The dead who made medicine possible

Robert Louis Stevenson’s The Body Snatcher was published in 1884, half a century after Britain’s Anatomy Act tried to regulate the supply of bodies to medical schools. The story belongs to the grim afterlife of the Burke and Hare murders in Edinburgh, where the demand for cadavers had turned into a market for the dead. Stevenson understood the public fear of anatomy where people were afraid of what might happen to the body after abandonment and after poverty had removed the protection of family and social standing. Anatomy became scientific by learning from the dead. The cadaver allowed students to see the body as it is, with variation, texture, asymmetry and surprise. Human dissection has trained generations of surgeons and given medicine confidence that no drawing can supply. Transplantation, trauma care, forensic practice, anaesthesia, orthopaedics and medical-device development owe a debt to cadaveric learning. Public memory rarely honours this debt though. Medical institutions mention it during ceremonies; then often let it fade.

The recent viral controversy over cadaver remarks at a comedy show has disturbed people for precisely this reason. A medical student’s reported comments about male cadavers reached the public through entertainment. The incident would have mattered less if India already had deep public confidence in how bodies are handled after death. Since it does not, body donation remains limited. Cadaveric organ donation remains low. Families hesitate even when they approve of donation in principle. Doctors themselves are not uniformly willing to donate their own bodies.

Total organ transplants increased from 4,990 in 2013 to 18,911 in 2024. But in 2024, India still recorded 15,505 living donor transplants against only 3,403 deceased donor transplants, from 1,128 deceased donors. The deceased donation rate rose from 0.27 per million population in 2013 to 0.81 per million population in 2024. For a country of India’s size, less than one deceased donor per million population is not enough. Living donation saves lives, especially in kidney and liver transplantation, but it places a heavy burden on families and can deepen gender imbalance and malpractice risks. Cadaveric donation distributes this burden more fairly and is essential for organs that cannot ordinarily come from living donors. Indian studies suggest that awareness does not reliably become willingness. Rokade and Gaikwad’s Maharashtra study found inadequate cadaver supply in 90.9 per cent of medical colleges surveyed. Only 19.5 per cent of the general population was willing to donate their bodies for anatomical education. Even among healthcare professionals, willingness was 44.9 per cent. This matters because doctors and medical students already know the value of cadavers. Their hesitation suggests that the barrier is not only ignorance but perhaps trust.

Body donation asks for a form of trust that ordinary awareness campaigns are rarely able to create. A person is being asked to imagine a future moment when the family is grieving, their body is being handed over, and the institution is taking control of what happens next. The family may want cremation or burial within a certain time. Certain relatives may disagree. The donor’s pledge may exist on paper, although the hospital will still have to speak to the family with tact. A campaign that highlights the nobility of donation does very little if it leaves these practical anxieties unanswered. This is why awareness campaigns are insufficient. Saving lives is a powerful message, but families also need process confidence. Public goodwill cannot overcome medico-legal delays, poor counselling, weak preservation systems or unclear final disposal. Better-performing Indian examples such as Chandigarh, Telangana and Tamil Nadu show that donation improves when systems are visible and institutionally owned through state platforms, trained coordination, green corridors, public recognition and reliable hospital procedures.

What would rebuild confidence?

The answer to the cadaver controversy cannot be only outrage or moral lectures. Families will trust donation only when they can see that bodies are treated with dignity at every step. Medical colleges should follow clear rules for body donation. Families should be clearly explained how the body will be used, how it will be stored, who can access it, and how final rites or disposal will be handled. Photography, jokes, public sharing of details, or casual discussion of cadavers should be treated as serious misconduct. Respect for the dead should not depend on the personality of a teacher or the culture of one department. It should be a basic standard for every medical college. Free speech has wide space in public life, but medical training carries a professional duty to protect the dignity and confidentiality of those who can no longer speak for themselves.

Colleges should also be more transparent, without revealing donor identities. Each year, they can publish a short public note saying how many bodies were received, how donations were used for teaching or training, how students were taught about dignity, and whether any breach took place. Such reporting would reassure families that donation is not a black box. This matters because, in society, a dead body is never treated as only biological material. For the family, it remains a person, a relative, a bearer of memory, caste, faith, ritual duty and social belonging. The body marks the final passage between the household and the world beyond it. Donation therefore asks families to do something emotionally and culturally difficult: to hand over that passage to an institution. Students, too, need formal training. Cadavers should not be introduced only through rituals or ceremony. Medical students need to be taught why body donation matters and why disrespectful speeches or stories about cadavers violate public trust. Modern medicine stands on the shoulders of the dead, and public trust depends on whether institutions can honour that debt with dignity.