May 11-14, I attended the annual meeting for the American Association for the History of Medicine at the University of Michigan in Ann Arbor. I chaired a roundtable entitled “Historical Medical Collections, Human Biomaterials and Remains” which explored the multiple ethical challenges surrounding historical medical collections, a category that is problematized also in Ethical Entanglements.
By historical collections the round table referred to the medical museums and anatomical and pathological cabinets that from the mid 18th century that all played a central role in medical research and pedagogy. At the time, and in the century and a half that followed, they functioned not only as reference points for medical knowledge production and reproduction, but also as shrines to medicine, the science, its men and their achievements. In the 20th and 21st centuries however, they are being perceived in new ways. Now the darker sides of their origin is coming into focus: unregulated trade, theft, and ethically dubious collection practices permeated the practice before institutional, professional and state governance and the development of professional ethics centered on bioethics and informed consent reshaped medical and anthropological practice. Nobody can contest the important contributions these collections made to our medical knowledge, our understanding of the human body, its biology, and the pathways to healing it. However, the dark past that looms over the legacy of these collections ties them to structures of classicm, racism, sexism, colonialism, and authoritarianism, that all facilitated their coming into being.
It is – without a doubt – a troubling legacy.
The Michigan Union at University of Michigan campus in Ann Arbor was the venue for the annual conference for the American Association for the history of Medicine, May 2023. Photo by Liv Nilsson Stutz.
Today, new methods and technical advances have made these collections less relevant for teaching medical students and for carrying out research on human biology, anatomy, and pathology. As their “value” for medicine has decreased, they have come under increased scrutiny and criticism with their troubling legacy casting longer and darker shadows, to the point of calling into question their continued existence. We are starting to hear more and more voices calling for their destruction, deaccessioning, and limitations in terms of both public access and research.
While recognizing the importance of the criticism and the dark legacy, this panel problematized this development and asked: Are there multiple and competing ethical claims to consider when exploring the theoretical, political and practical challenges facing these collections and the institutions that care for them? What are the possible futures for these collections? What role should they play for medical professionals, for scholars, in education, and for the public? As these collections no longer hold the status of shrines, can their role be redefined in productive and ethical ways, for example as public facing centers of historical research and exhibition – and if they are, can these centers be imagined in a way that also considers their dark history to operate as democratic, inclusive institutions in a way that adhers to the contemporary role of museums (as defined by ICOM)? What are the best ethical policies and practices when we approach these complex issues?
While recognizing the ongoing debate, which for the sake of simplification can be characterized as postcolonial debate, and that tends to be centered on specific categories of remains, and without trying to ignore or suppress it, the round table sought to explore additional questions around value, use and multiple ethics that tend to be marginalised in the current conversations. We came to this conversation from different experiences – from the fields of medicine, history and archaeology – all with various experiences of debating these issues on a theoretical level, carrying out research on human remains, and managing museum collections with human remains.
Speakers at the Roundtable on Historical Medical Collections, from the left, Mike Sappol, Olof Ljungström, and Rainer Brömer. Photo by Liv Nilsson Stutz.
The speakers at the roundtable were:
Mike Sappol – a medical historian based at Uppsala university with a significant experience as an exhibition curator and at the National Library of Medicine, and the author of several important books. His work focuses on the history of anatomy, death and the visual culture of medicine and science, the body, the history of museums and queer studies. His paper entitled “Endangered specimens. Historical Human remains and derivatives: competing claims, meanings, critiques, and practices” interrogated and explored the debates surrounding these historical collections and their different and complex values through the case of the Museo Morgagni di Anatomia in Padua: as materiality, artifacts, and perhaps even as a form of “relics of an extinct medical civilization.”
Olof Ljungström – a historian at Karolinska Institutet in Stockholm, where he oversees the anatomical collection. His work focuses on the history of medicine, including 19th century anatomy, race science and the history of research at KI. His paper The Body Politics in the Anatomy Collection: Where the politics of the past meets the politics of the present, contextualized the history of the Finnish crania at the KI collection and the contemporary claims surrounding them.
Rainer Brömer from the Institute for the history of Pharmacy and Medicine at the Phillips University in Marburg, where his research focuses on Anatomy and Pharmacy in the Ottoman Empire, Medical and research ethics, and the body, and where he has also been involved with the Marburg university anatomical collection, its Museum Anatomicum and the conception of a future museum in Marburg. His paper, Gazing at human bodies – epistemology, ethics, and aesthetics discussed the ethical challenges of this project.
After the presentation the room engaged in discussion that included voices form colleagues currently working with historical medical collections in museums across the United States who shared their perspectives and experiences.
“It is always more than one thing”
Lisa Harris in the opeing roundtable “Being a Public Scholar Now” on the subject of abortion
Personally I felt inspired as I made connections between what I was hearing in the room and what I had heard at the opening round table session for the entire conference earlier that day entitled “Being a Public Scholar Now: Obligations, Opportunities, and Dangers” chaired by Susan Reverby with Angela Dillard, Alice Dreger, and Lisa Harris. In her address Lisa Harris, who is an OBGYN, holds a PhD in American Culture, and is an activist for women’s reproductive rights, spoke about her role as a public intellectual and why it matters. Her thoughtful remarks were inspiring and, I believe, tie in with the conversation we were having hours later when discussing historical medical collections. She emphasised two dimensions that drive her work as a researcher and activist. First the presentism of history. “You learn from the past – about what was “bad” then, but you never distance yourself too much from the past, because the problems are still present.” She said, “you can biopsy any moment in American History and you can see similarities today.” The second dimension was her love of history and the ways in which its complexities reveal themselves through research. It is always more complicated than you think, she argued, and you need to embrace the complexity and hold the ambiguities. It is possible that something can be both good and bad, all at once – for example abortion: it is both a death and at the same time the opportunity for life and freedom for another person. “It is always more than one thing.” Given the subject of her research, it was also obvious that taking a stance that complicates the matters at first can be difficult, as many people who are engaged with a topic like reproductive rights may seek and want a more straight forward answer. But ultimately, the only way to really move forward and find the productive and real solutions requires a recognition of ambiguity and complexity. And here, in that recognition, the presentism of history comes back to enrich our sensitivities and our understanding of how phenomena like historic medical collections hold ambiguities and complexities that we need to embrace, not avoid, if we want to understand their potentials and their charge.
featured image: Baby Carraige” by Orin Zebest is licensed under CC BY-SA 2.0.
Ethical Entanglements 