Clinical Anatomy 27:291–295 (2014)
ORIGINAL COMMUNICATION
Naming the Body (or the Bones): Human Remains, Anthropological/Medical Collections, Religious Beliefs, and Restitution PHILIPPE CHARLIER* Section of Medical and Forensic Anthropology, UFR of Health Sciences (UVSQ/AP-HP), 2 avenue de la source de la Bie `vre, 78180 Montigny-le-Bretonneux, France
Human bones and biological remains conserved in anthropological, medical, and archaeological collections are foci of ethical debate, as recently illustrated by the affair of Charles Byrne’s bones. In the near future, curators will have to choose between global conservation of all (or almost all) anthropological collections and systematic restitution to their original communities or families. Various proposals and examples of restitution and nonrestitution are given (with justifications) in order to support the concept that the body (especially the dead body) is not property. We propose that the only element supporting arguments in favor of restitution could be the name of the individual, highlighting the importance of all identification processes for such “artifacts.” This is undoubtedly a universal value: naming the dead, identifying and then burying the person, i.e., reversing the progression along the timeline from individual to scientific specimen. Such elements could be of great interest to all universities and medical institutions that keep human remains in their collections for educational or historical purposes when they are confronted with ethical problems and/or repatriation requests. Clin. Anat. 27:291–295, 2014. VC 2014 Wiley Periodicals, Inc. Key words: biomedical research; repatriation; body property; anthropology; medical collection; ethical principles
INTRODUCTION A recent article by Doyal and Muinzer (2011) highlighted the fact that the skeleton of a man named Charles Byrne (who died in 1783 and had been preserved at the Royal College of Surgeons, London, UK) could be buried at sea, in accordance with his wishes. The ethical problem posed by the bones of this 18th century individual approximates to that of all human remains conserved in public collections, displayed in museums or other cultural institutions. In the near future, curators will have to choose between global conservation of all (or almost all) anthropological collections on the one hand and systematic restitution to their original communities or families on the other (Hallam, 2010). For example, can we invoke the inappropriate conditions of acquisition of the bones/skeleton/body as an argument for restitution? For works of art the answer is “yes” (if the act of restitution will benefit
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the country from which the artifacts were taken, even centuries earlier) (ICOM, 2006), but human body parts or cadavers are not works of art, even if they are ancient (mummies from archaeological collections, for instance, or simply isolated old bones). Maori heads, for example, even if tattooed, cannot be interpreted as “objets d’art.” So, in this case, the questions arising are: what kinds of arguments for restitution are legitimate? Which of them can be qualified as excessive from an
*Correspondence to: Philippe Charlier, Section of Medical and Forensic Anthropology, UFR of Health Sciences (UVSQ/AP-HP), 2 avenue de la source de la Bie `vre, 78180 Montigny-le-Bretonneux, France. E-mail: [email protected] Received 29 October 2013; Accepted 30 October 2013 Published online 31 January 2014 in Wiley Online Library (wileyonlinelibrary.com). DOI: 10.1002/ca.22358
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ethical point of view? Can a single element (simple identification of the remains, for example, i.e., the act of naming the individual) be presented/considered as a universal assertion to be used in favor of the restitution process?
What Is a Body? Human remains conserved in museums and scientific institutions can be of four kinds: (1) Ethnographical elements (hair, skin, sometimes with no certainty as to their human origin); (2) Human anatomical remains (complete skeletons, skulls, fragments of skulls, anatomical preparations, various bones, embryos, fetuses); (3) Archaeological remains from various parts of the world; (4) Modern skulls and moldings of skulls from various parts of the world as illustrations of “variability among human races.” Further questions could be: how much of a body is needed for it to be considered as a whole, a cadaver? Can an isolated skull or a femur be compared to a mummified head? Is it perhaps the symbolic (or representative) value of the artifact that makes the element important? What is a human body? In occidental communities, a body is a biological organism forming an independent whole, covered with skin. From the 1970s, this definition evolved as prostheses, implants and grafts appeared in increasing numbers, often incorporated into the body. Are bones and ashes a human body? Can isolated feet or hands be considered as human bodies? No, but rather human remains, although a complete skeleton could be interpreted as a human body because it constitutes the entire support and in a sense represents the integral structure of a human being. The same applies to a cadaver in an advanced state of decomposition/putrefaction: is it still a human body? What makes human remains a “body” in its recognizable patterns? The answer can be given without hesitation: when symbolic portions of the corpse are still present, allowing the whole cadaver to be mentally or physically reconstituted. An example: recently, the mummified head of the French King Henri IV was discovered in a private collection and was identified after complete forensic and historical examination (Charlier et al., 2010b, 2012). The original grave was profaned during the 1793 revolution and the only remains are: some hair, a left toe, one carpal bone, two phalanges, and the mummified head. If tiny remains cannot be considered emblems of the body, what about the head (which is much more than a simple skull, being accompanied by muscles, eyes, brain, skin, etc.)? Can it be considered as the body of the King? French officials have made their choice in this sense by organizing within the next few months an official reinhumation ceremony for the head, placing it in a coffin to be secondarily deposed in the original crypt. The head is clearly considered an equivalent of the whole body, proof being given by subsequent actions such as full religious benediction and the presence of officials (both political and Church representatives) at the funeral ceremony. It has to be said that other remains (hairs, left toe, isolated bones,
