Have you considered donating your remains to medical science? There is a constant demand for bodies, and you'd be repaying a lifetime's care
Constance, a retired teacher in her early 70s, has been immersed in poetry all her life. "Death appears in the work of so many poets that it impinged on me when I came to consider my own death," she says. And, unlike Dylan Thomas, she would like to pass gently into that good night.
It was after the death of her husband that she began seriously to consider leaving her body to medical science. "As I watched him pass from this life, I was very aware that we hadn't discussed the type of burial he would like." She was determined to plan her own arrangements in detail. After talking to the anatomy department of Trinity College, Dublin, she was sure that donating her body was the right decision for her.
"I was seriously ill with TB peritonitis. And following a gallstone operation, I have had several infections following the retention of a stitch. I like the idea of a medical student discovering the reason for this and, hopefully, learning from it."
Trinity's department of anatomy needs 12 to 15 bodies each year. With the number of medical and other students increasing every year, the demand for bodies for dissection is steady.
Obtaining bodies for the education of future doctors, dentists and therapists has come a long way since the infamous bodysnatching activities of William Burke and William Hare, in Scotland in the 1800s, when a brisk demand for cadavers meant there was good business for the "resurrectionists".
An Ulsterman who ran a boarding house in Edinburgh, Hare hit on the idea of selling bodies to anatomists after the death of one of his lodgers. Assisted by Burke, another of his lodgers, and also an Ulsterman, he then turned to murder. The pair lured victims to the house, where they suffocated them. They killed 16 people, selling the bodies for about £7 sterling each, before they were were apprehended, in 1828. Hare turned King's evidence and, in 1829, Burke was hanged.
An important outcome of such outrages was the British Anatomy Act of 1832, which awarded the medical profession rights to "unclaimed bodies" - in effect, those of workhouse paupers. The anatomy department at Trinity has been receiving donations since then. The process now involves voluntary donation, however. All anatomists would like to see the 1832 legislation updated.
How do you go about donating your body? You simply contact the anatomy department of one of the Republic's five medical schools, which will send you an information pack. You can then visit the college and have any of your questions answered. If you are happy to go ahead, you formally indicate your wish to donate. No special legal formalities are necessary.
Your wish does not have to appear in a will. Nor are there any objections by the main religious groups. In practice, most people will have a normal church service. Then, instead of a burial or cremation, the body will be taken to the anatomy department.
The main reason why your remains might not be accepted would be in the event of a coroner requesting a post-mortem. The other principal caveat is that the department must receive the remains within 48 hours of death.
The body is then prepared by the department's staff before being stored until the following October, when a new batch of students will begin their education.
Does having a real body to dissect make a difference? In my experience, it does. Medical students spend two years studying anatomy. You start with the chest, abdomen and limbs, then progress to the more difficult anatomy of the skull and the neurological system. Being able to see the structures of nerves, veins and arteries helps your understanding. Later in your career, when it comes to placing a drain in a person's chest cavity or performing a lumbar puncture, a three-dimensional understanding of the body's structures is important.
Constance's decision to donate was particularly driven by having relatives in the medical field and by a desire to help a future generation of students. "The thought also occurred to me that I was, in my own way, defeating death, by helping medicine to give longer and better lives to people who might otherwise die before their time," she says.
Paul Glacken, the acting head of Trinity's anatomy department, says: "We continue to believe that the dissection-based teaching of anatomy gives students a three-dimensional feel which they would otherwise not have."
Glacken and his colleagues teach a wide range of students. Each year they cater for 120 medical students, 30 aspiring dentists, more than 30 clinical speech therapists, 45 occupational therapists, two groups of physiotherapy students, about 10 radiographers and a number of postgraduates studying sports medicine.
Most of the dissecting is done by the students, under the instruction of demonstrators - recently qualified doctors who aspire to surgical careers and come to the department for a year to do research and to teach.
Students treat the bodies with respect. The dissecting room at Trinity has a hallowed air; it is, in fact, consecrated ground. After dissection, each cadaver is carefully covered with moistened cloths and sheets. Students are given strict guidelines to follow during their time in the department.
What happens to the remains after they have been dissected? Between two and three years after donation, the remains - including all dissected tissue and organs - are buried or cremated, according to the donor's wishes. Families can ask for the remains to be returned to them for private burial; otherwise, the college will bring the remains to the Dublin medical schools' plot in Glasnevin Cemetery. It can also arrange for cremation in Glasnevin.
Every three years, a service of remembrance and thanksgiving is held in Trinity's chapel, to acknowledge donors. The families of the deceased attend with staff and students; there is an informal gathering afterwards. In May 2000, the anatomy department commissioned a book of remembrance as a further gesture of acknowledgment.
I asked Constance if the thought of students dissecting her remains after death bothered her. "Not in the least. It does not conflict with my religious beliefs. Christianity stresses that the salvation of our soul is the main purpose of life. By donating , I feel I am in tune with St Paul when he said: 'Faith, hope and love are the three things that endure.' " Nor is she concerned about her immediate relatives. "I have discussed it in full with them, and in fact they have all reacted positively."
Constance is very happy with her decision to donate, although understandably not in a hurry to implement her wishes. She would encourage others to consider the option when planning for the future. "It is my special way of saying thanks to God, who gave me life, and to the many good people in the medical profession who helped me through my illnesses."
Who to contact to be a donor
Trinity College anatomy dept (01-6081352/1295)
Royal College of Surgeons anatomy dept (01-4022260)
University College Dublin anatomy dept (01-7167274)
University College Galway anatomy dept (091-750305)
University College Cork faculty of medicine (021-4902455)
