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Approaching the Ethics of Human Remains from a Medical History perspective. Report from the AAHM meetings.

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 18^th 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 20^th and 21^st 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 19^th 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.

Report from “Encountering Human Remains: Heritage Issues and Ethical Considerations” in Cambridge

On May 11 and 12, 2023, the 23^rd Cambridge Heritage Symposium took place at the McDonald Institute for Archaeological Research. The topic of these two-days symposium was “Encountering Human Remains: Heritage Issues and Ethical Considerations”.

Despite what one may think looking at the hosting place, archaeology was not the only point of view in discussing the human remains, nor was it the main one. On the contrary, many different approaches, methodologies, fields were presented and discussed in these two stimulating, interesting, and emotional days – as it is very well proved by the six sessions in which the days were divided: 1. European Conflictscapes and the War Dead, 2. Necropolitics and Commemorating the Dead, 3. Shifting the Narrative and Management of Human Remains, 4. Encountering Death in Museums: Ethics of Display and Public Perception of Human Remains, 5. Studying the Dead: Curation and Archival Research of Human Remains, and 6. Reflecting on Epistemology, Spirituality, and the Social Dead.

The Symposium was organized by Dr. Trish Biers, Elif Dogan, Leanne Daly, Dr. Miriam Saqqa-Carazo, Dr. Gilly Carr, Dr. Paola Filippucci, and Ben Davenport.

File:Ivory model of a human skeleton, suspended in a case with op Wellcome L0058603.jpg” is licensed under CC BY 4.0. This file comes from Wellcome Images, a website operated by Wellcome Trust, a global charitable foundation based in the United Kingdom. Ref Wellcome blog post (archive).

Alongside the sessions, two keynote speakers presented their unique perspectives on two interesting themes: the first day Dr. Layla Renshaw explored the different dimensions of personhood sought by the living when a mass grave is exhumed, bringing case studies of contemporary exhumations of Republican mass graves from the Spanish Civil War; on the second morning, George Gumisiriza used the lens of migrant corpses to explore potential individual and collective ways of encountering human remains in society. The registration of these interesting and moving intervention are available on the site of the research center.

After Dr. Renshaw keynote, Dr. Gilly Carr kicked-off the first session with a question that everyone working with human remains – and ethics in general – asked themselves at least once in their life: “What is an inappropriate behavior?”. The question pairs perfectly with the general recommendation of treating human remains “with respect”, when one encounters them. After Dr. Carr her colleagues in the session, Dr. Margaret Comer, Leonora Weller, and Dr. Magdalena Matczak beautifully interrogated regarding war and holocaust dead and on what the human rights of human skeletal remains are as heritage – and if human remains resulting from atrocities should be heritage at all.

The following session, with the talk of Dr. Daniel Gaudio, Oliver Moxham and Hyunjae Kim, explored the commemoration of dead and the connection with politics, from different perspectives, starting with the challenges of analyzing frozen remains in Northern Italy, going through the possible linguistic barriers in Japan and finishing with the interpretation of colonial deathscapes and local’s narrative in South Korea.

The last session of the first day explored new possible narratives around human remains, specifically shifting from the dominant Western approaches and discourses. Dr. Yunci Cai presented the case of the Monospiad Cultural Village in Sabah, East Malaysia, while Dr. Heba Abd el Gawad underlined the invisibility to which the contemporary Egyptian people are subject, when it comes to their discomfort towards the display of mummified Egyptian human remains in Western museums. Paloma Robles Lacayo proudly described the efforts undertaken in trying to identify the Mummies of Guanajuato, to eradicate their objectification, without hiding the difficulties encountered (and still encountering) and Dr. Guido Lombardi showed the possibility of carrying on the Ancestors’ legacy, respecting their body-preserving traditions and bridging them with modern education and local specialists.

Following the beautiful keynote lecture, the second day opened with the encounter of death in museums. To open the session, Dr. Katie Stringer Clary draw the history of the exploitation of the Indigenous or “abnormal”, sometimes living, bodies. She begun by discussing the very first freakshows up until today, pointing out that: “Museums no longer exhibit living people. Still, how far have they come?”. Olga Nikonenko focused instead on the complicated issues of the provenance, public display and repatriation of the multi-cultural Graeco-Roman mummified remains discovered in Egypt. More personal perspectives were those offered by Dr. Jody Joy, who told his experience in curating the Lindow Man, and by Cat Irving, who closed this session telling the stories “of those that you don’t find in history books”.

Since the beginning of the Symposium questions arose at the back on my mind, and they haven’t left yet: where do we draw a line, if we can draw a line at all?

The speakers of the second session of the day, Dr. Miriam Saqqa-Carazo, Dr Rachel Sparks, Jelena Bkvalac and Dr. Ayesha Fuentes, focused more on the curatorial aspects of handling human remains in museums, as well as on the archival research.