etc.) will not be reburied and will be kept in public museum collections as “historical souvenirs” or “curiosities.” The same scenario occurred with the official re-inhumation of the heart of a putative son of Louis XVI (called “Louis XVII”), which occurred in June 2004 after a preliminary forensic identification (Jehaes et al., 2001); this reburial was organized and considered legitimate because of the symbolic value of the remains (the heart). Other symbolic human parts could include the brain (for example, the brain of Buffon, held by the National Museum of Natural History, Paris) or a large sample of skin (for example, the complete tattooed skin of a 18th century French Revolutionary held by the Museum of Natural History in Nantes, France) (Charlier, 2006). But what about other organs or anatomical parts of famous cadavers? It is almost certain that conserved non-symbolic pieces of a body will not be retained for any re-inhumation ceremony (for example, the socalled “leg of Catherine of Medici” held by the TavetDelacourt Museum in Pontoise, France). In such a case, full reinhumation appears unnecessary, respectful presentation of the remains being sufficient; indeed, a soul or existence or a body cannot be encapsulated in a leg or other nonsymbolic anatomical segment. . . except in the religious concept of relics. A similar ethical problem arose in June 2011 during the recovery by the French authorities of hundreds of victims of the Rio-Paris Air France plane crash: a total of 104 bodies (or fragments of bodies) were extracted from the wreck, lying 3,900 m below sea level. If all the passengers were identified following DNA analyses and returned to their families, some wondered if their optimal place would not have been on the bottom of the sea rather than in France (leaving all the victims together at the accident site rather than separating them for isolated inhumations or cremations). Indeed, can we really speak about cadavers (considering their aspect and bad state of conservation), or rather DNA fragments, comparable to minute human remains from the 11th of September sites? Maybe we should consider such remains as metaphorical representations of the dead, i.e., a kind of proof of their reality. Some parents and relatives need such a recovery of the cadaver in order to place something within the grave: “I always wanted somebody to give me back my son. I had him in myself, I need to take him to his tomb. It is very difficult for me to stand in front of an empty grave,” said the mother of a victim (Legros, 2011). Others considered such a large-scale recovery of bodies (2 years after the accident!) to be a tomb violation.
Naming the Remains Perhaps the only element clinching the argument in favor of restitution is the name of the individual, highlighting the importance of forensic and multidisciplinary identification processes for such “artifacts” (Charlier et al., 2009, 2010a,b). In the following examples from all over the world and from various fields of anatomy, anthropology, medicine, and archaeology, we will test the pertinence of a restitution
Charlier process based on the nominal identification of human remains, i.e., their precise name. The latter is undoubtedly a universal value: naming the dead, identifying the burial, i.e., reversing the transition that occurs “naturally,” because of the passage of time, from individual to anonymous scientific specimen. If one can name the body (and if its descendants ask for repatriation or religious ceremonies such as inhumation, cremation or burial at sea), no authority could ethically oppose this moral choice. For example, should it not be legitimate for the descendants of criminals whose skulls are conserved in the Delmas Medicine Museum (Paris, France) to demand the restitution and definitive inhumation of the remains? Indeed, the reasons for conserving them (characterization of aggressiveness according to Lombroso’s theories based on skull and face morphology) are now considered obsolete. More obviously, isolated bones or full skeletons exhibited for entertainment or as curiosities no longer have a place in 21st century society. If these objects are not kept for entertainment, perhaps they have another utility? From a forensic point of view, the cadaver of an individual characterized by a suspicious death is to be considered “socially living” because it represents a source of information (Hallam et al., 1999). Could the same not apply to archaeological remains and bodies conserved in anthropological collections or displayed in museums?
DISCUSSION Let us focus initially on osteo-archaeological remains (i.e., prestigious or famous archaeological or historical remains) such as the skull of the Macedonian King Philip II (Prag et al., 1984), the mummies of numerous pharaohs [for example the recently identified mummies of Akhenaton and Nefertiti (Hawass et al., 2010)], or the skeleton of the 6th c. A.D. rin et al., 2005). Is it French Queen Aregonde (Pe acceptable to present them in altered forms (partially mummified, skeletonized, fragmented) to thousands of tourists every day in a public display such as a museum or exhibition? Lindow Man, an Iron Age individual (1st c. A.D.) exhumed from the marshes of Lindow Moss in a perfect state of preservation, has been permanently exhibited in the British Museum since its discovery in 1984, and was temporarily exhibited at Manchester University from 2008 to 2009; grasping the opportunity, a pagan organization (“Honoring the Ancient Dead”) emphasized the need to consider this individual as a person and “an ambassador of his community” rather than an archaeological object. In 2008, the Manchester institution decided to cover all naked Egyptian mummies with small pieces of fabric as a token of respect toward their original community and in the name of decency: a decision that generated a huge public controversy (Jenkins, 2011; Cadot, 2009). Public display can also lead to diffuse marketing. Human bones and relics are sold at auctions—for example the so-called head of Saint Vitalis of Assisi, an Italian Benedictine monk from the 14th century;
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original or not, the head was valued at between 800 and 1,200 euros (BBC News, 2001). Is a commercial context appropriate for and compatible with biological remains? If a reliquary can be sold like any other work of art (even a sacred one), what about a consecrated bone? The internet auction site eBay has finally decided not to allow any selling of human bones online as long as the origin of the “object” remains unclear (Huxley and Finnegan, 2004; Seidemann et al., 2009). In Paris (France) again, where the human body is legally considered a nonproperty entity, the National Museum of Natural History (NMNH) holds the remains of almost 23,000 human individuals, including 18,000 skulls. Within this collection are the remains of political opponents from 1830, which could be returned to the people of Algeria, and other individuals from hospital autopsies, archaeological excavations, and ethnological travels, which could potentially be identified: for example, the skeleton of Diatta, the last King of Casamance (died 1903), claimed by the state of Senegal. In the next few months, the skull of Ata€ı, a famous Kanak chief who died in 1878, will officially be restored to the Kanak community of New Caledonia. To prevent abusive repatriation processes, this NMNH follows two clear and simple rules: only human remains that are nominally identifiable or already identified are considered appropriate for repatriation; furthermore, the request has to be legitimate, i.e., emanating from relatives (or a nation, in the case of historical figures). For these reasons, the NMNH recently refused to repatriate 35 Aborigine skulls and a collection of hair samples to Australia because they were completely anonymous. For reasons based on secularity, the NMNH also refuses to restore human remains for religious reasons; and more importantly, the restitution process does not concern objects or ritual artifacts. However, the French parliament has different rules from the NMNH, which include sacred items in the restitution process (Esquerre, 2011): (1) The request must be formulated by a legitimate entity, i.e. a democratic country; (2) The request must be made by the intermediary of a living community; (3) In order to be sent back to their rightful owners, the human remains must be part of the cultural patrimony of those communities; (4) It has to be proven highly important for such items to go back home (for reburial, for example); (5) The restitution process has to be based on respect for human dignity, cultures, and beliefs. It is interesting that such rules are the same for human remains and sacred items, as if the former (human remains) could also be considered sacred entities. . . The remains of Saartjie Baartman have been restituted by the NMNH (Paris) to South Africa (2002) because a name was unequivocally associated with them. The 16 Toi Moko (18th to early 20th century mummified and tattooed Maori heads) given back by France in 2012 no longer had names, but it is hoped that further details for identification will be found within a few years under the direction of the Te Papa Tongarewa Museum (New Zealand). Indeed, this recent official restitution has been the occasion of a complete (and unprecedented) forensic and anthropological
