From: sbharris@ix.netcom.com(Steven B. Harris)
Newsgroups: sci.med
Subject: Re: Donating Blood to thin and lower iron
Date: 1 Jan 1999 10:21:22 GMT

In <sbelknap-3112981558050001@slip6a-15.dialin.uic.edu>
sbelknap@uic.edu (Steven Belknap) writes:

>It has never been clear to me why we could not require that the remains
>of the deceased automatically become the property of the state after a
>person is declared brain dead.

   Probably because of a long, long tradition in common law that the
corpse "belongs to no man."  It cannot be owned.  The best any entity
can do is take legal custody of it.


> Charge people who have religious objections to
>this a nominal fee to retain posession of the corpse after death.

    Methinks that a nominal fee would not satisfy a certain fraction.
Perhaps a large one.  I think that a fee would indeed satisfy another
large fraction, however, and that's the one we need to get at.



>This would allow us to do autopsies without interference from the family,
>provide lots of donor organs, and simplify both processes.


    Well, we don't need family permission in coroner's cases.  Perhaps
we just need to lower the standard for coroner's cases.  The problem is
that they are already overworked and underpaid.  They don't get any of
the money that comes from medicine, and the ethicists are busy making
sure they don't.

   BTW, there is a private 1-800-AUTOPSY service, and that includes a
little known "traffic" in just about any body part you want, since many
people don't care what happens to their bodies, and don't mind a bit if
they are sold off in pieces for a good purpose.  If you need (say) a
human brain or entire head for your research, it can be had.  Legally
and already with standards in place.

   The problem is not traffic in dead body parts.  This, we have.  The
problem is how to have an effective traffic in LIVE ones.  I completely
fail to see how the ethical standards of the latter are so much
different from the former.  If anything, we should have fallen all over
ourselves to market the stuff that directly saves lives FIRST.

                                Steve Harris, M.D.

From: sbharris@ix.netcom.com(Steven B. Harris)
Newsgroups: sci.med
Subject: Dead Bodies and Their Uses (was Re: Donating Blood to thin and lower 
	iron)
Date: 1 Jan 1999 11:43:14 GMT

In <368c272f.307537423@news.erols.com> vl-hb001@erols.com (Terri)
writes:

> Religious beliefs are, by definition, irrational.

   They are?

> That does not diminish their importance to those who hold them.

   No argument.  Everybody's entitled to believe in a few irrational
things.  I do, myself.  I think.  I'm almost sure of it.


>Not at all. Most people are fully aware  of 'dust to dust.' Only they
>believe that the germ of the individual remains within the dust to be
>resurrected - and the entire body must be there for that to be
>possible.

    I'm sorry, but I've talked to a LOT of people about their beliefs
in the resurrection of the body, or lack of it, and what you state
above is NOT common.  No major religion teaches it.  It's not in any
major religious scripture.  If all these people have this idea, where
do they get it?  And why do they hide it?

    At this point I invite personal comments from people reading along.
Do you believe this?  Your family?  ANYBODY you know?


>  Too bad more doctors don't take religious beliefs
>seriously. If they did, they might be able to overcome families'
>reluctance to allow organ donation by treating such beliefs with
>respect. .

    Something wrong with your logic there.  If one treats a believe
that the "germ" of the decayed organ has to be with the body in order
for God to fix it, that will somehow cause the person to be more likely
to agree to donate his family member's organ?  Say what?

    I treat patients and especially grieving families with great
respect.  Your mistake is in imagining that I treat all people in my
life the same, and that when I engage in political argument or argument
about medical matters with strangers on the net, that this indicates
some kind of character flaw.  On the contrary, such things must be
debated.  Bad and illogical and just plain mean or idiotic ideas must
be identified as such, at least in some area.  The fact that I'm
willing to do it here does not mean, or even imply, that I would go
about this, or even attempt it at all, in the ICU waiting room.

   However: The world does not work if all opinions are entitled to the
same respect by all people under all circumstances.   Indeed, the
suffering caused by treating bad ideas with more respect than they
deserved has cause incalculable suffering in medicine in the past.  And
the present.  And Lord knows, no doubt in the future.


> By the way, do you (and Belknap) ridicule people's religious beliefs
>to their faces or do you wait until you are in the doctor's lounge
>before you ROFL?


    I personally wait until I'm in the doctor's lounge.  Do you have a
problem with that?   There are some real wackos you meet in medicine.
Most people can only see them on E.R.   I get to see them in real life,
and my reaction is entirely human, I assure you.



>Exactly how would either of you approach the family
>member who wants his/her loved one to be buried intact in anticipation
>of bodily resurrection?

    He's (relative) is entitled to his desires, if the donee hasn't
previously expressed them (as on the back of the drivers license in my
state).  I point out that it can save a life if he changes his mind,
and he gets a telephone number to call if he does.  But it's his
decision to make.  I don't get angry or nasty with him about it.  He
is, after all, suffering.  Certainly suffering worse than the guy I
want the organ from.


