolulu Harbor and scatter the ashes into the deep-blue Pacific.

So why are some universities running ship-shape body-donation programs while others are drifting into turmoil and criminal misconduct? Part of the answer is that there is no centralized umbrella organization monitoring willed-body programs around the country. The structure of accountability fluctuates wildly from university to university. Many programs, like the one at Montana State, report to state-level agencies. "We have a chain of command," Phillips says. "We act in concert with the state anatomical board."

But states such as Ohio don't have anatomical boards, so program administrators have to install a system of internal checks and balances. Drake reports to the chairman of the anatomy department at Cincinnati. Susan Eastman, an assistant in the University of Arizona's willed-body program, says, "Ours is under control of a department head, and we have a review committee comprised of faculty that meets to review procedures."

But when school officials are less vigilant, and when program directors are basically running one-person operations, willed-body programs might benefit from the watchful eye of a parent organization like the United Network for Organ Sharing, the national group that oversees organ transplantation procedures in this country.

UNOS maintains the national transplant waiting list, matches donors to recipients and monitors the matches to ensure adherence to policy. Spokesperson Bob Spieldenner says that having a centralized outfit to manage the donation process helps to minimize public mistrust of the system -- and to keep transplant administrators on their toes. "There's one source, and that's UNOS," Spieldenner says. "We have checks within our system. We conduct regular audits of hospitals and transplant centers. We go and look at the patient records. We're making sure that nothing untoward happens [to donated organs], so we can reassure people."

When UNOS agents sniff out possible misconduct at a transplant center or hospital, they contact the health department in that state to crack down on the offending institution. But who, from a national perspective, is keeping an eye on the cadavers at willed-body programs? Nobody, really.

The National Anatomical Service, headquartered in New York, tracks the needs of medical schools and offers counsel to prospective donors. But according to NAS representative Kevin Moran, the organization plays no part in dictating program regulations or enforcing them. "We steer people to medical schools in their area -- that's it," Moran says. "The schools follow their own guidelines."

Or don't follow guidelines, as the case may be. Still, Drake doubts that an umbrella organization would make much difference in the ups and downs of willed-body programs. "I'm not sure that added bureaucracy would help. It falls to the institution to be accountable."

Meanwhile, back at UC-Irvine, school officials are trying to clean up the mess created by Brown's alleged misconduct and dismissal. Many of his records are incomplete or missing, making it difficult for school officials to determine whether or not the 225 bodies donated to the university during Brown's tenure have been used and disposed of properly. Med school dean Thomas Cesario promises to "work closely with any families who have any concerns."

The biggest concern for other willed-body programs is that would-be donors will be frightened off by scandals like the one at UC-Irvine. "This makes all the programs look bad," Eastman says. But she believes that the essential flaw, even in the UC-Irvine case, is more human than institutional. "Individual people will always try to twist things around for profit. Most programs are on the up and up."

Drake believes that the scandal at Irvine, in a roundabout fashion, will actually serve to improve programs across the country. "This kind of high-visibility problem calls attention to body-donation programs everywhere. People will be making sure that their house is in order. This is a wake-up call."
salon.com | Oct. 27, 1999

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