All his adult life, Paul Ward heard his parents say they wanted their bodies given to a medical school after their deaths. “They felt that training a new doctor would be a gift to society,” he said.
In 2011, his 93-year-old father, Ralph, suddenly took ill and entered hospice care. So Mr. Ward’s wife, Maureen Arrigo, undertook to arrange a donation. Giving a body to science proved more difficult than expected, however.
Ms. Arrigo first called the University of Southern California. No go.
“You had to be within either an hour’s drive or a certain number of miles,” she recalled. The nursing home where Ralph Ward was dying was too far away.
![Ralph and Pearl Ward in 2010.](https://webarchive.library.unt.edu/web/20141029225643im_/http://graphics8.nytimes.com/images/2014/09/18/health/wards_noa/wards_noa-blog480.jpg)
Next, Ms. Arrigo tried nearby Loma Linda University School of Medicine. It required a form signed by the donor himself, not a family member, even one with power of attorney. Her father-in-law, by that point, “was well beyond being able to sign anything,” she said.
Loma Linda advised, however, that other schools would accept donations by family members.
“It would make my mother-in-law very sad not to be able to do this last thing for him,” Ms. Arrigo said. “I was frantic to make it happen.”
Her third call, to Western University of Health Sciences in Pomona, Calif., which trains many kinds of health care professionals, brought success.
The university emailed a simple document, collected Ralph Ward’s body after he died and asked whether his widow wanted the cremains returned to her or scattered at sea. She chose the latter option.
And her son made sure that she signed her own gift document, so that the university can receive her body when she dies.
Though many of the nation’s 170 medical schools have begun to supplement their anatomy labs with digital instruction, “all still use cadavers for some aspect of their medical education,” said Richard Drake, director of anatomy at the Cleveland Clinic Lerner College of Medicine and a board member of the American Association of Anatomists. “It’s still one of the best ways to learn anatomy.”
Programs that train dentists, physical therapists and nurse-practitioners use cadavers, too; so do researchers developing new surgical techniques and other experimental procedures.
But while the need continues — particularly in places with lots of medical schools and research facilities, like New York City — donating a body can take both planning and documentation.
Under the Uniform Anatomical Gift Act — its most recent version, introduced in 2006, has been adopted by 48 states — any individual can sign a “document of gift” donating his organs and tissue, or his full body, for transplantation, therapy or for research or education.
Organ donation draws far more attention, partly because we have all heard and read about transplants’ lifesaving potential, but perhaps also because federal law requires hospitals to refer families and patients to an organ procurement organization.
You’re less likely, if a relative is near death or has just died, to hear anything about donating his or her body. “Nobody’s there making a pitch,” said Sheldon Kurtz, who teaches health law at the University of Iowa College of Law and was the principal drafter of the 2006 act.
The law says that if the donor didn’t arrange during his lifetime to donate his body, family members can do so on his behalf unless he signed a form refusing donation. Family members can do so even without holding power of attorney. “A spouse, children, parents or grandparents — it’s an inclusive list,” Mr. Kurtz said.
Here’s the rub: While organs for transplantation go through a national allocation system, body donations usually must be arranged through specific schools, and they have considerable latitude to set their own policies.
“As with any gift, the recipient has to agree,” Mr. Kurtz said. “They tend to be a little picky.”
For example, as the Ward/Arrigo family discovered, “some schools will not consider a next-of-kin donation,” Dr. Drake said — even though the act allows it. “You have to register yourself.”
Many don’t want to collect bodies from distances greater than 70 to 100 miles. His program at the Cleveland Clinic also sets a size limit: a body mass index of 40. “A large, obese body unfortunately is not the best educational material for students learning anatomy,” Dr. Drake said. “Some schools are stricter.”
Nor will schools or research facilities accept bodies of people with infectious diseases like hepatitis, H.I.V., MRSA or C. difficile. Most won’t accept an autopsied body, either.
A few states — Indiana, Florida, Maryland and Illinois among them — make things a bit simpler with state anatomical boards that distribute bodies to schools where they are needed.
But the best way to avoid make a grieving family scramble for a school willing to accept a donated body is for the donor to make arrangements ahead of time. It’s a fairly straightforward matter, with minimal paperwork, when she does.
“Make sure your whole family knows about this,” Dr. Drake said. The family has to notify his school that the donor has died, “otherwise I might never know.”
What happens to bodies after students or researchers are finished with them? They’re cremated, and the ashes can be returned to families or buried in a cemetery, sometimes on the school campus.
“Most medical schools have some sort of memorial service to honor those individuals,” with family members often invited, said Carol Aschenbrener, chief medical education officer for the Association of American Medical Colleges.
“The memorial circles back from the notion of the body to the notion of the person who made the decision to donate,” she said. “It’s a way of saying thank you.”
An earlier version of this post incorrectly asserted that Western University of Health Sciences does not train physicians. In fact, the school does train osteopathic physicians.