Navigating Mortality and Morality: Making Sense of Dehumanization in Cadaver Labs
Author: Ng Hei Yue, Bachelor of Medicine and Bachelor of Surgery, Class of 2027
Contact Email: hayleyng@connect.hku.hk
Artwork: The Anatomy Lesson of Dr Nicolaes Tulp by Rembrandt van Rijn
Published: 30th January 2024
Cadaver dissection is a profoundly paradoxical experience:
You are acutely conscious of the lifelessness of the body before you, once animated by a soul, it is now devoid of sensation and feeling. However, on an emotional level, every inch of the body seems to scream at you of its personhood, desperately reminding you of its capacity for life.
You know that to be professional and competent, you must cut into the body—meticulously exploring every organ and cavity, isolating, and identifying structures, and to articulate your findings in the most technical terms possible. But you find yourself washed over by waves of guilt and shame as you touch its skin and tear apart its delicate structures, as though you are intruding upon a sacred place, violating some unspoken universal morality.
You started off your medical journey to gain the ability to heal, to care for the most vulnerable populations, to preserve and restore human dignity. Yet, in cutting through a naked body, every action you take seems to be destroying human dignity instead. Trapped in your internal turmoil, you find yourself eventually succumbing to the human tendency of dehumanization—after-all, it is easier to see the body as separate parts rather than as a memorial body of a person, reduced to mechanical objects exempted from the needs for compassion and empathy. As you justify your indifference and apathy towards the body, you find yourself becoming the person you vowed never to be.
In the anatomy dissection lab, one is forced to confront two significant, yet often unexplored questions in life—one pertaining to mortality, and the other to morality. The nuances surrounding these questions render the lab a disorienting space, infused with intense emotions and ethical considerations. In grappling with these uncertainties, many medical students, including myself, often subconsciously resort to a coping mechanism: dehumanization.
During my time in the lab, I have experienced an array of unsettling and disheartening encounters. Sometimes, I hear comments comparing the cadaver’s body parts to objects and food, such as muscle fibers to minced pork and beef tendons, and adipose tissue to oranges. Other times, I see students unknowingly place their arms on the cadaver’s face during dissection, which is covered by a cloth, as if the face’s an armrest. These visual analogies and actions often leave me markedly disturbed, and elicit in me a strong sense of revulsion and moral discomfort. Initially, I was perplexed—how can medical students, physicians-to-be, be capable of treating a body with such insensitivity and disrespect? Eventually, I came to realize that what I am witnessing is the phenomenon of dehumanization. And I became aware that I, too, although never uttering it aloud, engage in acts of dehumanization as I silently echo the phrase in my thoughts while dissecting the cadaver—“she is dead, and she doesn’t feel.”
Dehumanization is often understood as the “denial of a distinctively human mind to another person”—to see another person as incapable of feeling, thinking, and making decisions [1, p.177]. Here, one may question how cadavers can be dehumanized, since they no longer possess the mind of a living person. As will be described below, dehumanization can be applied to more than just “alive” humans. In the context of cadavers, dehumanization manifests itself as the denial of the memorial aspects of the body, which involves removing the agency the cadaver once embodied, and suppressing the awareness that there are living people who possess knowledge and empathy for the body.
Within the social sciences and humanities, there exists a notable collection of literature discussing dehumanization in medicine [1–5]. Western medicine centers on the culture of biomedicine, where health and diseases are “fundamentally, even exclusively, biological” and the causes of illness are often reduced to physiological causes [2, p.70]. This understanding of the human body as standardized and universal can lead to objectification and reduction of individuals, where people, alive or not, are treated as objects, and the understanding of disease is disconnected from the sociocultural context in which the person is situated. Subsequently, any subjective feelings and experiences of the patients, along with the matter of morality, are often disregarded, if they cannot be translated into molecular models that offer pathophysiological explanation.
One way to understand dehumanization in anatomy lab is the very fact that we are positioned face-to-face with the reality of death, one that we are wired to escape. In The Denial of Death, anthropologist Ernest Becker posits that human’s anxiety of death, along with our tendency to suppress our awareness of it, are fundamental drivers of our behaviors [6]. Many of us might have witnessed death in the past, such as the passing of a loved one or attending funerals. However, none presents the concept of mortality as vividly as a cadaver dissection. As we cut through the cadaver, we are hit with the reality that what remains after death is nothing but a body of flesh, robbed of agency, vulnerable to physical harm, and no longer eligible for human dignity. This is threatening because if our pursuit of meaning in life revolves around evading death, acknowledging death as the reality implies that our actions are ultimately futile. Perhaps, then, by removing our shared humanity which connects us to the cadaver, we momentarily convince ourselves that the perceived differences between us and the cadaver could lead us to a varied fate, separating the concept of mortality from our practices.
The emotion of guilt adds another layer to the internal conflict one experiences in the lab. Many of the actions performed in the lab, such as making incisions and observing the naked body, would be considered as immoral if performed on a living person under ordinary social settings, eliciting feelings of guilt. In theory, these actions can be morally justified in a cadaver lab. After-all, donors autonomously gave their consent to be dissected, and no pain can be inflicted on a cadaver that cannot feel.
Still, when interacting with the cadaver, it is often impossible to ignore the tiny details on its body surfaces. The presence of age-spots and the unevenly trimmed toenails serve as a stark reminder of the person the cadaver once was. These details interfere with our moral reasoning, evoking guilt as though we are treating a sentient being and engaging in morally unacceptable actions. To mitigate this feeling, our subconscious minds eventually opt for a coping mechanism that involves mentally removing the last vestige of humanity from the cadaver, suppressing our awareness of the cadaver’s personal aspects, ultimately perceiving them as objects rather than memorial bodies.
In the preceding paragraphs, I briefly discussed some challenges I personally experienced in the dissection lab. These challenges stemmed from conflicts related to questions of mortality and morality. The complexities surrounding these issues, however, extend far beyond what has been described. By highlighting these challenges, my intention is not to express disdain towards acts of dehumanization, but rather to emphasize my heightened awareness, shaped by my experience as a medical student, of the necessity and inevitability of dehumanization in medicine, considering our human nature and the functional demands in the field.
This necessity of objectification, however, is by no means a justification for the actions that follow it. What is truly alarming about dehumanization is when we fail to recognize our tendencies to objectify, which can lead to apathy and the erosion of human dignity. By cultivating a better awareness of our potential to dehumanize, we can pause and reflect when we find ourselves engaging in the act of objectification. By taking a step back, we can allow the individuals before us to regain their full humanity, enabling ourselves to honor and dignify the lives they lived.
References
6. Becker, Ernest. The Denial of Death. Free Press.