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study of these human remains, initiating the provision of much better knowledge about their origin, preparation, signification, utilization and—paradoxically—conservation. In fact, the decision for restitution or inhumation of such “human artifacts” can provide a “second life” and ultimate study before any complete physical (though not scientific) disappearance. It could be the occasion when life and activity are instilled into sleeping and antiquated collections. Why is this repatriation of Toi Moko to New Zealand an example of high morality and respect for scientific goals? It is because all the mummified heads will be deposited in the Te Papa Tongarewa Museum (Wellington), not cremated or inhumed. Placed in a specially dedicated sacred area of the museum, they will still be accessible for research by local and international scholars with the aim of further identification. The same situation exists at the Dupuytren Museum in Paris, where a medical and anthropological collection is held by Paris 6 University and the curator is a hospital pathologist (Dr. Patrice Josset). If all the remains are voluntarily anonymous (the scientific system is characterized by its general anonymity), one of them, a fully dried body, retains complete biographical details: “General softening of the bones with severe deformation of the four limbs and trunk observed on Anne Elisabeth Querian, married Supiot, died at 35 years old; body deposed at the Royal Academy of Sciences, 1752–1753.” Should this identified body be restituted to its descendant and be buried? Probably not, because it was the original will of this individual to serve Science and Humanity by being studied, dissected by her private surgeon (Dupouy) and presented to the next generation as a kind of scientific curiosity (Anonymous, 1753). For Philippe Mennecier, a curator at the Museum of Man (Paris), who held the funeral mask of Frantz Liszt Descartes: “this face and the so-called skull of Rene can be touched and this is, for me, the person, but not this skull; Descartes is not in his skull, which represents nothing, in contrast to Liszt’s facial mask” (Esquerre, 2011). This point of view is morally very interesting: is it the face (even in plaster with no original parts of the body) that makes the individual rather than original pieces of bones (including the skull, the most symbolic part of the skeleton). . . because the individual can more easily be recognized by his facial features than by his skull (in the absence of any complementary procedures such as facial reconstitution)? Comparable “problems” could also arise in Italy, where a significant portion of the anthropological collections comprises mummified Italian individuals. In Palermo (Sicily), an 86 year-old woman asked for immediate cessation of all scientific analyses and special displays related to the mummy of her sister, Rosalia Lombardo, who died at the age of 2 years in 1920. Conserved in the Capuchin Catacombs, this individual is considered by local authorities as “un bene culturale” (i.e., a “cultural good”), not a private entity belonging to her family (Brunetto, 2012). The affair ceased with the death of the claimant. Some supposed that the initial motivation of the sister could have been financial. But how immoral is the contemplation (or at least the visibility) of the cadaver of a
little baby by her older sister when it is based on the legal decision of her parents? Comparable cases exist elsewhere in Italy, for example in the Town Museum of Salo, where anatomical fragments, body parts and complete mummies of 13 brigands from the early 19th century are displayed; should not their descendants (or political partisans such as “Neoborbonici”) claim the property and/or heritage, and ask for inhumation rather than public exhibition of their ancestors (Nicoletti, 2012)? The same dilemma affects the eight anatomical preparations from the collection of Giovan Battista Rini conserved at the Desenzano Hospital Pathology Division in Brescia, recently the objects of a complete scientific examination (Panzer et al., 2012). Meanwhile, what about the Anglo-Saxon community? The 2004 Human Tissue Act is to be considered inappropriate and irrelevant owing to the antiquity of such collections and items, and their very particular nature. In the USA, the Native American Graves Protection and Repatriation Act of 1990 gave directives for the return of human remains connected to American-only (not worldwide) modern-day tribes (Ousley et al., 2005; Misesuah, 2000); the practical disposition of so-called culturally unidentifiable remains was finalized only in 2010 by the USA Department of the Interior. This administrative position deals with more than 650 institutions (hospitals, anatomy departments, and universities) housing almost 116,000 individuals in their collections. The basic principles of such a position are respect for societies of all kinds (including tribal ones), and the fact that public and scientific interests in such “objects” no longer have any weight. Political aspects are not to be forgotten, as reburials are powerful social dramas and testimonies of the highly complex historical relationships between the concerned parties (living and dead, indigenous and non-indigenous) (Cantwell, 2000). One example suffices to show the complexity of such a repatriation process: at the end of December 2011, the Navajo Nation claimed hundreds of human remains unrightfully exhumed, and held in a collection in Tucson (Arizona), in order to bury them again (Associated Press, 2011). As a consequence, the Navajo Nation asked a judge to declare whether the remains were their property, and, if so, to order their immediate return for reburial. The situation remains unclear: further anthropological and archaeological analyses are necessary, as such bones could originate not only from the Navajo but also the Hopi, Apache, and Ute tribes. . . Some believe that, taken to the extreme, the demand to bury aboriginal skeletons (not only in America but all around the world) raises a potentially serious impediment to scientific enquiry (Weiss, 2001). Would such restitutions entail the complete disappearance of data for future generations? Not necessarily. In the case of an eventual inhumation or cremation, modern technologies could enable complete 3D conservation of all anatomical details to be obtained with great ultrastructural precision (for example photogrammetry: Ebert et al., 2011). A complementary limited sampling for further analyses is also possible, without destroying or significantly mutilating the remains.