To conclude this full, thought-provoking two-days Symposium, the last session tackled a more epistemological, spiritual and social perspective. The speakers, Prof. Shawn Graham, Ellie Chambers, and Dr. Svetlana Seibel, went from unveiling some (disturbing) sides of the trade of human remains on e-commerce and social media platforms, through their exploitation on online news platform as clickbait, to showing literary encounters with ancestral remains. Closing the session, Prof. Charles Clary (see also his IG) moving talk guided us towards his personal exploration of death, mourning and healing through his art, which also provided the beautiful cover of the Symposium’s programme.

Since the beginning of the Symposium questions arose at the back on my mind, and they haven’t left yet: where do we draw a line, if we can draw a line at all? Should politics be allowed to objectify the remains, using them for its own purposes? What’s the distance in time that determines whose ancestors are worthy of asking for repatriation? And is this distance really sufficient, to ignore this type of concern? And should professionals working with human remains be completely detached and unemotional, as usually required to scientists, to be considered professionals?

As for all the best encounters, these two days left me with more new open questions than answers. Unfortunately, it is not possible to see all the amazing talks that have been delivered in those two days, but the online poster session is still available and showcases very interesting researches.

by: Nicole Crescenzi

featured image: File:Ivory model of half a human head, half a skull, Europe Wellcome L0057081.jpg” is licensed under CC BY 4.0. This file comes from Wellcome Images, a website operated by Wellcome Trust, a global charitable foundation based in the United Kingdom. Ref: Wellcome blog post (archive).

Reading Alexandra Ion: on ruins, nostalgia, and lonely specimens

Last week the project invited Alexandra Ion, formerly at the Institut de Antropologie Francisc I. Rainer, Academia Romana in Bucharest, to discuss her article “Anatomy Collections as “modern ruins”: The nostalgia of lonely specimens, published in 2021 in Science in Context.

This beautifully written paper explores a range of entangled issues relating to the collection and scientific handling of human remains. The piece departs from the discovery of a strange specimen – a preserved human face in a wooden crate – in the attic of the Francisc I. Rainer Institute of Anthropology in Bucharest in 2010. The face, extracted from a human cadaver at the turn of the last century, showcased a unique method to preserve human tissue developed by anthropologist and pathologist Francisc I. Rainer, a technology that very soon after its conception fell into oblivion, and with it, the scientific relevance of the face itself.

The face in anterior and posterior view.
Original published in Ion 2021. Intentionally blurred for this blog. Published with permission from Alexandra Ion.

The article explores the history of the specimen and contextualises it within the anatomy practice of the time. We can follow a sort of chaîne opératoire of the making of anatomical objects from human bodies, and how the process unfolds in space, in different parts of the building – from the intake on the ground floor, through different rooms of preparation and display. At some point in time as it becomes obsolete and forgotten, it moves out of the public eye into a closed crate in the attic, tucked away with other items from the past, including papers and photographs. An object among objects. Form here it then emerges at the time of its discovery in 2010. But it is changed. No longer a valuable piece to demonstrate technological skill and methodological progress, it has become an uncomfortable artifact of a problematic past. Like many liminal phenomena, by definition situated between categories, it causes discomfort. Ion describes how she moves it through the building to find a place for it that seems appropriate…the office, the lab….it no longer fits anywhere.

The attic of the Francisc I. Rainer Institute of Anthropology. Published in Ion 2021.
Photo by Alexandra Ion. Published with permission from Alexandra Ion.

In many ways the journey described by Ion for this specimen, is typical for many anatomical collections today. They have become matter out of place (sensu Mary Douglas). No longer useful in the way they were once perceived and even made, they have transformed into something strange, historical, and perhaps, to some, upsetting. The transfer of many anatomical collections from medical spaces to history museums is a tangible expression on a larger scale of this redefinition.

The recurring question then becomes: What to do with them? This is a central question also for the Ethical Entanglements project. Ion offers an interesting approach when suggesting that we can view them, not only as archives (which they are), but also as ruins. Drawing inspiration from Thora Petursdottir’s and Bjornar Olsen’s writings on modern ruins, she views them as “caught between the past and present, between fascination and strangeness.” This opens up a venue to explore our own encounter with them as meaningful and important in new ways, drawing on scientific curiosity, but also emotion and nostalgia.

