This story was originally published in our Sept/Oct 2023 issue as "Bone Keepers." Click here to subscribe to read more stories like this one.
You can donate your someday-dead self to science. Just sign before witnesses at the bottom of a consent form laden with legalese: “Being age eighteen years or over, and of sound mind and under no duress or coercion, I hereby voluntarily offer as an unrestricted gift, my body, after death, for education, research and the advancement of science.”
So begins the three-page consent for the anatomical gift program at the University of Massachusetts Chan Medical School.
Each year around 100 adults sign that form, volunteering to become cadavers that will be dissected by UMass med students during their anatomy classes or probed by scientists developing medical devices. Nationwide, around 20,000 individuals in the U.S. gift their bodies to scientific research and education annually.
That figure has nearly doubled over the past decade, due to rising funeral costs and evolving religious and cultural views about the dead. But the option has existed in the U.S. since 1968, when Congress passed the Uniform Anatomical Gift Act. The law granted individuals the legal right to donate their bodies after death.
Like at many med schools, when the year wraps, UMass medical students hold a memorial service for the dissected cadavers, their educational service completed. In a flower-garnished auditorium, attendees sing, strum guitars and deliver eulogies, thanking donors and their families. Later, the cadavers are cremated, buried and/or returned to families, according to their wishes.
As of March 2023, UMass Med offers potential donors another option: Instead of their remains being laid to rest after dissection, individuals can elect to become preserved as skeletons, which will be studied for generations to come. Only a handful of universities offer this possibility, in part because removing the soft tissue from skeletons is an unpleasant task. UMass keeps colonies of beetles that nibble away the connective tissue, leaving mostly clean, isolated bones. Other institutions, like the University of Tennessee Knoxville Forensic Anthropology Center — aka The Body Farm — bury corpses on a plot of land only to exhume the skeletons after their soft tissues naturally decompose.
Programs like UMass and The Body Farm are one solution to a major problem: Universities need human bones for education and research, but ethically sourced skeletons are rare. “We’re creating consented, properly procured, ethical bone donation, which historically has not been what’s happened,” says Amanda Collins, director of anatomical services at UMass Med, who is leading the new skeleton program. “There is a long history of shady practices that we’re trying to counteract now.”
Throughout the 1800s and 1900s, schools and museums amassed millions of skeletons from unclaimed bodies at morgues or overseas bone traders. Though these avenues were legal at the time — and keeping those bones remains legal — the dead persons never agreed to have their remains stored, studied and showcased in perpetuity. Families of the deceased were often pressured, duped or kept unaware while their loved ones became academic specimens and resources.
Today, most colleges and universities maintain these so-called legacy collections, which range from one or two skeletons to thousands at Harvard University alone. “A lot of academics just think of the bones as another teaching resource, as if it’s a model,” says Collins. But every school year, students across the U.S. study the skeletons of people who didn’t ask to become classroom props.
Universities have long demanded more bodies than society has been willing to supply. Beyond anatomical dissections in medical schools, students study skeletons in fields like forensic science, biological anthropology and archaeology. The aspiring scientists must learn to “read” bones — identifying subtle ridges, nubs and nicks that indicate an individual’s identity, physical activities and cause of death. Fake, replica bones don’t show enough detail or variation. Education’s want for body parts has spurred legal and ethical offenses for centuries.
Before the 20th century, in Europe and the U.S., prevailing Christian beliefs held that the dead must be buried. No one wanted their loved ones desecrated on the dissection table. Yet, to learn anatomy and practice procedures, medical students needed somebody’s body. A series of laws, passed over several hundred years, ensured that those corpses came from the most marginalized and powerless groups — starting with death-row convicts.
As early as 1506, for example, James IV of Scotland allotted one death row subject per year to Edinburgh’s surgeons guild. The British Parliament’s 1752 Murder Act sentenced all convicted murderers to execution, which could be followed by scientific dissection before public crowds.
While murder convicts were deemed socially deviant enough for the cutting board, they were still too few for the growing field of medicine. So, doctors and students turned to nefarious means. They exhumed corpses from graveyards, or paid so-called resurrectionists to do the bodysnatching.