Charlier
CONCLUSIONS Human skeletons and biological remains conserved in anthropological, medical, and/or archaeological collections are the foci of active ethical debate. In the near future, curators will have to choose between global conservation of all (or almost all) anthropological collections and their systematic restitution to the original communities or families. From all the previous examples of restitutions and non-restitutions, we found that the concept of the body (especially a dead body) as nonproperty is anything but clear, and depends heavily on local political views and the administrative status of the human remains. We propose that the only precise element permitting any restitution should be the name of the individual, as in the case of Charles Byrne. This proposal highlights the importance of all identification processes for such “artifacts.” Anatomists and forensic anthropologists could then play important roles in this identification, and subsequently in the restitution process, in close relationships with historians, archaeologists, ethnologists, etc. The name of an individual is undoubtedly a universal value: naming the dead is comparable to an identified burial, i.e., reversing the process by which they passed, years ago, from individual to scientific specimen. Such determining ethical elements could be of great interest and help to all universities and medical institutions that keep human remains for educational or historical purposes when they confront ethical debates and/or repatriation requests. In any case, researchers have to remember that these anatomical parts are not simple bones, but people.
ACKNOWLEDGMENTS The author extends warm thanks to Dr. Luc Brun (MD, University of Parakou, Benin), Dr. Isabelle Huynh (MD, -Salpe trie University Hospital Pitie `re, Paris, France) and (MD, PhD, head of the Laboratory of Dr. Christian Herve Medical Ethics, University Paris 5, France) for constructive discussions and original suggestions, and Ana-Maria Lazar (BNF, Paris, France) for English proofreading.
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Charlier P, Poupon J, Eb A, De Mazancourt P, Gilbert T, HuynhCharlier I, Loublier Y, Verhille AM, Moulheirat C, Patou-Mathis M, Robbiola L, Montagut R, Masson F, Etcheberry A, Brun L, Willerslev E, de la Grandmaison G, Durigon M. 2010a. The ‘relics of Joan of Arc’: A forensic multidisciplinary approach. Forensic Sci Int 194:e9–e15. Charlier P, Huynh-Charlier I, Poupon J, Keyser C, Lancelot E, Favier D, Vignal JN, Sorel P, Chaillot PF, Boano R, Grilletto R, Delacourte S, Duriez JM, Loublier Y, Campos, P, Willerslev E, Gilbert MTP, Eisenberg L, Ludes B, de la Grandmaison G. 2010b. Multidisciplinary medical identification of a French king’s head (Henri IV). BMJ 341:c6805–c6806. N, Ramirez O, Babelon JP, Galland B, Charlier P, Olalde I, Sole Calafell F, Lalueza-Fox C. 2012. Genetic comparison of the head of Henri IV and the presumptive blood from Louis XVI (both Kings of France). Forensic Sci Int (Epub ahead of print / doi: 10.1016/J.forsciint.2012.11.018). Doyal L, Muinzer T. 2011. Should the skeleton of “The Irish giant” be buried at sea? BMJ 34:d7597. Ebert LC, Thali MJ, Ross S. 2011. Getting in touch: 3D printing in forensic imaging. Forensic Sci Int 211(1-3):e1–e6. Esquerre A. 2011. Les os, les cendres et l’Etat. Paris:Fayard. 336 p. Hallam E, Hockey J, Howarth G. 1999. Beyond the Body: Death and Social Identity. New York: Routledge. 256 p. Hallam E. 2010. Articulating Bones: An Epilogue. J Mater Cult 15: 465–492. Hawass Z, Gad YZ, Ismail S, Khairat R, Fathalla D, Hasan N, Ahmed A, Elleithy H, Ball M, Gaballah F, Wasef S, Fateen M, Amer H, Gostner P, Selim A, Zink A, Pusch CM. 2010. Ancestry and pathology in King Tutankhamun’s family. JAMA 303:638–647. Huxley AK, Finnegan M. 2004. Human remains sold to the highest bidder! A snapshot of the buying and selling of human skeletal remains on eBay, an internet auction site. J Forensic Sci 42:17–20. International Council Of Museums (ICOM). 2006. Museums operate in a legal manner. Code of ethics for museums. Paris. Jehaes E, Pfeiffer H, Toprak K, Decorte R, Brinkmann B, Cassiman JJ. 2001. Mitochondrial DNA analysis of the putative heart of Louis XVII, son of Louis XVI and Marie-Antoinette. Eur J Hum Genet 9:185–190. Jenkins T. 2011. Contesting human remains in museum collections: The crisis of cultural authority. New York: Routledge. p 121–139. Legros C. 2011. Blessures en profondeur. La Vie. p 26. Mihesuah DA, editor. 2000. Repatriation reader: Who owns American Indian remains? Lincoln: University of Nebraska. 