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A deadly serious matter, dressed up as entertainment

This is a travesty of medical science, a grotesque pastiche of a dark but necessary side of the healer's art

Robert Baker
Thursday 21 November 2002 01:00 GMT
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Why would anyone want to attend a post-mortem examination? They're horrible. Attending one unless you have to is, in my view, pretty much like taking a holiday on the Costa del Sol in peak season. Both involve unnecessary exposure to quantities of unappealing and not very fragrant flesh. And it takes a peculiar sort of person to want to do either.

Professor Gunther von Hagens was last evening performing the first public autopsy in Britain since 1710. His motive, he claims, was to demystify the process. Making autopsies the preserve (no pun intended) of the medical profession was like "when only clergymen had the right to read the bible". Not a convincing metaphor. The police officers who fainted during the opening credits of TV pathology drama Quincy weren't doing so because Jack Klugman was reading from Revelations.

The Ministry of Health has muttered about banning the spectacle, by invoking the 1832 Anatomy Act. There is real irony here. The Act was passed in order to protect the public from exactly the sort of thing Von Hagens wants to do – but people are volunteering to take part from the grave, or shortly before it.

Prior to the end of the 18th century, the only legal source of cadavers was the right of the College of Barbers and Surgeons to take four hanged criminals every year, granted by Henry VIII. The public hated the idea of post-mortem dissection. It was occasionally tacked on to a death penalty as an extra punishment. Many believed that the body had to be intact on Judgement Day, a belief that persists in some cultures. A grieving Maori family once asked me, while I was working in the South Pacific, to return a relative's leg, amputated several years before.

The Anatomy Act was a response to the body-snatching and murder scandals of Burke and Hare in Edinburgh. In essence, it made provision for the bequest of one's corpse should you wish it for dissection. The body of Jeremy Bentham, the founder of University College London and prime mover of the Act, can still be viewed in the college cloisters. More controversially, it made unclaimed corpses available for the purpose, unless the patient had specifically refused permission. It also ensured that it could only take place in licensed premises, the section the ministry has invoked against Von Hagens.

How far we have come! From an Act designed to prevent an unwilling public from becoming anatomy specimens, to a moment where people are queuing up for their moment on the marble slab. A shame Andy Warhol is dead – do your 15 minutes count if you aren't alive? In Britain 20 people have volunteered to be plastinated – unfortunately for the Prof, none has yet died. So he turned yesterday to the cadaver of an elderly man already preserved in formaldehyde.

Could this be called a real autopsy? Professor von Hagen has perfected – if that is the right word for such a ghoulish and pointless activity – plastination. On this occasion, because of the formaldehyde, there were none of the visceral aromas usually associated with the organs of the recently dead. Nor was there any of the personal distress of seeing your patient, whom you could not save but might have spoken to only hours before, in the undignified disarray of dissection. Von Hagens champions a travesty of medical science, a grotesque pastiche of the dark but necessary side of the healer's art.

Post-mortem examinations are carried out really for two reasons. One is the educational purpose the Anatomy Act was designed for: to teach medical students. The other is to establish a cause of death where it may be obscure or suspicious or under certain legal rules specified by the coroner. Professor von Hagens intended to perform a deranged hybrid of both. The preserved gentleman must already have a cause of death, because his body would not have been released without a death certificate. This carnival – and I use the word in its most literal sense – clearly serves neither purpose.

Should he be banned? Some people say autopsies are irrelevant anyway. Newer medical schools are considering using virtual dissection instead of the traditional formaldehyde-drenched scalpel and forceps variety. The Alder Hey scandal has made the public once again deeply suspicious of post-mortems. Most doctors agree, though, that we probably do not do enough, and that much education and many diagnoses are missed as a consequence.

I wouldn't ban it, on the grounds that Von Hagens and his audience, although plainly very strange, are doing nothing to hurt anyone who has not volunteered to take part. But what will be "demystified" by viewing the performance that couldn't be achieved by looking in a medical encyclopedia or a trip to the butcher? The real motivation is clearly entertainment, although I can't quite bring myself to call it a bit of harmless fun.

I have to attend autopsies, and, of course, I had to dissect corpses for my training as a doctor. I have to say I am pretty hard pressed to spot the entertainment value in either. Perhaps I'm not the best judge. Someone somewhere must have thought the BBC's puerile and demeaning new medical sitcom TLC was reasonably entertaining to commission it. De gustibus non est disputandum.

The author is a doctor in a London teaching hospital

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