Esteemed institutions committed this crime, including Harvard and the New York Academy of Medicine, where the first five presidents admitted to bodysnatching. Furious citizens rioted at medical schools, waving torches, throwing rocks and dragging physicians into the streets — events that reportedly inspired the mob scene in Frankenstein. In the U.K., outrage peaked in 1828 when the grave robbing escalated to murder. Two infamous resurrectionists in Scotland, William Burke and William Hare, murdered at least 16 people and sold their bodies to an anatomy professor at the University of Edinburgh.
In response, governments expanded the pool of legal corpses. Several U.S. states and Great Britain passed laws from the 1830s through the 1850s that permitted unclaimed bodies to be used for medical training. New York’s 1854 Act to Promote Medical Science and Protect Burial Grounds — better known as the “Bone Bill” — said qualifying universities would receive bodies that were unclaimed within 24 hours of death.
Depending on the state, within one to three days, corpses were “distributed sans consent for anatomization,” says bioarchaeologist Carlina de la Cova, a professor at the University of South Carolina and deputy coroner for Richland County. “It’s the law, but does that make it right ethically?”
These laws satisfied politicians, physicians, and society’s upper and middle class. Medical students got the bodies they needed to train. Governments and taxpayers were relieved from the financial burden of cremating or burying unclaimed bodies. And well-off families no longer feared physicians stealing the corpses of their loved ones.
Marginalized groups, however, often unwillingly remained the corpse supply. In addition to unclaimed bodies, poor families were bullied into donating relatives who died in hospitals. Staff at New York City’s Bellevue and Harlem hospitals reportedly pressured mourning families with threats like “the body will be cut into mince-meat” unless donated, according to New York City Coroner’s Office physician Timothy D. Lehane, quoted in a 1914 Evening World news article. Lehane continued: “I have met in the ante rooms of these two institutions hundreds of weeping relatives, powerless to save their dead kinsfolk from the dissecting table.”
The body supply once again fell short in the mid-1900s. Thanks to the post-war economic boom and social reforms like Social Security, more people could afford health care and funerals. While the Uniform Anatomical Gift Act in 1968 helped secure cadavers for medical students in the U.S., those bodies rarely became skeletons for long-term study — due in part to damage caused by the dissection process and rules about returning the remains to family. So, for much of the 20th century, educators purchased skeletons from abroad, and overwhelmingly from India.
“India was the No. 1 exporter of human skeletal remains for over a hundred years,” says Sabrina Agarwal, an anthropologist at the University of California, Berkeley. “Most everybody who does anything to do with human biology, anatomy, bioarchaeology, osteology has had some contact with one of these skeletons.”
The exports began in the 1850s under British colonial rule and continued after India’s independence in 1947. Coercion, theft and murder fed the supply. Bodies were purchased from the desperately poor, dug up from graves and even snatched from funeral pyres. The bodies belonged to marginalized people and were usually taken against their family’s wishes and religious beliefs, Agarwal explains.
At its peak between 1930 and 1985, India’s bone trade likely exported more than 65,000 skeletons per year, with 70 percent sent to the U.S. Due to public pressure, the Indian government banned exports of human tissue in 1985, but illegal trafficking persisted and likely still occurs today. In sum, it’s estimated that more than 2 million skeletons of Indian origin now lie in collections outside of India. “The number is staggering,” says Agarwal.
Besides the abundant supply, India’s skeletons were popular among Western scientists for another reason: In warehouse like facilities, line workers vigorously scrubbed and doused these bones with toxic chemicals, which endangered their own lives but produced immaculate skeletons. (This work was typically done by members of the Dom caste who traditionally disposed of dead bodies.)
As Agarwal explains, these “super clean and super white” skeletons became the “perfect maps of human anatomy.” But, when scrubbed so white, it’s easy for a classroom of students to forget the skeletons were ever people — especially people with brown skin.
Not for Agarwal, however. When she was an undergraduate at the University of Toronto, she studied bones that she knew were purchased from India. As a woman of South Asian descent in a classroom of all white students, she felt she had more in common with the skeletons than she had with her fellow classmates. “I can imagine what the lives of these people were like,” she says.