335 p. Nicoletti G. 2012. I tredici briganti che dopo un secolo riappaiono come mummie da museo. La Stampa. Ousley SD, Billeck WT, Hollinger RE. 2005. Federal repatriation legislation and the role of physical anthropology in repatriation. Am J Phys Anthropol Suppl 41:2–32. Panzer S, Zink AR, Piombino-Mascali D. 2010. Scenes from the past: Radiologic evidence of anthropogenic mummification in the Capuchin Catacombs of Palermo, Sicily. Radiographics 4:1123– 1132. Panzer S, Carli A, Zink AR, Piombino-Mascali D. 2012. The anatomical collection of Giovan Battista Rini (1795–1856): A paleoradiological investigation. Clin Anat 3:299–307. rin P, Calligaro T, Buchet L, Cassiman JJ, Darton Y, Gallien V, Poirot Pe gonde. JP, Rast-Eicher A, Rucker C, Vallet F. 2005. La tombe d’Are tallique et des Nouvelles analyses en laboratoire du mobilier me funte du sarcophage 49 de la basilique restes organiques de la de s Nationales 37:181–206. de Saint-Denis. Antiquite Prag AJNW, Musgrave JH, Neave RAH. 1984. The skull from tomb II at Vergina: King Philip II of Macedon. J Hellenic Stud 104: 60–78. Seidemann RM, Stojanowski CM, Rich FJ. 2009. The identification of a human skull recovered from an eBay sale. J Forensic Sci 54: 1247–1253. Weiss E. 2001. Kennewick man’s funeral: The burying of scientific evidence. Polit Life Sci 20:13–18.
ORIGINAL COMMUNICATION
Naming the Body (or the Bones): Human Remains, Anthropological/Medical Collections, Religious Beliefs, and Restitution PHILIPPE CHARLIER* Section of Medical and Forensic Anthropology, UFR of Health Sciences (UVSQ/AP-HP), 2 avenue de la source de la Bie `vre, 78180 Montigny-le-Bretonneux, France
Human bones and biological remains conserved in anthropological, medical, and archaeological collections are foci of ethical debate, as recently illustrated by the affair of Charles Byrne’s bones. In the near future, curators will have to choose between global conservation of all (or almost all) anthropological collections and systematic restitution to their original communities or families. Various proposals and examples of restitution and nonrestitution are given (with justifications) in order to support the concept that the body (especially the dead body) is not property. We propose that the only element supporting arguments in favor of restitution could be the name of the individual, highlighting the importance of all identification processes for such “artifacts.” This is undoubtedly a universal value: naming the dead, identifying and then burying the person, i.e., reversing the progression along the timeline from individual to scientific specimen. Such elements could be of great interest to all universities and medical institutions that keep human remains in their collections for educational or historical purposes when they are confronted with ethical problems and/or repatriation requests. Clin. Anat. 27:291–295, 2014. VC 2014 Wiley Periodicals, Inc. Key words: biomedical research; repatriation; body property; anthropology; medical collection; ethical principles
INTRODUCTION A recent article by Doyal and Muinzer (2011) highlighted the fact that the skeleton of a man named Charles Byrne (who died in 1783 and had been preserved at the Royal College of Surgeons, London, UK) could be buried at sea, in accordance with his wishes. The ethical problem posed by the bones of this 18th century individual approximates to that of all human remains conserved in public collections, displayed in museums or other cultural institutions. In the near future, curators will have to choose between global conservation of all (or almost all) anthropological collections on the one hand and systematic restitution to their original communities or families on the other (Hallam, 2010). For example, can we invoke the inappropriate conditions of acquisition of the bones/skeleton/body as an argument for restitution? For works of art the answer is “yes” (if the act of restitution will benefit
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the country from which the artifacts were taken, even centuries earlier) (ICOM, 2006), but human body parts or cadavers are not works of art, even if they are ancient (mummies from archaeological collections, for instance, or simply isolated old bones). Maori heads, for example, even if tattooed, cannot be interpreted as “objets d’art.” So, in this case, the questions arising are: what kinds of arguments for restitution are legitimate? Which of them can be qualified as excessive from an
*Correspondence to: Philippe Charlier, Section of Medical and Forensic Anthropology, UFR of Health Sciences (UVSQ/AP-HP), 2 avenue de la source de la Bie `vre, 78180 Montigny-le-Bretonneux, France. E-mail: [email protected] Received 29 October 2013; Accepted 30 October 2013 Published online 31 January 2014 in Wiley Online Library (wileyonlinelibrary.com). DOI: 10.1002/ca.22358
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Naming the Body (or the Bones)
ethical point of view? Can a single element (simple identification of the remains, for example, i.e., the act of naming the individual) be presented/considered as a universal assertion to be used in favor of the restitution process?