How do ethics relate to this? The paper centres on the multiple ethics entangled in the engagement with human remains – something that our discussion about the paper came to focus on:

“Alexandra’s inspiring approach to anatomy collections as “modern ruins” made me reflect about our responsibility towards human remains collections. As archaeologists, we work on the principle of preservation through documentation, and it would not occur to us to bury an archaeological site before investigation and documentation. Likewise, I believe it is our duty to engage with these legacies, however uneasy they may be.”
Rita Peyroteo Stjerna

“Alexandra’s paper was intelligent, thought-provoking and sophisticated. I was delighted that she was able to talk with us about it. In a wide-ranging discussion, we talked about how we can extend debates beyond the post-colonial critique, about multiple ethics and how we manage the tension between object and person that human remains present, among other things. We talked about circumstances in which displaying human remains might be a more appropriate solution than concealing them. We went on talking well past our scheduled hour of discussion, which is testament to how rich and engaging Alexandra’s work is. I hope that we will find ways to include her in some future discussions.”
Sarah Tarlow

I too congratulate Ion on this important and beautiful paper. The metaphor of the ruin is interesting and captures an important dimension in the engagement with human remains of the past, emphasising the emotional and affective in this encounter, adding an important dimension to the scientific and historical values often mentioned in the debate. But it also has limitations.

“…to me, as ruins these human remains from the past remain inhabited, if not necessarily haunted”
Liv Nilsson Stutz

To me it remains a metaphor that captures an encounter between a subject in the presence of an object from the past. But human remains are not neutral objects, something Ion also discusses. I want to embrace the liminality of the category fully, and recognise, as a point of departure, that human remains from the past always retain a certain level of their subjectivity, also in the present. To build on the metaphor: to me, as ruins these human remains from the past remain inhabited, if not necessarily haunted.

Addressing dark heritage in exhibitions. The University Museum in Groningen.

After our visit in Amsterdam I continued to Groningen which aslo has an anatomical collection on display in its University Museum. Here, the anatomical collection is part of the exhibition on the history of the university and its scholars, and it is thus clearly inscribed in the broader history of research and scholarship. A separate room is dedicated for this purpose. The anatomical display is arranged on stepped shelves organised in a semi-circle, with mounted skeletons on top and with preparations of body parts and organs on the lower shelves. The room has a claire-obscure quality with dimmed lights and spots illuminating the white bones, and the body parts almost glowing through the amber coloured liquid of the old preparations. The display is accompanied by an interactive screen where visitors can see close-up photographs of each displayed specimen and read descriptions about pathologies and preparations. The exhibition is extremely interesting, quite moving, and, I must admit, very aesthetic.

The anatomical collection arranged on stepped semi shelves organised in a semi-circle. Photo by Liv Nilsson Stutz (intentionally manipulated)

On the opposite side in the same room, an exhibition is devoted to the contribution of Petrus Camper (1722-1789). Camper was Professor Medicinae Theoreticae, Anatomiae, Chirurgiae et Botanicae at the University of Groningen from 1763 and to his death. He was an academic celebrity of his time and a leading scholar in many fields, including comparative anatomy.

Tibout Regters – De anatomische les van Petrus Camper. Amsterdam Museum, Public Domain.

As part of his research, Camper studied the anatomical differences between humans and apes, in particular crania and larynxes. To address the context of this research, the museum signage both celebrates and problematises his legacy. The exhibition called “Bitterzoet Erfgoed” (Bittersweet Heritage) informs us that while Camper lived in a time of colonialism and slavery, he “did not accept this worldview” (i.e. slavery). That being said, the text continues “Camper’s work cannot be separated from colonial history,” as “he collected specimens (human and animal) from colonised regions including the skulls and skin specimens on display in this exhibition.” The next sentence sums up the central dilemma:

“This raises complex questions. We want to tell the story of Petrus Camper, but also treat the remains of people who did not choose to become subjects of scientific research with respect”
Text in the exhibition about Petrus Camper at the University Museum in Groningen.

Several human crania are on display in this part of the exhibition, and a color coded map indicates their provenance including Madagascar, Europe, Java, Russian Republic of Kalmykia, Angola, China, Jakarta, and Mongolia.

Display of skulls from different parts of the world. The crania wee collected by Camper for his research into comparative anatomy. Photo: Liv Nilsson Stutz, intentionally blurred.

The transparent and honest way in which the exhibition communicates about the content of the collections and their problematic history, is interesting and quite admirable. The display of remains such as skin samples brings the hot button topic of racism into focus. The exhibition strikes the balance between communicating that while Camper’s research was not seeking to support racism as an ideology and a “scientific” concept, he still worked within a context of colonialism and othering. And while not explicitly stated, the knowledgeable visitor can probably fill in the blanks as to how this research tradition came to be enmeshed with race science only a few generations later. While taking risk with this display, the museum paradoxically takes responsibility for its collections as it does not try to avoid confronting difficult issues or hide its collections.