Ethics of legacy
Now, as a professor, Agarwal teaches students about bones at UC Berkeley — an institution with a controversial record when it comes to human remains. In the early 1900s, the university assembled a collection of the remains of around 11,600 Native Americans, many ripped from Indigenous graves. Despite later federal and state laws mandating the return of Native American remains to descendant communities, over the years some scientists and administrators have reportedly resisted or legally fought certain repatriations.
Berkeley’s anthropology museum still holds bones from some 9,000 Indigenous individuals, and it’s not alone. According to 2022 data gathered by ProPublica, 609 federally funded institutions self-reported that they had yet to initiate repatriation efforts for some Native American remains in their collections. The list included Illinois State Museum with 7,590 such individuals, University of Kentucky with 4,504, and the U.S. Department of Interior with 2,970.
Unlike some at her university and elsewhere, Agarwal has aided repatriation efforts and does not teach with Indigenous remains or skeletons from India’s bone trade. In undergraduate classes focused on learning the basic parts of a skeleton, she relies primarily on plastic replicas and virtual models, rather than real bones. For advanced students training to become professional bone examiners, she uses a small collection of modern skeletons that were obtained with informed consent. She’s part of a growing number of scholars who are questioning the ethics of legacy collections.
At Mississippi State University, bioarchaeologist Molly Zuckerman follows an approach similar to Agarwal’s. In her classroom, students use mostly replicas as well as skeletons excavated from a medieval burial chamber in Croatia, which are now available at MSU courtesy of Anna Osterholtz, a professor there. The descendants of those skeletons, who still live near the site, gave enthusiastic written and verbal consent for students and scholars to study their ancestors. “The descendant community is just absolutely freaking delighted at what’s happening,” says Zuckerman.
Her department does hold two skeletons purchased decades ago from India. On the rare occasions she uses these skeletons, Zuckerman first ensures the students understand their problematic history.
Every educator and institution that keeps bones must decide how to handle them. For guidance, they can look to statements issued by professional groups like the Society for American Archaeology. In 2021, the group’s taskforce on the treatment of human remains released broad principles, including “Working with human remains is a privilege, not a right,” and “Archaeologists should consult, collaborate, and obtain consent when working with human remains.”
Following such principles becomes murky, however, when universities hold large legacy collections. Often amassed by long-gone professors, the skeletons lack documentation about their origins. Typically, it’s a good guess that the individual did not consent.
An expert on the ethics of working with human remains, Sabine Hildebrandt has helped develop recommendations for legacy collections. According to Hildebrandt, an associate professor at Boston Children’s Hospital and Harvard Medical School, institutions should do everything they can to learn about the origins of bones in their custody. Perhaps there are notes in a deceased professor’s journals or receipts archived in a library.
If descendant communities are identified, then they should be contacted and consulted. In cases when the remains belong to Native Americans, federal and certain state laws require repatriation (though some institutions, including Harvard, still house Native American remains that have not yet been published on the lists referenced by tribes to make repatriation claims).
For legacy collections assembled from India or unclaimed bodies in the U.S., usually no direct descendants can be located. “They are not traceable,” says Hildebrandt.
For example, DNA tests might, at best, point to a geographic region in India — not a particular family or community. Residents there, suffering poverty and climate disasters, don’t have the resources or desire to receive heaps of repatriated bones. According to Agarwal, such repatriation might assuage white guilt, but it won’t benefit contemporary Indians.
In these cases, institutions have three options, says Hildebrandt. They can put a moratorium on teaching and research with their legacy collections — a pause-and-think temporary fix. Or, institutions can dispose of remains, usually through a funeral. But lacking any information about the individuals’ religion, ethnicity or traditions, “we wouldn’t even know what would be the appropriate way of putting them to rest,” Hildebrandt says. She points to human remains, uncovered in Berlin, Germany, in 2014, that may have stemmed from Jewish Holocaust victims. They were deemed unidentifiable, then cremated and buried in a Christian cemetery — against the beliefs and to the horror of some Jewish groups.
