Opinion | Pay-Per-View Autopsy: Sideshow or Science?

In October 2021, a company called Death Science held a live, for-profit, pay-per-view event advertised as a forensic autopsy at a Portland, Oregon convention dubbed the Oddities & Curiosities Expo. The body being dissected in a hotel ballroom had been, in life, a 98-year-old man. It had traveled from a Baton Rouge funeral home to a Las Vegas cadaver broker, who then sold it to the show’s performers.

“There will be several opportunities for attendees to get an up close and personal look at the cadaver,” said an advertisement for the Oddities & Curiosities Expo. The priciest tickets went for $500. The dead man had not given permission for his body to be used as an exhibit in a public, ticketed dissection show, and neither had his family. The event’s organizer defended himself from accusations of disrespecting the family and desecrating the corpse by telling a local news channel, “This is not a sideshow. This is very professional.”

You would be forgiven for observing that someone who says something like that is usually running a sideshow of dubious professional scientific merit.

Was it, though? I mean, I found the story pretty horrifying, and I’ve dissected more than 3,000 bodies in the interest of science and the law. But how about the edification of the curious public? Is that not a worthy enough goal to justify a public autopsy?

For help in exploring the ethics of this subject, I turned immediately to TV host and scientific historian Lindsey Fitzharris, PhD, who steered me to the perfect expert. Cat Irving is the Human Remains Conservator for the Surgeons’ Hall Museums at the Royal College of Surgeons of Edinburgh, Scotland, and a blogger who has spent her career exploring the ethics of working with human cadavers. She was kind enough to answer some questions I put to her.

Do you know whether there are historical incidences similar to this, where the public (not medical students or trainees) were allowed to view autopsies? Surgeries? Was it paid entertainment?

Irving: From the Renaissance through to the 19th century, the public has had many opportunities to view dissection — where the body is being cut open to study its structures rather than determining the cause of death.

For example, in Paris in the late 17th to 18th centuries, a full-time anatomist was employed at the Jardin du Roi, paid by royal funds, and part of the job was to carry out public dissection, which viewers could attend for free. From 1692 there was an anatomical theatre there that could seat 600 people to watch these spectacles. There was also a dissection season, because before we had mechanical refrigeration you had to restrict dissection to the coldest time of the year to preserve the cadaver for as long as possible.

In Bologna, where the first modern authorized human dissection took place in 1315, dissection season coincided with Lenten carnival at the end of winter, and dissection would be attended by revelers and be accompanied by drinking and music. In Scotland, where I am based, the first public dissection before an audience took place in 1702.

These events functioned to educate and entertain — it was noted at the Jardin du Roi that attendance was higher when the subject was female — but there was also a moral aspect to the public dissection. It served as an opportunity to wonder at the full glory of God’s creation, and there was an association with punishment: Those being publicly dissected were often executed criminals.

This would become explicit in Britain in 1752 with the Act for Better Preventing the Horrid Crime of Murder, also known as the Murder Act. As the common belief among Great Britain’s Christians at the time was that resurrection on Judgment Day was dependent on being buried intact, denying a burial was seen as effectively denying the person any chance at eternal life. Instead, the judge could condemn the convicted murderer to one of two fates: gibbeting or public dissection. If gibbeted, the body was taken down from the gallows and suspended high up, outside, in an iron cage, where it would then very publicly decompose after suffering depredation by scavenging birds.

Both gibbeting and dissection were public punishments that were intended to act as a warning. Of the 1,166 people who were sentenced under the Murder Act between 1752 and 1832, fewer than 10% were gibbeted. A very small proportion were spared, but the majority wound up being publicly dissected at the hands of the anatomists.

Public dissection fell out of favor in the 19th century but was resurrected in 2002 by Gunther von Hagens, the man behind the Body Worlds exhibitions of plastinated corpses. Though he’d been warned by Her Majesty’s Inspector of Anatomy that he would be in breach of section 11 of the 1984 Anatomy Act, Hagens went ahead anyway and performed the first public dissection in Britain in 170 years. It was done in front of a paying audience of 500 people.

When did bodies first get donated for scientific use or medical training?

Irving: Body donation really begins only in the 20th century, as the horrors of two World Wars changed the way people would think about their dead body and about funerary rituals. The scale of death during the First World War of 1914-18 made the prescribed Victorian funeral rituals seem not just impractical but also slightly obscene, and the mechanization of death in these conflicts made the religious tradition of intact burial (as essential to entry into heaven) go into quick decline.

In the 19th century, the idea of body donation was largely unthinkable. One person who did think this way was a woman of “extraordinary opinions” called Charlotte Baume, who died in December 1832. She had stated that she wanted to be dissected at the anatomy theatre of the new London University and then cremated, with the profits from the sale of her body going to charity.