Skin samples on display in the museum. To the left, skin samples form humans from different parts of the world, displayed in the Bittersweet Heritage exhibition. The samples were used by Camper to understand human variation between white and black skin. To the right, human tattooed skin (the face of a woman and the British and Norwegian flags) exhibited with the skin of whale to illustrate Camper’s work in comparative anatomy. Photos by Liv Nilsson Stutz, intentionally blurred.

Interestingly (and typically) the problematisation is limited to the anthropological research and exhibition, and does not discuss the medical collection displayed only a few meters away in the same room. The context of the “bitter sweet heritage” is not extended to include collection practices from other contexts (such as, presumably, maternity wards and other care facilities). This relates to a more general pattern that we can see in how different categories of human remains sometimes are treated with different consideration and levels of problematisation.

Museum Vrolik and Body Worlds Amsterdam: reflecting on two exhibitions of human remains

In early November, we (Sarah Tarlow and Liv Nilsson Stutz) visited the Netherlands with the objective of viewing two different exhibitions of human remains: Museum Vrolik and Body Worlds, The Happiness Project, Amsterdam. While we realised it would be two distinct experiences, we were not quite prepared for just how radically different these two exhibitions would be, and how entangled the ethics of it all would appear at the end of the day.

The signage to the museum in the hospital foyer underscores the medical context of the collection. Photo by Liv Nilsson Stutz.

The Museum Vrolik is located on the bottom floor of the Amsterdam University Medical Center. As you enter the building you find yourself in a contemporary hospital, but as you turn left and enter the dark space of the museum you take a step into the past. A sign at the entrance cautions you that the exhibition contains human remains and may not be suitable for sensitive visitors. Photography is not allowed. The Museum website states:

“You should compare your position as a visitor to the Museum Vrolik with students of medicine during a practical anatomy session in the dissecting room. They observe and dissect mortal remains, but do so with proper respect and they are not allowed to take photographs of whatever they see in the room”
https://www.museumvrolik.nl/en/about-the-museum/human-remains/

Museum Vrolik has an impressive collection. The remains were collected between 1750 and 1950. It contains 3300 human bones, skulls, and complete skeletons, 840 anatomical preparations with congenital defects, 1230 human anatomy preparations, 7400 glass negatives, 600 preparations related to dentistry, 530 plaster models and casts, 1760 drawers of brain slices, and 410 wax models. In addition the museum also contains animal bones and preparations. Only a small sample of this impressive collection is exhibited.

Cover of the catalogue of the Museum Vrolik “Forces of Form,” for sale in the museum shop. While I do not want to link to any online content of the displays, I show the cover of this book to provide an impression of the kind of specimens exhibited in the museum.

The exhibition consists of one square shaped room with dimmed lights and aesthetically illuminated glass display cases forming four areas in the center of the room displaying anatomical and pathological specimens, and along the perimeter of the room, a series of display cases that chronicles the history of the collection. It is breathtaking.

The collected are categorized as “objects of science” – but the display invites us to see people who once lived with pain, disability and strength to survive many years under difficult circumstances. It is moving and unsettling all at the same time.

In the historic overview the collection is contextualised with a focus on the collectors and their roles in the history of research. The presentation is honest and transparent and mentions collections from cemeteries and medical wards. In contrast to the matter of fact tone in the texts, the actual exhibition in this part of the museum is sometimes very moving – especially the mounted skeletons of physically disabled individuals, one of which is still leaning on their cane. The juxtaposition between the factual narrative on the signs with the emotional displays is interesting. While only the collectors are visible as agents in the narrative, the collected demand our attention in the display. It suddenly dawns on us that there is contextualisation but no problematisation. The collected are categorised as “objects of science” – but the display invites us to see actual people who once lived with pain, disability and the strength and support to survive many years under difficult circumstances. It is moving and unsettling all at the same time.

The main part of the exhibition focuses on anatomy and pathology. Here there is very little contextualisation of the collection beyond that of the human body itself, which presents itself as a timeless medical fact. The preparations of fetuses and new borns, or of more complete body parts, add a dimension of subjectivity to the exhibition, bringing to the fore a shadow of individual lives – viable or not. But in the end, these remains are exhibited as objects of science.

While an explicit reflection on the ethics of collection is absent from the exhibition, the museum webpage includes a statement that recognises that collection practices in the past were very different to contemporary medical practices, and that it is not possible to know if the deceased or their relatives consented to, or were even aware of the fact that the remains were collected. Just like in the exhibition itself, it is in the voids between what is explicitly stated and what is implicitly felt, that the ethical entanglements emerge for us to reflect on. It is interesting and moving.

Entrance to Body Worlds in Amsterdam, advertising the exhibition of “over 200 real human specimens” in the midst of the Amsterdam tourist district. Photo by Liv Nilsson Stutz.

Later the same day we visited Body Worlds, The Happiness Project, Amsterdam, located in the tourist area of the city center, and marketed at the entrance by a man who, like in a manner that reminded us of old time fair ground exhibitions or freakshow, enthusiastically invited us in.