> On second thought, Belknap is already on
>record as believing that family members have no right to the remains
>of their loved ones and should have to pay for such rights. Are you in
>accord with him on this issue?

   No.  But in law a dead body does not become the family's property,
like something in the will.  It's a very ticklish and funny area of the
law, which I've had the opportunity to look into, with regard to
cryonics.  I think the family's wishes should generally be respected,
unless there is real reason to believe that the previous owner of the
body wished differently, or some overwhelming interest of the State
superceeds.  That's pretty much the way things are anyway, except for a
few odd things.  If you become a coroner's case because you died in
strange circumstances, and the coroner decides he wants to keep your
brain or your heart in a jar in his office, forever, there's not
blinking thing you can do about it.  Whether or not he has a good
reason beyond the idea that it might someday serve as new evidence.
But the state it generally forbidden to confiscate live organs from
dead (brain dead or freshly clinically dead) people, for reasons that
are far better than the coroner's.  So-- which law would YOU change.

> Does a dead body belong to the state to
>use as the medical establishment (I assume) sees fit?


   Some of it does.  Sorry to shock you.

                                    Steve Harris, M.D.

From: sbharris@ix.netcom.com(Steven B. Harris)
Newsgroups: sci.med
Subject: Re: excesses of medical science
Date: 11 Jan 2000 08:01:32 GMT

In <85am5s$5ge$1@spnode25.nerdc.ufl.edu> "Beachhouse"

>Seems like the article in question refers to organs removed for
>preservation and examination.. not transplantation in another child... In
>any event, consent should clearly have been obtained and the above
>practices are unethical. I don't think we should go to a policy of
>"presumed consent" for organ donation for obvious reasons.


   For "obvious reasons"?  Oh, no you don't.  Can't get away from the
ethical dilema that easily.  Let us start with organs used to save
lives.  Does our duty not to unduly mutilate a body supercede our duty
to save a life where we can?  Suppose someone is trapped in a building
along with some bodies, and the live person cannot be rescued in time
to save them except by blowing up part of the building where the bodies
are wedged in?  The relatives of the dead people argue with the fireman
placing the explosive charges, that they will be multilating the dead
in order to save the living.  How dare they?  What do you say to this
argument?

   It is, after all, essentially YOUR argument.  It seems silly to me,
but perhaps you can convince me.

   Now, for the next case, we have a person die in odd circumstances.
Perhaps a child who looks beaten to death.  The coroner or medical
examiner wants to do an autopsy, at which some tissue will be retained
for good forensic reasons.  The parents are orthodox something or
other, and they want every last body part, and they want it in 24
hours.  Scientifically, this is impossible.  Now you have to argue
about mutiliating a body just on the chance that you might learn
something important.  Does the state have the right to do this?  Should
it?  And if the state has the right to take an organ for this purpose,
why not in order to culture cells to be used to save a life?  Or to use
the preserved organ in experiments which may learn something that will
one day save a life?

   These last points touch on the issue of public health vs private
autonomy.  You can't always get what you want, and sometimes the
reasons are good, and sometimes they aren't.  If you want to poop in
the water supply, we don't let you, and that's good.  It might be
supposed that the same kinds of tradeoffs operate when it comes to
bodies, but you'd be wrong.  If you want to keep your dead grandma in
the living room, we don't let you do that.  Hell, you'll have a hard
time getting a permit to bury her in the back yard.  But all this is
only for the vaguest of public health reasons, since 80 lbs of dead
granny after her heart attack is not a lot more hazardous to your
neighbors than that much venison or hamburger, and certainly not if you
bury her.  If your 80 lb mastif dies, after all, you can bury the dog
in your back yard without a second thought.  The real problem with
granny isn't so much public health as it is real-estate values and the
funeral directors' lobby.  If we control what we do with bodies so
carefully for silly reasons like this, why should we not for reasons of
science, also?

From: sbharris@ix.netcom.com(Steven B. Harris)
Newsgroups: sci.med
Subject: Informed Consent in What To Do With Grandpa's Body. (was-- A Startling 
	Statistic)
Date: 29 Jan 2000 23:15:53 GMT

In <86ttbj$6n2$1@bob.news.rcn.net> "Wayne" <wlogsdon@erols.com> writes:
>
>In forced government coroner / medical examiner autopsies they frequently
>keep organs over the protests and objections of the family and never with
>permision.  If they don't follow Due Process and the law, it could be
>argued that the organs were taken illegally.  I like to think of it as
>theft.


   You can think as you like.  However, as a matter of common law,
corpses are owned by nobody.  Not even by their former owners.

>  A jury would actually have to decide whether it was or not.  Mine
>decides in about 2 months.

>Also, in hospital consent autopsies, even without organ donations, I
>doubt that the physician tells the family that frequently, if not
>almost always, their loved one's brain is not returned.  It soaks in a
>jar for a few weeks so that it firms up and can be sliced better, then
>it is later burned like a piece of garbage.