What Is a Body? Human remains conserved in museums and scientific institutions can be of four kinds: (1) Ethnographical elements (hair, skin, sometimes with no certainty as to their human origin); (2) Human anatomical remains (complete skeletons, skulls, fragments of skulls, anatomical preparations, various bones, embryos, fetuses); (3) Archaeological remains from various parts of the world; (4) Modern skulls and moldings of skulls from various parts of the world as illustrations of “variability among human races.” Further questions could be: how much of a body is needed for it to be considered as a whole, a cadaver? Can an isolated skull or a femur be compared to a mummified head? Is it perhaps the symbolic (or representative) value of the artifact that makes the element important? What is a human body? In occidental communities, a body is a biological organism forming an independent whole, covered with skin. From the 1970s, this definition evolved as prostheses, implants and grafts appeared in increasing numbers, often incorporated into the body. Are bones and ashes a human body? Can isolated feet or hands be considered as human bodies? No, but rather human remains, although a complete skeleton could be interpreted as a human body because it constitutes the entire support and in a sense represents the integral structure of a human being. The same applies to a cadaver in an advanced state of decomposition/putrefaction: is it still a human body? What makes human remains a “body” in its recognizable patterns? The answer can be given without hesitation: when symbolic portions of the corpse are still present, allowing the whole cadaver to be mentally or physically reconstituted. An example: recently, the mummified head of the French King Henri IV was discovered in a private collection and was identified after complete forensic and historical examination (Charlier et al., 2010b, 2012). The original grave was profaned during the 1793 revolution and the only remains are: some hair, a left toe, one carpal bone, two phalanges, and the mummified head. If tiny remains cannot be considered emblems of the body, what about the head (which is much more than a simple skull, being accompanied by muscles, eyes, brain, skin, etc.)? Can it be considered as the body of the King? French officials have made their choice in this sense by organizing within the next few months an official reinhumation ceremony for the head, placing it in a coffin to be secondarily deposed in the original crypt. The head is clearly considered an equivalent of the whole body, proof being given by subsequent actions such as full religious benediction and the presence of officials (both political and Church representatives) at the funeral ceremony. It has to be said that other remains (hairs, left toe, isolated bones,
etc.) will not be reburied and will be kept in public museum collections as “historical souvenirs” or “curiosities.” The same scenario occurred with the official re-inhumation of the heart of a putative son of Louis XVI (called “Louis XVII”), which occurred in June 2004 after a preliminary forensic identification (Jehaes et al., 2001); this reburial was organized and considered legitimate because of the symbolic value of the remains (the heart). Other symbolic human parts could include the brain (for example, the brain of Buffon, held by the National Museum of Natural History, Paris) or a large sample of skin (for example, the complete tattooed skin of a 18th century French Revolutionary held by the Museum of Natural History in Nantes, France) (Charlier, 2006). But what about other organs or anatomical parts of famous cadavers? It is almost certain that conserved non-symbolic pieces of a body will not be retained for any re-inhumation ceremony (for example, the socalled “leg of Catherine of Medici” held by the TavetDelacourt Museum in Pontoise, France). In such a case, full reinhumation appears unnecessary, respectful presentation of the remains being sufficient; indeed, a soul or existence or a body cannot be encapsulated in a leg or other nonsymbolic anatomical segment. . . except in the religious concept of relics. A similar ethical problem arose in June 2011 during the recovery by the French authorities of hundreds of victims of the Rio-Paris Air France plane crash: a total of 104 bodies (or fragments of bodies) were extracted from the wreck, lying 3,900 m below sea level. If all the passengers were identified following DNA analyses and returned to their families, some wondered if their optimal place would not have been on the bottom of the sea rather than in France (leaving all the victims together at the accident site rather than separating them for isolated inhumations or cremations). Indeed, can we really speak about cadavers (considering their aspect and bad state of conservation), or rather DNA fragments, comparable to minute human remains from the 11th of September sites? Maybe we should consider such remains as metaphorical representations of the dead, i.e., a kind of proof of their reality. Some parents and relatives need such a recovery of the cadaver in order to place something within the grave: “I always wanted somebody to give me back my son. I had him in myself, I need to take him to his tomb. It is very difficult for me to stand in front of an empty grave,” said the mother of a victim (Legros, 2011). Others considered such a large-scale recovery of bodies (2 years after the accident!) to be a tomb violation.
Naming the Remains Perhaps the only element clinching the argument in favor of restitution is the name of the individual, highlighting the importance of forensic and multidisciplinary identification processes for such “artifacts” (Charlier et al., 2009, 2010a,b). In the following examples from all over the world and from various fields of anatomy, anthropology, medicine, and archaeology, we will test the pertinence of a restitution
Charlier process based on the nominal identification of human remains, i.e., their precise name. The latter is undoubtedly a universal value: naming the dead, identifying the burial, i.e., reversing the transition that occurs “naturally,” because of the passage of time, from individual to anonymous scientific specimen. If one can name the body (and if its descendants ask for repatriation or religious ceremonies such as inhumation, cremation or burial at sea), no authority could ethically oppose this moral choice. For example, should it not be legitimate for the descendants of criminals whose skulls are conserved in the Delmas Medicine Museum (Paris, France) to demand the restitution and definitive inhumation of the remains? Indeed, the reasons for conserving them (characterization of aggressiveness according to Lombroso’s theories based on skull and face morphology) are now considered obsolete. More obviously, isolated bones or full skeletons exhibited for entertainment or as curiosities no longer have a place in 21st century society. If these objects are not kept for entertainment, perhaps they have another utility? From a forensic point of view, the cadaver of an individual characterized by a suspicious death is to be considered “socially living” because it represents a source of information (Hallam et al., 1999). Could the same not apply to archaeological remains and bodies conserved in anthropological collections or displayed in museums?