Three separate displays of plastinated human bodies at Body Worlds Amsterdam. Note the sexualised position of the woman (left), the active position of the male (center). To the right an arrangement of sexual intercourse. Photos by Liv Nilsson Stutz.

Body Worlds has become a world wide sensation and a lucrative private enterprise. Günter Hagen who developed the plastination process which makes it possible to display the anatomical structures of the human body like sculptures, has marketed the venture as a mission to educate lay people about anatomy and health. Body Worlds has been criticised for using unethically sourced bodies, but today claims that all bodies on display are of people who have given their informed consent.

The Amsterdam exhibition mixed the exhibition of plastinated bodies staged in evocative poses with the display of individual organs. The whole bodies were positioned in a way that was always gendered and sometimes even sexualised, with female bodies placed lifted, lying down or leaning to the side with their legs apart, and with male bodies jumping a fence, playing a saxophone and steering a ship. One room was devoted to sexual intercourse. The theme chosen to frame the exhibition was happiness, and it was communicated through basic educational texts about health and well being, and through inspirational quotes. Despite the unique selling point of Body Worlds – the display of actual human bodies (in the middle of the tourist district no less) – the experience seemed artificial. It was difficult to connect to the material/humans on display. The commercialisation of the venture added to the confusion. Was the purpose of the exhibition to provide education, and the plastinated bodies were used as a way to lure people to pay over 20 Euros for a mediocre learning experience? Or, was the educational theme just added on as a justification to show dead human bodies? It was impossible to say.

The contrast between the two exhibitions could not be greater. Museum Vrolik showed old and admittedly sometimes problematic collections, but managed to inspire compassion and emotion, while Body Worlds felt like a commercial carnivalesque display trying to pass as education. Even if these bodies were displayed with consent, the ethics seemed more muddled than ever.

The Anatomical Collection at Karolinska. Report from a seminar.

On March 29, 2022, Karolinska institutet organised a seminar on their anatomical collection. The purpose of the seminar was to present the history of the collection, and to discuss possible ways forward as the institution grapples with a problematic history. This work is part of a broader engagement on behalf of Karolinska with regards to its history, and in particular its past connections to research on “race”, and the place the collection of crania had in this history. As a first formal step of this process of reckoning with the past, the institution raised the issue of honorific names on its campus – a topic already discussed in this blog. The second step is now to handle the collection of human remains.

Biomedicum, Karolinska Institutet – location for the seminar. Photo: Liv Nilsson Stutz

The seminar was introduced by the University President Ole Petter Ottersen who welcomed all to the newly inaugurated lecture hall named in honor of Eva and Georg Klein, both Jewish immigrants from Hungary after the Second World War, and viewed as representing the value of civil discourse and academic conversations also about difficult topics. To me, this introduction rightly framed the collection of human remains as such a difficult topic, as one worthy of civil discourse and academic exchange and – perhaps most importantly, as a topic around which we need to start by listening to one another.

The seminar was not uncontroversial and had received criticism even before it started, for example by Amnesty Sápmi. The critique focused on the fact that the speakers were identified as majority population seniors, and as such not able to speak on behalf of the remains themselves, or on behalf of descendants. This is true. But then again, the participants did not claim to do this, but rather participated to explore the topic from historical, anthropological and legal perspectives and expertise.

As the first speaker, Dr Imelda Helena Ek (Karolinska Institutet), presented her report on the history of the collection and placed it within a broader 19th century context in which race biology was an inherent component. The history of the collection is complicated by the fact that it was partially destroyed by a fire in 1892, during which the archives that today would have allowed researchers to retrace a lot of the history of individual remains, were lost. Typically, as the collection became obsolete for medical science and eventually also problematic, it has circulated between different institutions including Stockholm Univerity, Gutavianum and the Medical History Museum. In 2015 the collection returned to Karolinska and once more became its responsibility. Since the remains were returned they are not available for research and are not exhibited. Several international repatriations have been completed following international praxis. A sensitive part of the collection constitutes the remains of 70 individuals, a majority represented only by their cranium, that were taken from graves (both from prehistoric sites and from abandoned historic cemeteries) in Finland, during an expedition in 1883. While these remains were dug up, they were not part of any regular archaeological excavation, but must be viewed as collected for anatomical purposes. The motivation to collect these remains was to obtain specimen of what was considered to be “Finnish types” for the comparative anatomical collection. There is thus a direct line here between both race science and Sweden’s colonial history. It is generally felt that this collection is problematic, but according to KI any repatriation must be negotiated between the Swedish and the Finnish states. All KI can do is to inform about what they have in their care.