The final option, which Hildebrandt employs in her own classroom, is to use the remains with great respect. This includes teaching ethics and disclosing the historical offenses first. After her students learn and contemplate the problematic context, each student can choose to study the bones or opt to use plastic or virtual models.
Emotionally and professionally
Beyond the classroom, some researchers are studying legacy collections with the goal of restoring personhood to the remains. This is the case for three 20th-century skeletal collections that became foundational to osteology, the scientific study of bones: the Robert J. Terry Anatomical Skeletal Collection, the Hamann-Todd Human Osteological Collection and the William Montague Cobb Collection.
Anthropologists have treasured the “Terry,” “Hamann-Todd” and “Cobb” because — unlike bones from unknown sources — the collectors carefully documented information about the individuals at their time of death. For most corpses in the collections, they noted name, age, sex, race, height, cause of death, and other injuries or diseases. Researchers have used the collections to develop methods, like estimating a person’s full height from just their femur, or their age from a bit of the pelvis bone. Then, they have applied these estimations to bones from around the world, discovered at ancient sites or modern crime scenes.
“These collections essentially created the methods that we use” in forensic science, biological anthropology and archaeology, de la Cova explains.
Anatomy professor Robert J. Terry started the Terry Collection, now housed at the Smithsonian Institution’s National Museum of Natural History. Between 1910 and 1967, the collection grew to include 1,728 of Missouri’s unclaimed bodies. Later, voluntary donations increased its size. The Hamann-Todd Collection, stored at the Cleveland Museum of Natural History, comprises bones from about 3,100 individuals who died between 1893 and 1938 in Cleveland; anatomy professors Carl August Hamann and T. Wingate Todd amassed the collection from the city’s unclaimed dead. The nation’s first Black biological anthropologist, William Montague Cobb, assembled the Cobb Collection from nearly 1,000 unclaimed Black persons who died in Washington, D.C. between 1932 and 1969.
De la Cova has been studying these collections for over a decade, but she isn’t focused on developing new ways to judge height or age from individual bones. Rather, she’s interested in the complete human beings — the biographies of the people who constitute these collections. Her reverence for the dead traces back to her upbringing in “old school, Black Southern culture,” as de la Cova puts it. Raised in Jacksonville, Florida, her family spoke of hauntings and hexes, and conferred with deceased kin as if they were alive. “The dead were always with us,” she says.
But more specifically, the three iconic collections command de la Cova’s attention because she knows, had fate taken minor deviations, these collections might have included her family members. The anthropologist was raised by her great-grandmother, Lula Mae Snead, who went north in her younger years to study nursing in the early 1900s. Had her granny died during this time, de la Cova says, her family wouldn’t have realized she was missing within the allotted one to three days. The unclaimed body easily could have been forfeited to anatomists, and perhaps claimed by scientists like Terry, Hamann, Todd and Cobb. Tied to the remains emotionally and professionally, de la Cova feels driven to reanimate the collections’ erased lives, work that has proven to be a “guttural personal experience.”
In her research, de la Cova examines skeletons first. Though the bones may seem rigid, they were once dynamic tissues that morphed in response to activity, diet, diseases and trauma.
For help deciphering these osteological clues, de la Cova also searches historical archives for letters, newspaper articles, hospital records and other documents that describe the conditions individuals faced. “It’s multiple lines of data that are used to not only restore the identities of these individuals, but really show their struggles, and who they were as people. That these aren’t just bones, these are actual humans,” de la Cova says.
In a 2010 American Anthropologist paper, she documented injuries for 651 males from the Terry, Hamann-Todd and Cobb collections. In addition to their immediate cause of death, over 90 percent of the men exhibited past fractures or wounds that had healed. Violence and hazards seemingly pervaded their lives, and de la Cova noticed differences between racial groups.
The collections’ white men, or “Euro-American” skeletons, showed more nose and knuckle fractures — injuries probably incurred from fisticuffs and drunken brawls. Supporting this pattern, in 19th- and 20th-century newspapers, de la Cova found more than 100 reports of white men street fighting, and only about five accounts of fistfights among Black men. In contrast, the Black men’s skeletons bore more gunshot wounds; a few bones still had bullets lodged in them. De la Cova says those wounds, in the context of these individual remains, align with patterns of racial violence directed at African Americans during the Reconstruction and Jim Crow eras.