Her brother, who seems to have been a man of similarly unconventional opinions (he had produced a pamphlet saying he’d like his bones to be made into knife handles when he died), followed his sister’s wishes. He was arrested for murder. It turned out the new Anatomy Act, which had been introduced earlier that year to give anatomists the use of the unclaimed dead for dissection, had no way of dealing with someone doing something as outlandish as making a bequest of a corpse.

Jeremy Bentham died the same year. Bentham, the founder of the utilitarian school of philosophy, thought it a waste for bodies just to go into the ground and decompose, and had been involved in drafting an act to give anatomists a reliable source of bodies for dissection other than the gallows and the grave robbers. He stated that after his death he wished to be dissected in front of an invited audience of his friends, and on June 9, 1832, his friend Thomas Southwood Smith, a physician, carried out that dissection.

The rest of the philosopher’s wishes for his final disposition were seen as even more eccentric: Bentham wanted his body to be transformed into an “Auto-Icon,” his skeleton draped in his own everyday clothes, walking cane fixed in hand, with his preserved head mounted on top. His preserved head was deemed so disturbing that it was replaced with a wax model which can famously still be seen at University College London today.

When I was a medical student, I remember learning about the 1828 Burke and Hare murders in Edinburgh, when a pair of grave robbers who had been selling cadavers to sell to an anatomy school decided to streamline their business by instead killing people by asphyxia and supplying those fresh corpses. Can you give us other less famous (or infamous) instances of inappropriate use of cadavers for research or science?

Irving: Burke and Hare were never grave robbers — just opportunists and murderers. Their method of simultaneous smothering and positional asphyxiation even birthed a new word: burking. They weren’t the first to turn to murder in the body market, though; they weren’t even the first in Edinburgh.

In 1752, Jean Waldie and Helen Torrance were hanged for murdering a young boy to sell his body. The reporting on the 16 murders perpetrated by Burke and Hare led many grave robbing gangs to realize there was an easier way to get bodies than with all that digging, and some turned to murder instead. Among them were the infamous London burkers led by John Bishop and Thomas Williams, who were caught, convicted, and hanged in 1831.

In Britain’s recent history we’ve had the Alder Hey organ retention scandal. From 1988 to 1996, three children’s hospitals in England had been retaining organs from babies without their parents’ informed consent, leading to England’s Human Tissue Act 2004 and the Human Tissue (Scotland) Act in 2006, which created a new ethical framework for the use and storage of human bodies. There have also been a number of cases reported in the U.S. of funeral directors selling body parts for research and education without consulting with the decedents’ families.

What were your thoughts on the viral story of the pay-per-view autopsy? Does it surprise you?

Irving: It disappoints me that something like this could be done without appearing to consider the family involved, but it doesn’t surprise me. That many people are fascinated with our bodies after death and want to witness their internal workings can be clearly seen in the popularity of exhibitions like Gunther von Hagens’ Body Worlds, which, according to their website, has received more than 50 million visitors, and in visitors to museums such as ours at Surgeons’ Hall, Edinburgh.

Does dissecting cadavers actually educate the public? Does it help or hurt the death-positive movement?

Irving: I think it can educate the public, yes. I think there are ways events like this could be beneficial if done in a sensitive way, and with informed consent from both the deceased and their family. However, any reporting of events which brings into question the way body donations will be used postmortem is likely to be detrimental in getting people to consider donating their bodies for study after death — many people who would be happy for their bodies to be used for scientific purposes would not be happy to end up on display at an Oddities & Curiosities Expo.

That breaking of trust would be harmful for medical students and surgeons reliant on those donations, and, ultimately, for their patients. Anything that erodes the trust of the institutions working with cadavers will ultimately be harmful to the death-positive movement, too.

Cat Irving, MA, has been caring for human remains in museum collections for 20 years. She is a licensed anatomist with a particular interest in the history of anatomy. She blogs at Wandering Bones and maintains a lively presence on both Twitter and Instagram.

Judy Melinek, MD, is an American forensic pathologist and CEO of PathologyExpert Inc. She is currently working as a contract pathologist in Wellington, New Zealand. She is the co-author with her husband, writer T.J. Mitchell, of the New York Times bestselling memoir Working Stiff: Two Years, 262 Bodies, and the Making of a Medical Examiner, and two novels, First Cut and Aftershock, in the Jessie Teska forensic detective series. You can follow her on Twitter and Facebook.

Melinek expressed thanks to Lindsey Fitzharris for connecting her with Irving. Fitzharris’ latest book, the 2018 winner of the PEN/E.O. Wilson Literary Science Writing Award, is The Butchering Art.