DISCUSSION Let us focus initially on osteo-archaeological remains (i.e., prestigious or famous archaeological or historical remains) such as the skull of the Macedonian King Philip II (Prag et al., 1984), the mummies of numerous pharaohs [for example the recently identified mummies of Akhenaton and Nefertiti (Hawass et al., 2010)], or the skeleton of the 6th c. A.D. rin et al., 2005). Is it French Queen Aregonde (Pe acceptable to present them in altered forms (partially mummified, skeletonized, fragmented) to thousands of tourists every day in a public display such as a museum or exhibition? Lindow Man, an Iron Age individual (1st c. A.D.) exhumed from the marshes of Lindow Moss in a perfect state of preservation, has been permanently exhibited in the British Museum since its discovery in 1984, and was temporarily exhibited at Manchester University from 2008 to 2009; grasping the opportunity, a pagan organization (“Honoring the Ancient Dead”) emphasized the need to consider this individual as a person and “an ambassador of his community” rather than an archaeological object. In 2008, the Manchester institution decided to cover all naked Egyptian mummies with small pieces of fabric as a token of respect toward their original community and in the name of decency: a decision that generated a huge public controversy (Jenkins, 2011; Cadot, 2009). Public display can also lead to diffuse marketing. Human bones and relics are sold at auctions—for example the so-called head of Saint Vitalis of Assisi, an Italian Benedictine monk from the 14th century;
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original or not, the head was valued at between 800 and 1,200 euros (BBC News, 2001). Is a commercial context appropriate for and compatible with biological remains? If a reliquary can be sold like any other work of art (even a sacred one), what about a consecrated bone? The internet auction site eBay has finally decided not to allow any selling of human bones online as long as the origin of the “object” remains unclear (Huxley and Finnegan, 2004; Seidemann et al., 2009). In Paris (France) again, where the human body is legally considered a nonproperty entity, the National Museum of Natural History (NMNH) holds the remains of almost 23,000 human individuals, including 18,000 skulls. Within this collection are the remains of political opponents from 1830, which could be returned to the people of Algeria, and other individuals from hospital autopsies, archaeological excavations, and ethnological travels, which could potentially be identified: for example, the skeleton of Diatta, the last King of Casamance (died 1903), claimed by the state of Senegal. In the next few months, the skull of Ata€ı, a famous Kanak chief who died in 1878, will officially be restored to the Kanak community of New Caledonia. To prevent abusive repatriation processes, this NMNH follows two clear and simple rules: only human remains that are nominally identifiable or already identified are considered appropriate for repatriation; furthermore, the request has to be legitimate, i.e., emanating from relatives (or a nation, in the case of historical figures). For these reasons, the NMNH recently refused to repatriate 35 Aborigine skulls and a collection of hair samples to Australia because they were completely anonymous. For reasons based on secularity, the NMNH also refuses to restore human remains for religious reasons; and more importantly, the restitution process does not concern objects or ritual artifacts. However, the French parliament has different rules from the NMNH, which include sacred items in the restitution process (Esquerre, 2011): (1) The request must be formulated by a legitimate entity, i.e. a democratic country; (2) The request must be made by the intermediary of a living community; (3) In order to be sent back to their rightful owners, the human remains must be part of the cultural patrimony of those communities; (4) It has to be proven highly important for such items to go back home (for reburial, for example); (5) The restitution process has to be based on respect for human dignity, cultures, and beliefs. It is interesting that such rules are the same for human remains and sacred items, as if the former (human remains) could also be considered sacred entities. . . The remains of Saartjie Baartman have been restituted by the NMNH (Paris) to South Africa (2002) because a name was unequivocally associated with them. The 16 Toi Moko (18th to early 20th century mummified and tattooed Maori heads) given back by France in 2012 no longer had names, but it is hoped that further details for identification will be found within a few years under the direction of the Te Papa Tongarewa Museum (New Zealand). Indeed, this recent official restitution has been the occasion of a complete (and unprecedented) forensic and anthropological
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Naming the Body (or the Bones)
study of these human remains, initiating the provision of much better knowledge about their origin, preparation, signification, utilization and—paradoxically—conservation. In fact, the decision for restitution or inhumation of such “human artifacts” can provide a “second life” and ultimate study before any complete physical (though not scientific) disappearance. It could be the occasion when life and activity are instilled into sleeping and antiquated collections. Why is this repatriation of Toi Moko to New Zealand an example of high morality and respect for scientific goals? It is because all the mummified heads will be deposited in the Te Papa Tongarewa Museum (Wellington), not cremated or inhumed. Placed in a specially dedicated sacred area of the museum, they will still be accessible for research by local and international scholars with the aim of further identification. The same situation exists at the Dupuytren Museum in Paris, where a medical and anthropological collection is held by Paris 6 University and the curator is a hospital pathologist (Dr. Patrice Josset). If all the remains are voluntarily anonymous (the scientific system is characterized by its general anonymity), one of them, a fully dried body, retains complete biographical details: “General softening of the bones with severe deformation of the four limbs and trunk observed on Anne Elisabeth Querian, married Supiot, died at 35 years old; body deposed at the Royal Academy of Sciences, 1752–1753.” Should this identified body be restituted to its descendant and be buried? Probably not, because it was the original will of this individual to serve Science and Humanity by being studied, dissected by her private surgeon (Dupouy) and presented to the next generation as a kind of scientific curiosity (Anonymous, 1753). For Philippe Mennecier, a curator at the Museum of Man (Paris), who