   Instead of being buried like a piece of garbage?  Or cremated
immediately?  I'm trying like mad to imagine the suffering of some poor
family because their dearly-departed's brain got pickled-then-burned,
instead of being properly shoveled into a hole to rot, liquify, and
disappear into dust. Why, the very idea! How dare they convert that
brain to dust, except in the proper way? I must have money to make me
whole against the psychological damage of having mummsie's slumber
party disturbed...

  Not that most autopsies really have the time to do the entire brain
formalin fixing these days, unless the death involved something
especially neurologically interesting. The mundane reality is that in
most autopsies, the brain merely winds up in the wrong place (the body
cavity).

   Unless perhaps somebody was planning on cryonics, I can't quite see
the point of going into a tizzy about all of this. The average person
has no idea what happens in a normal embalming or cremation, either,
but in all these cases the reason they don't know, is that they really
don't want to. It's not like it's a giant secret.  "What, you're
telling me that normally, embalming fluid doesn't even make it into the
brain?  What, the undertaker sucked out Grandma's innards?  What, they
burned Gramps into a shrunken skeleton and then smashed it in a giant
trash compactor?  Thanks for telling me that."  Not.

   Okay, you have me curious. You must tell us about your own case.
Let me guess-- your brain was pickled without anyone asking you.  And
this has been a severe impediment in your assisting with your own civil
suit against the state....

From: sbharris@ix.netcom.com(Steven B. Harris)
Newsgroups: sci.med
Subject: Re: Informed Consent in What To Do With Grandpa's Body. (was-- A 
	Startling Statistic)
Date: 31 Jan 2000 03:17:11 GMT

In <870vq1$he9$1@bob.news.rcn.net> "Wayne" <wlogsdon@erols.com> writes:

>Steven B. Harris wrote in message
><86vsb9$sra$1@nntp4.atl.mindspring.net>...
>
>>   You can think as you like.  However, as a matter of common law,
>>corpses are owned by nobody.  Not even by their former owners.
>
>Sure they are owned.  They (we) are owned by the government, under common
>law and under statutory law, both dead and alive.

   Wrongo.  Try again.  The government controls disposition of bodies,
but does not own them in either common law or any English-derived law I
know of.  If you dig up a corpse or do something with it that society
doesn't like, you cannot be prosecuted for theft (they have to get you
on separate statues like desecration of a corpse).  There was a very
good reason why resurrectionists left the clothes in the coffin and
took only the naked cadaver.


> Ever tried to sell an
>organ.  It'll get you arrested.

   Yes, but not for theft.

> We cannot be dead until a government
>licensed physican signs the death certificate.

   Incorrect.  Death may be prounced by a coroner or other such
official.  Even by a paramedic, if you are found decapitated in a
traffic accident.  The law is not quite so stupid as you would make
out.  They have it more correctly than you, even in fantasy films.  You
will remember the munchkin coroner examining the Wicked Witch of the
East:

   "As coroner I must aver
   I've thoroughly examined her,
   And she's not only MEARLY dead,
   She's really most SINCERELY dead..."



> We cannot be embalmed except
>by a government licensed embalmer, we cannot be cremated except in a
>government licensed crematorium, nor buried except in a government
>licensed cemetary.


   Nope.  In California, for example, if you die of cancer and the
local officials sign off that your death was natural (which they
probably will with no more than phone call from your hospice nurse),
your family can legal load you into the pickup, drive you to the
marina, load you onto a boat, motor you 5 miles out to sea, weight you
down, and drop you over the side. Saves on expense.  No doctor need be
involved, and often no doctor is, in expected deaths.  It's all a
matter of expectation.

> And if the government wants to dig you up and mutilate you some
>more, there is not a thing your family can do to protect you.


   Again, that depends on the jurisdiction.  In California, for
example, there's a card you can sign (called a "Certificate of
Religious Belief") which says you have a religious (in practice,
philosophical) wish that you not be autopsied.  If you have done this,
the state must show complelling reason to perform one, as per section
27491.43 of the California state code.  Which in practice means that
there must be very good reason to suspect foul play in your death.  A
judge must make that decision before the autopsy in contested cases,
and per state code, it's not made lightly.  It's enough to protect
against autopsy 99% of the time, since very few people die in very
suspicious circumstances, and since the Medical Examiner's office is
always overloaded as is.  If you don't like the law where you live, I
suggest you move to CA.

>In the U.S. we have a God given, Constitutionally protected,  right to
>freedom of religion.

   Which doesn't protect against the government's right to investigate
murders, suspicious unnatural-looking deaths, and the like.  Nor would
anybody reasonably argue that it should. Your religion doesn't mean you
can do anything you like.  Never has.

> My religion says that I must be laid to rest, whole,
>in hallowed ground.  I suggest that you and the government do not
>violate the law and trample on my rights.

   I suggest you get real.