Injuries among women also differed along racial lines, de la Cova reported in the International Journal of Paleopathology in 2012. Examining 256 Terry Collection females, the bioarchaeologist observed that Black women had more skull, nose and hand fractures. These might have resulted from interpersonal or domestic violence. With an average age of 75 years old, the white women in the collection suffered more broken hips, likely caused by falls and osteoporosis.
Nearly a third of the Terry females died in Missouri mental hospitals, and some of these injuries likely reflect the dire conditions of these institutions. In newspapers and government records, de la Cova discovered reports that the state’s asylums were chronically underfunded, poorly staffed and rife with hazards: “everything from [building] elements falling on people to people falling out of windows,” says de la Cova.
While each biography is unique, these bones in the hands of science share a collective narrative arc. De la Cova says individuals exist in these collections because of cultural apathy, or what other scholars have called structural violence.
Institutions and laws permitted their dissection without consent. And long before their deaths occurred, institutions and laws deprived the individuals of opportunities, education, health and safety. Who suffered in this way — in both life and death — wasn’t random: The victims belonged to marginalized groups, which were defined by aspects of their identity like race, gender, age, mental health, and socioeconomic status.
These identity traits compounded, determining the total discrimination or privilege that individuals faced — a phenomenon that Black feminist scholar Kimberlé Crenshaw first called intersectionality in 1989, describing bias and violence against Black women. This intersectionality, combined with cultural apathy, helps explain why the bones in these collections appear so battered, and why the individuals wound up in the collections at all.
“These are not people who had lives that were valued,” says Zuckerman. “Then this really dehumanizing research has been done on them for decades.”
By dehumanizing, Zuckerman means that scientists treated the remains as specimens, rather than people. Researchers isolated particular body parts, studying a collection’s lot of femurs or pelvises to identify features that distinguished the old from young, males from females, diseased from healthy, and so on. Some of this research actively targeted and harmed these communities. Specifically, certain 20th century scientists searched for physical differences among the skulls to support now debunked ideas that Homo sapiens could be divided into a hierarchy of distinct biological races.
Zuckerman hopes that recovering details of these individuals’ lives will lead to researchers treating the skeletons with greater respect.
She and colleagues did that in a 2022 Communications Biology paper, which began with an unusual opening: “Dedicated to St. Louis Individual, whose partial story we hope to respectfully tell here.” They then reported the health and likely social conditions of a Terry collection person, whom they called St. Louis Individual. At age 23, the Black man died of lobar pneumonia in City Hospital #2, St. Louis’s hospital for Black patients and physicians, which 20th-century newspapers described as “unfit for patients,” “a disgrace,” having worse sanitary conditions than the zoo, and holding one bathtub for 149 patients.
St. Louis Individual’s bones bore signs of frequent injuries and poor health, including an improperly healed jaw, cavities, missing teeth and tuberculosis. Bone markers suggest he suffered chronic stress through adolescence. Extracted DNA from tooth tartar pointed to bacteria that often cause pneumonia. Pairing this biological evidence with historical records, the study concluded that structural violence and racialized terror plagued the man, culminating in his diseases, early death and inclusion in the Terry.
After this research occurred, the National Museum of Natural History put a moratorium on research involving Black individuals in the Terry and other collections housed there — a move Zuckerman fully supports. For Zuckerman, de la Cova and their collaborators, this work is not just about respect for past people. Their research exposes long-standing, systematic injustices and cultural apathy that harms marginalized groups. “We see the same patterns repeating themselves through time,” says de la Cova. This includes higher rates of diseases, premature deaths and lack of health care and housing based on race.
The skeletons in legacy collections suffered in life and death. In most cases, they cannot be laid to rest or returned to their loved ones, but they do provide lessons for today. First, institutions must find a solution for current remains that bear a troubled pasts. And in the long term, strategic efforts and policy can ensure that future generations of skeletons for science are clean — meaning, cleaned by beetles or Body Farm-style burials, and always donated by individuals of sound mind, under no duress or coercion.