Back of bust of Gustaf Retzius. Source: Stockholms Aktionsverk

The second speaker was me (Liv Nilsson Stutz), and I focused on problematising one of the main ideas of the project Ethical Entaglements, i.e. the way in which human remains are situated on a sliding scale between objects of science and lived lives, and how the ways in which we perceive them depend on their state, character and history, and on external factors such as social and cultural awareness. As a suggestion of consideration for the future I also proposed that instead of rushing to clean out the closets, we approach the responsibility from a perspective of ethics of care, and thus move beyond the idea of formulating strategies based on the perceived value of the remains for science. An ethics of care perspective also means that institutions may have to take long term responsibility for remains that will never be claimed for repatriation, and also for its history and heritage – even when dark and uncomfortable.

The final speaker was professor emerita Kirsti Ström Bull who presented her experiences as a legal scholar involved in the legal cases leading up to the repatriation of Sámi remains from institutions in Norway. These cases have had a long term impact on the handling of ethical evaluation of research on human remains in Norway, where currently a national ethcis committee (Skjelettutvalget) reviews all requests for research on human remains. In cases of Sámi remains, the Sámi parliament is always included in the consultation. This kind of mechanism might be very valuable also for Sweden to consider as we build a more solid research ethics on human remains from all contexts – going beyond the immediate considerations of the Karolinska collection. Professor Bull underscored the importance of allowing the process to take time and be an opportunity to build trust and understanding.

“While we’ve had an academic discussion today on complex issues in which different opinions and criticisms have been raised, what we’ve also discussed concerns the concept of the equal value of all humans.”
President of KI, Professor Ole Petter Ottosen

After the presentation the floor (and online chatroom) opened for questions and comments. Natte Hillerberg from the organisation Sträva at Karolinska (an organisation of students and alumni at Karolinska organising for equal care for all) called out the lack of representation on the panel. She drew attention in particular to the human remains collected in Finland. The Q&A with participants in the auditorium and online explored issues relating to what might happen to the collection in the future, what kind of research questions may be explored, possibilities and experiences of repatriation of human remains from the collection, and what KI can learn from good experiences of repatriation from, for example Norway.

President of KI, Professor Ole Petter Ottosen concluded: “While we’ve had an academic discussion today on complex issues in which different opinions and criticisms have been raised, what we’ve also discussed concerns the concept of the equal value of all humans.”

FEATURED IMAGE: ANATOMICAL PLATES 1855. RETZIUS, ANDERS et al. Museum anatomicum Holmiense quod auspiciis augustissimi regis Oscaris primi ediderunt professores Regiae Scholae Medico.Chirurgicae Caroliensis. Sectio Pathologica.

Some thoughts about the connections between Ethics and Theory. Review of Geller’s Theorizing Bioarchaeology.

I recently published a book review of Pamela L. Geller’s noteworthy book Theorizing Bioarchaeology for the American Journal of Biological Anthropology. The book takes a broad approach to how social and critical theory can inform and improve our study of human remains. The book outlines how a bio-cultural perspective on humanity informed by considerations of practice, habitus, intersectionality, etc., allow us to highlight how power structures, including systemic violence and oppression in the past and present, frame our lived experiences and literally seep into our bones as readable traces of an often unwritten history. What I find particularly interesting is how Geller’s book demonstrates how this more theoretically informed bio-archaeology also leads us toward a more reflexive and ethical practice.

“A bioethos,” Geller writes “is only imaginable if we seek to consciously entangle—materiality and discourse, words and deeds, knowing and being and doing, science and humanities, fact and compassion.”

In the final chapters Geller proposes a way forward toward a more ethical bioarchaeology that in many ways builds on these theoretical insights. “It starts out firmly grounded in a North American experience discussing NAGPRA but evolves to consider race, class, gender, and religion, and to take on a range of emerging ethical conundrums for the discipline including the ethics of digitization and of ancient DNA, to the globalization of a discipline that still is very scattered in terms of priorities and values which makes the establishment of a broader code of ethics challenging. In the face of this complex challenge, Geller encourages us to engage in a proactive ethical practice of our discipline and develop moral normative practices in our interactions with the dead and the living. Drawing on an understanding of practice theory, she underlines the importance of understanding that these practices participate in forming our epistemological frames and ontological positions. She also embraces the entangled character of the responsibilities and accountabilities in our way (with reference to Karen Barad). “A bioethos,” Geller writes “is only imaginable if we seek to consciously entangle—materiality and discourse, words and deeds, knowing and being and doing, science and humanities, fact and compassion.”

Read the review open access in full text here.

credit featured image: “old book’s” by v.max1978 is marked with CC BY-NC-SA 2.0. To view the terms, visit https://creativecommons.org/licenses/by-nc-sa/2.0/?ref=openverse

Exploring Sustainable Collection Practices. Report from a workshop.