held the funeral mask of Frantz Liszt Descartes: “this face and the so-called skull of Rene can be touched and this is, for me, the person, but not this skull; Descartes is not in his skull, which represents nothing, in contrast to Liszt’s facial mask” (Esquerre, 2011). This point of view is morally very interesting: is it the face (even in plaster with no original parts of the body) that makes the individual rather than original pieces of bones (including the skull, the most symbolic part of the skeleton). . . because the individual can more easily be recognized by his facial features than by his skull (in the absence of any complementary procedures such as facial reconstitution)? Comparable “problems” could also arise in Italy, where a significant portion of the anthropological collections comprises mummified Italian individuals. In Palermo (Sicily), an 86 year-old woman asked for immediate cessation of all scientific analyses and special displays related to the mummy of her sister, Rosalia Lombardo, who died at the age of 2 years in 1920. Conserved in the Capuchin Catacombs, this individual is considered by local authorities as “un bene culturale” (i.e., a “cultural good”), not a private entity belonging to her family (Brunetto, 2012). The affair ceased with the death of the claimant. Some supposed that the initial motivation of the sister could have been financial. But how immoral is the contemplation (or at least the visibility) of the cadaver of a
little baby by her older sister when it is based on the legal decision of her parents? Comparable cases exist elsewhere in Italy, for example in the Town Museum of Salo, where anatomical fragments, body parts and complete mummies of 13 brigands from the early 19th century are displayed; should not their descendants (or political partisans such as “Neoborbonici”) claim the property and/or heritage, and ask for inhumation rather than public exhibition of their ancestors (Nicoletti, 2012)? The same dilemma affects the eight anatomical preparations from the collection of Giovan Battista Rini conserved at the Desenzano Hospital Pathology Division in Brescia, recently the objects of a complete scientific examination (Panzer et al., 2012). Meanwhile, what about the Anglo-Saxon community? The 2004 Human Tissue Act is to be considered inappropriate and irrelevant owing to the antiquity of such collections and items, and their very particular nature. In the USA, the Native American Graves Protection and Repatriation Act of 1990 gave directives for the return of human remains connected to American-only (not worldwide) modern-day tribes (Ousley et al., 2005; Misesuah, 2000); the practical disposition of so-called culturally unidentifiable remains was finalized only in 2010 by the USA Department of the Interior. This administrative position deals with more than 650 institutions (hospitals, anatomy departments, and universities) housing almost 116,000 individuals in their collections. The basic principles of such a position are respect for societies of all kinds (including tribal ones), and the fact that public and scientific interests in such “objects” no longer have any weight. Political aspects are not to be forgotten, as reburials are powerful social dramas and testimonies of the highly complex historical relationships between the concerned parties (living and dead, indigenous and non-indigenous) (Cantwell, 2000). One example suffices to show the complexity of such a repatriation process: at the end of December 2011, the Navajo Nation claimed hundreds of human remains unrightfully exhumed, and held in a collection in Tucson (Arizona), in order to bury them again (Associated Press, 2011). As a consequence, the Navajo Nation asked a judge to declare whether the remains were their property, and, if so, to order their immediate return for reburial. The situation remains unclear: further anthropological and archaeological analyses are necessary, as such bones could originate not only from the Navajo but also the Hopi, Apache, and Ute tribes. . . Some believe that, taken to the extreme, the demand to bury aboriginal skeletons (not only in America but all around the world) raises a potentially serious impediment to scientific enquiry (Weiss, 2001). Would such restitutions entail the complete disappearance of data for future generations? Not necessarily. In the case of an eventual inhumation or cremation, modern technologies could enable complete 3D conservation of all anatomical details to be obtained with great ultrastructural precision (for example photogrammetry: Ebert et al., 2011). A complementary limited sampling for further analyses is also possible, without destroying or significantly mutilating the remains.
Charlier
CONCLUSIONS Human skeletons and biological remains conserved in anthropological, medical, and/or archaeological collections are the foci of active ethical debate. In the near future, curators will have to choose between global conservation of all (or almost all) anthropological collections and their systematic restitution to the original communities or families. From all the previous examples of restitutions and non-restitutions, we found that the concept of the body (especially a dead body) as nonproperty is anything but clear, and depends heavily on local political views and the administrative status of the human remains. We propose that the only precise element permitting any restitution should be the name of the individual, as in the case of Charles Byrne. This proposal highlights the importance of all identification processes for such “artifacts.” Anatomists and forensic anthropologists could then play important roles in this identification, and subsequently in the restitution process, in close relationships with historians, archaeologists, ethnologists, etc. The name of an individual is undoubtedly a universal value: naming the dead is comparable to an identified burial, i.e., reversing the process by which they passed, years ago, from individual to scientific specimen. Such determining ethical elements could be of great interest and help to all universities and medical institutions that keep human remains for educational or historical purposes when they confront ethical debates and/or repatriation requests. In any case, researchers have to remember that these anatomical parts are not simple bones, but people.
ACKNOWLEDGMENTS The author extends warm thanks to Dr. Luc Brun (MD, University of Parakou, Benin), Dr. Isabelle Huynh (MD, -Salpe trie University Hospital Pitie `re, Paris, France) and (MD, PhD, head of the Laboratory of Dr. Christian Herve Medical Ethics, University Paris 5, France) for constructive discussions and original suggestions, and Ana-Maria Lazar (BNF, Paris, France) for English proofreading.
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