October 26, 2017

$300 for a spine, $3,575 for a torso: Inside the big business of donated human bodies

Daily Briefing

    In the United States, corpses donated to science enter a largely unregulated market that allows practically anyone to dissect bodies and sell parts for profit, a Reuters investigation finds—and several academics and others familiar with the industry are calling for increased oversight.

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    The 'body broker' industry

    Donated bodies are crucial to medical education and research, Brian Grow and John Shiffman report for Reuters. Surgeons say that nothing compares to the tactile response and emotional experience of training on human parts. In addition, researchers depend on human body parts for development of new implants and instruments, as well as to develop new medicines.

    But in contrast with the highly regulated organ transplant industry, the industry of body donation—which is largely operated by so-called "non-transplant tissue banks," or, as Reuters refers to them, "body brokers"—is largely unregulated at both the federal and state level.

    According to Reuters, there is no federal law on the sale of cadavers or body parts for research or education. Moreover, there is no national registry of brokers, nor are there restrictions on who can purchase body parts. Just four states—Florida, New York, Oklahoma, and Virginia—provide state-level oversight. 

    Angela McArthur, director of the body donation program at the University of Minnesota Medical School and former chair of the state's anatomical donation commission, called the "current state of affairs … a free-for-all," comparing the situation to "grave-robbers centuries ago." McArthur said, "I don't know if I can state this strongly enough. … What they are doing is profiting from the sale of humans."

    How the industry works

    Reuters in its investigation identified 34 body brokers in the United States that were active over the past five years. Of the 34 brokers, 25 were for-profit corporations. One of the for-profit corporations made at least $12.5 million from the body parts business over three years, according to Reuters.

    And while the lack of regulation makes it difficult to access information on how the industry operates, data Reuters obtained under public record laws in the four states with some regulation "provide a snapshot."

    Specifically, Reuters reports that body brokers typically acquire donated bodies at no cost by offering families no-cost cremation for part of the body of a deceased loved one in exchange for donating the rest of the body for medical research.

    Some industry insiders say the offer of no-cost cremation is a way of appealing to low-income families who might not be able to afford a traditional funeral. Further, brokers and the funeral industry "have become intertwined," according to Reuters, as the funeral homes can connect brokers with potential donors. Reuters found 62 funeral homes that have mutually beneficial agreements with brokers.

    After receiving the donation, body brokers either will sell a body at varying market prices—averaging from $3,000 to $5,000, but in some cases more than $10,000—or will sell individual body parts, ranging from a torso priced at $3,575 to a spine at $300.

    Overall, based on the data from the four regulated states, Reuters calculated that between 2011 and 2015, private brokers acquired a minimum of 50,000 bodies and distributed more than 182,000 parts. And since 2004, according to Reuters, more than 2,357 body parts acquired by the industry from at least 1,638 donors "have been misused, abused, or desecrated across America."

    Case studies

    While some donated body parts are sold for medical research and training, donated bodies are not always used in the way families might be led to believe.

    For instance, in a case in New Mexico, a woman and her dying father were told by Albuquerque broker Bio Care that his body would be donated for medical research, citing knee replacement techniques as a possible use for his body. The company also said it would send the woman her father's ashes.

    However, the company ended up sending the woman sand, claiming they were her father's ashes. And later, following an independent investigation into the company, the woman learned from authorities that her father's head had been discovered at a medical incinerator and that Bio Care—rather than facilitating donations—sold the body parts it acquired.  "We would … never have signed up if they had ever said anything about selling body parts—no way," the woman said. "That's not what my dad wanted at all."

    Overall, authorities in their investigation of Bio Care discovered at least 127 body parts from 45 different people—all of which, according to a police affidavit, "appeared to have been dismembered by a coarse cutting instrument, such as a chainsaw."

    Bio Care's owner denied abusing the bodies. He was charged with fraud but the charge was dropped, as prosecutors said they could not prove deception or another crime as no state laws regulated how donated bodies should be handled or protected donors' family members.

    Other cases spotlight how body brokers can save on costs by ignoring the "meticulous quality control procedures and sophisticated training" that the American Association of Tissue Banks—a national accrediting organization—calls for, Reuters reports

    For example, in 2011 and 2012, police were called to a Honolulu storage facility, where they found decomposing remains. However, they could not charge the owner with any crimes, as there was no law on the issue. And in a Nevada case, officials at one body broker site found a man with a garden hose thawing a frozen human torso in broad daylight, in addition to finding a bloody, motorized saw commonly used in construction and moldy body parts in an unplugged freezer. In that case, Reuters found that the incident led to one person pleading guilty to a misdemeanor pollution citation.

    Time for regulation?

    Several academics and others familiar with the industry are calling for increased oversight, saying that regular inspections of facilities and reviews of donor consent forms would not present a substantial burden to the government.

    Christina Strong, a New Jersey lawyer who co-wrote a set of standards that most states largely adopted for the organ transplant industry, said, "This isn't reinventing the wheel." She continued, "It would not be a stretch to envision a uniform state law which requires that those who recover, distribute, and use human bodies adhere to uniform standards of transparency, traceability, and authorization."

    However, lacking regulation, Todd Olson, an anatomy and structural biology professor at Yeshiva University's Albert Einstein College of Medicine, said, "[n]obody is accounting for anything." He added, "We regulate heads of lettuce in this country more than we regulate heads of bodies" (Grow/Shiffman, Reuters, 10/24).

    Drive transplant program growth: Tactics to attract & retain transplant patients

    Given the high-profile nature of transplant programs and perceived halo effect on other services, planners tend to regularly evaluate investment in transplant services. But the supply-limited nature of transplants challenges traditional planning efforts because even with high demand there’s no volume guarantee.

    Download this briefing to learn how to expand the pipeline of potential transplant patients and engage them across the care pathway.

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