Doctors duties under the Human Tissue Act

Resurrection men

Detail of wax anatomical head © Science Museum, Science and Society Picture Library

In 1820s London the dead could not always rest in peace. The growing demand from the anatomy schools for human bodies for dissection drove a shadowy but lucrative trade in illicitly exhumed corpses.

Here, the MDU Journal delves into anatomy's murky history and examines doctors' duties today under the Human Tissue Act.

The 'resurrection men' who prowled the capital's graveyards, undertakers' premises and even hospitals, were feared and loathed by ordinary Londoners. Only the bodies of executed murderers could be legally passed to the anatomists for dissection and the prospect of a family member meeting such a fate was horrifying.

Grieving relatives made strenuous efforts to thwart the body snatchers, employing iron coffins, locks, man-traps and even armed security guards. But the financial rewards on offer were enough to outweigh these deterrents. The price of a corpse – up to 20 guineas when demand was at its highest – could provide a handsome living for a working man and special rates could be negotiated for bodies of special interest to the anatomists.

Grave robbing required a good deal of planning. Professional resurrection men would monitor the phases of the moon for the most suitable conditions and haggle over prices with the anatomy schools before setting out for the night. A common technique, to minimise disturbance to the burial plot, was to dig down at the head-end of the coffin. The coffin lid would then be snapped open with a crowbar and the body – assuming it had not putrefied – would be pulled from the hole by rope. The corpse's clothes and possessions were often abandoned because being caught with stolen property carried harsher penalties than taking a body.

Diagram of muscles

The superficial muscles of the thorax and axilla 1876, Wellcome Library

By the 1820s, there were an estimated 50 resurrectionists working in gangs to supply the capital's four major hospitals and 17 private anatomy schools. Many of the foremost surgeons of the day, such as Sir William Blizard and Sir Astley Cooper, were forced into uncomfortable alliances with these disreputable characters to ensure a steady supply of specimens during the 'dissection season' (October to April).

When, in 1823, medical students were legally obliged to obtain a certificate from one of the London schools of anatomy recognised by the Royal College of Surgeons before they could qualify, demand for bodies soared. By 1831 there were estimated to be over 900 students studying anatomy in London but only 11 bodies legally available for dissection. Respectable surgeons reviled the resurrection men but they also desperately needed their services.

It was perhaps inevitable that some would go too far to meet the demand. In 1820s Edinburgh, the murderous Burke and Hare made a criminal career out of supplying Dr Knox, a respected local surgeon, with fresh corpses for his dissection table, no questions asked. Burke's conviction and execution in 1828 (on the evidence of his partner-in-crime) led to widespread panic about 'burking', which intensified after the 'Italian boy' case in London two years later. On this occasion, anatomists from Kings College raised the alarm when three resurrectionists attempted to sell them the body of a street urchin although it was still bleeding.

The trial, execution and dissection of two of the culprits in the Italian Boy case generated extensive press coverage and public outcry about the dissection trade but it also gave renewed impetus to efforts to regulate the work of the anatomists and address the shortage of bodies available for dissection.

The result was the 1832 Anatomy Act which made it lawful for certain parties to be in possession of corpses (for ultimate disposal to the medical schools) and established an inspectorate to visit the anatomy schools and examine paperwork. The Act was controversial for religious reasons but also, critics argued, because the poor would pay the price of medical advancements since most of the bodies would come from workhouses and hospitals, whose residents were less able to object. Others questioned whether the legislation reinforced the value attached to dissection subjects.

While it did not have an immediate impact, the Anatomy Act 1832 did eventually drive the resurrection men out of business, as well as the private anatomy schools. In their place was a system which effectively guaranteed that medical schools had access to the specimens needed for teaching and research, arguably helping to bring about significant improvements in surgical technique over the next 150 years.

Anatomy today - ruled and regulated

Part of human stomach

Part of human stomach dissected by Edward Jenner 1790-1823 Science Museum, Science and Society Picture Library

Human Tissue Act

After the first Anatomy Act, legislation developed piecemeal and against a background of significant changes in clinical science and public opinion.

The Human Tissue Act 1961, which applied to England, Wales and Scotland, allowed for a person 'lawfully in possession' of a body, to authorise removal of any part, or a specified part, in accordance with the express wishes of the deceased, to be used for 'therapeutic purposes or for purposes of medical education or research'. If the deceased had not expressed any wishes, the person lawfully in possession of the body could authorise the removal of any part for these purposes provided he had 'made such reasonable enquiry as may be practicable', and had no reason to believe that the deceased, surviving spouse or relative had objected.

This meant in effect that specific consent to remove and use organs and tissue was not required by the Act.

In 1999, widespread dismay at the discovery that Bristol and Alder Hey hospitals had retained organs of deceased patients without valid consent brought about a definitive change in the law. A succession of inquiries revealed that relatives of deceased individuals were unaware that human material was being retained, for a variety of purposes, typically following post-mortem examinations.

Following a public consultation, the government embarked on draft legislation to update the law in this area, culminating in the Human Tissue Act 2004 (the Act) and the establishment of the Human Tissue Authority (HTA). Today, the Act provides a consistent legislative framework for issues relating to body donation and the taking, storage and use of human organs and tissue.

Principles of the Human Tissue Act 2004

Activities regulated by the Act are:

  • the storage and use of whole bodies
  • removal, storage and use of human materials (organs, tissues and cells) from the deceased 
  • the storage and use of material from living people, for 'scheduled purposes' set out in the Act.

Consent is considered the underpinning principle of the legislation. Appropriate consent must be obtained to undertake regulated activities. Appropriate consent is defined by reference to who may give it, such as a 'nominated representative', who becomes a decision-maker after a person's death. There are penalties for carrying out regulated activities without appropriate consent.

It is also unlawful to obtain any bodily material with the intention of analysing its DNA without qualifying consent, subject to certain exceptions. This offence applies to the whole of the UK.

The Human Tissue Authority (HTA)

The HTA is the regulatory body which licenses organisations that store and use human tissue for purposes such as research, patient treatment, post-mortem examination, teaching and public exhibitions. The HTA codes of practice set out expected standards for each of the sectors regulated. The codes of practice, which are available online, provide guidance to support professionals.

Scotland

Scotland has its own legislation in the form of the Human Tissue (Scotland) Act 2006, which introduced the concept of 'authorisation'. The Act was designed to embody the principle that people can expect the wishes they express during life about what should happen to their bodies after death to be fulfilled.

James Lucas
Medico-legal adviser

Advice

  • Members are advised to follow guidelines published by the relevant Health Departments as well as the codes of practice produced by the Human Tissue Authority.
  • The GMC has published guidance Consent to Research which includes advice on research involving human tissue.
  • Members with specific queries, for example in relation to consent and the Human Tissue Act, should contact the MDU's telephone helpline for further advice.

We would like to thank the Museum of London for its excellent exhibition, Doctors, Dissection and Resurrection Men which inspired this article.

This article originally appeared in the printed edition of the MDU journal April 2013 entitled "The dark world of the resurrection men"

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This page was correct at publication on . Any guidance is intended as general guidance for members only. If you are a member and need specific advice relating to your own circumstances, please contact one of our advisers.

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