On May 2-4, 2022, I participated in a workshop “Museums, sustainability, collections” at the Africa Museum / the R oyal Museum for Central Africa in Tervuren, Belgium. The workshop was organised within the European cooperation project “TAKING CARE – Ethnographic and World Cultures Museums as Spaces of Care” and included curators, conservators and other museum professionals from ethnographic museums from across Europe and Africa. A central focus of the TAKING CARE project is the climate crisis and the Anthropocene with a particular focus on entanglements with colonial histories and their reverberations in our contemporary world.

Glimpse of the workshop program. Photo: Liv Nilsson Stutz

The workshop included three keynotes that in different ways addressed sustainable collection practices. Chris Ssebuyungo (Conservator at Uganda National Museum) discussed the relationships between the museums and their publics from his experiences in Uganda. André Ntagwabira (Researcher in Archaeology at the Rwanda Heritage Academy) and Siska Genbrugge (Objects Conservator at the Royal Museum for Central Africa) explored challenges relating to collections care of African collections weighing conflicting interests such as accessibility, cost, environmental impact, and health risks relating to, for example, exposure to pesticides used in conservation practices. My talk on the care for human remains discussed the ethical entanglements of different collections with a range of power structures, including those of colonial histories, and explored alternatives for ethical care practices for these sensitive collections. The talks were all followed by extensive collaborative workshop discussions where participants shared their experiences and perspectives with these issues. It was clear that we are in a moment when museums across Europe are all grappling with the challenges of how to best deal with their history, their role as contemporary inclusive and safe spaces, and their role as agents for sustainable futures.

*Freddy Tsimba “Centres fermés, rêves ouverts” Tervuren, 2016.* Tsimba’s sculpture is made from materials recovered from the building site during the new constructions of the museum in 2016. The sculpture gives form to his experiences in a closed center in Belgium and is a tribute to refugees being interrogated across the world. Photo: Liv Nilsson Stutz

In the segment of the program devoted to discussing sensitive collections we discussed different strategies used by museums to tread the difficult balance between accessibility and respect – for example the ways in which searchable databases can include specific protection for sensitive materials, or only be accessible from within the museum by researchers, descending communities, and curators. Participants also discussed what ethical engagement might look like in the work with human remains – and one participant shared how many bioarchaeologists and biological anthropologists systematically talk to the human remains as they study them to maintain the connection to and acknowledge their humanity. The discussions also raised new questions emerged in relation to new museology techniques. As auditory elements become increasingly incorporated in museum exhibitions, we could for example ask ourselves whether the documented sound of a voice should be included in the category.

The TAKING CARE project involves museums with ethnographic collections, and this means that the focus of any ethical exploration will be rooted in a critical analysis of colonial research and collection practices. In this discussion human remains is only one of many categories of sensitive collections. But there is nevertheless significant overlap in the challenges we all face, and many of the ethical considerations are very similar. In 2013 The Royal Museum for Central Africa closed to accomplish a complete overhaul of its exhibitions. The ongoing work on provenance and restitution is currently central to the mission of the museum.

Sculpture in openwood work by Aimé Mpane representing the *Skull of Chief Lusinga* which was taken by the Belgian officer Emile Storms as a trophy (the Chief was killed and beheaded) during a raid on the on the village of Lusinga in 1884. The cranium was part of the collections of the Royal museum for Central Africa until 1964, and was then passed on to the Royal Belgian Institute of Natural Sciences. The cranium has not been repatriated. Photo: Liv Nilsson Stutz

While the theme of human reamins was not central for this workshop, it is relevant when thinking about decolonisation and collections. Currently a large scale project called HOME (Human Remains Origin(s) Multidisciplinary Evaluation), to inventory all human remains collected abroad and currently located in museums, research institutions and private collections in Belgium has been initiated. The interdisciplinary project will identify “the individual people, the conditions under which their remains were collected and in some cases, will try to better understand past lifestyles, both from a cultural and biological point of view.”

“In Belgium, there are currently no guidelines for the conservation and management of human remains, nor a legal framework for the return of human remains to family members, institutions or countries of origin. “
Reinout Verbeke, http://www.naturalsciences.be

The project will also study Belgian and international legal frameworks for repatriation and restitution. Just like in, for example Sweden, “there are currently no guidelines for the conservation and management of human remains (in Belgium), nor a legal framework for the return of human remains to family members, institutions or countries of origin. A large inventory supplemented with archive material should help to identify more individual people and better understand the circumstances in which they were acquired.” This is in and of itself not unusual. What stands out in the case of Belgium however, is that up to today, Belgium has never repatriated any human remains to another state. This is perhaps especially striking given the well known colonial history of Belgium.

Human Remains in Contract Archaeology – report from a workshop

The Ethical Entanglements project mainly focuses on collections of human remains in museums, but a significant process by which they get there today is contract archaeology. In contrast to the scientific practices that resulted in many of the older collections in museums, including ethnographic, anatomical and archaeological collections, these new additions to archaeological collections are dominated by a practice driven primarily by development (such as the constructions of roads, schools and railway stations) – where archaeology is inserted as a measure to record and document cultural heritage before the destruction of these contexts for other purposes, rather than driven purely by scientific aims. To an extent this shifts the discussion. This means that it is not the scientific practice that is the root to the excavation and collection of these remains, but development. It also makes archaeology and collection into a protective practice, rather than an exploitative one. That being said, the ethical challenges remain the same, and the field, just like with the case of museum collections, lacks a clear regulation.

Participants in the workshop (from the left): Anna Tornberg, Caroline Ahlström Arcini, Lisa Hartzell, Liv Nilsson Stutz, Hayley Mickleburgh, Ina Thegen, Niels Lynnerup, and Clara Alfsdotter.

To explore these complex issues Ina Thegen, a guest researcher at at the Linnaeus University Center for Concurrences in Colonial and Postcolonial Studies, and a graduate student in Archaeology at the Department of Archaeology and Heritage Studies at Aarhus University, and I organised a workshop on the theme of Contract Archaeology, Human Remains, and Ethics in 2022, at Linnaeus University, April 8, 2022. The workshop was generously sponsored by LNUC Concurrences.

The workshop gathered experts and colleagues working with human remains from contract archaeology contexts in Sweden and Denmark. While presenting a broad view, the different perspectives all highlighted both a concern for ethical issues and an awareness of the importance of professional ethics, and a lack of clear structures, which results in a variation in practices and decision making.

Dr. Clara Alfsdotter, osteologist at Bohuslän County Museum presented the view from a regional museum in Sweden, and highlighted how, despite the existence of guidelines and recommendations, the interpretation of these very guidelines can vary and often depends on the single museum or, even individuals. These issues were discussed around two examples. In one case there were very different views within the museum whether it would be ethical to create an exhibition on the topic of syphilis in historic times using human remains in the mueusm collectons. The other example discussed how priorities in the field could favour the documentation of architecture over human remains. This example was especially problematic as it concerned a medieval monastery, where human remains can be expected.

Charina Knutsson, archaeologist at the museum Jamtli, and graduate student at the Linnaeus University Graduate School in Contract Archaeology (GRASCA) discussed the issue from the perspective of contract archaeology in Sápmi. Her previous research, published in her licentiate thesis Conducting Archaeology in Swedish Sápmi: Policies, Implementations and Challenges in a Postcolonial Context has demonstrated the lack of consultation with the Sámi communities in contract archaeology, and this disconnect potentially also affects how human remains are treated in the process. In her presentation she discussed that museums in the region all have policies regarding the handling of human remains, but there are no special recommendations for Sámi remains. The topic is current, but also still, to an extent sensitive.

Dr. Carline Ahlström Arcini, osteologist at the contract archaeology firm Arkeologerna opened her presentation with a moving account of how childhood visits to the paediatric ward at the hospital in Norrköping where her father worked as a physician, initially drew her to the field of osteology. This presentation reminded us of the importance of compassion as a key feature of a discipline that not only allows us to come face to face with an individual of the past, but also allows us to glimpse their lived experience, including pain and illness. Her presentation discussed how different stakeholders have different voices in the Swedish context, and that the Swedish church tends to be among the most critical, while the public ususally are mostly interested in the results. Who, we might ask, are the most important stakeholdes here?

Ina Thegen presents her paper on Danish contract archaeology.

A similar concern was raised by Ina Thegen, graduate student at Aarhus University, who placed these questions in the frame of her thesis that maps and problematises the connections between the legal frameworks, practices, and stakeholders in Danish contract archaeology. She too, points to the Church as a vocal stakeholder along with the media. But she also asked us to problematise if a stakeholder is less valid only because they do not represent the majority. She also discussed how human remains are categorised as movable objects and do not have a clear caretaker within Danish archaeology per se, but rather is under the purview of other disciplines (predominantly medicine), which may create a series of ethical challenges as they are not prioritised by the contract archaeology praxis.

Dr. Niels Lynnerup, head of the Forensic Department at the University of Copenhagen which holds the vast majority of human remains collected in Denmark by contract archaeology (the second depository is at the University of Southern Denmark / Odense), spoke on behalf of this other side of the Danish equation. From the perspective of a vast experience with a range of different contexts he underscored the importance of communication with all stakeholders as a fundamental step toward ethical practice – a theme that was echoed in the other presentations as well, thus highlighting a crucial arena for progressive and constructive work.

Discussion and exploration of concepts during the workshop.
All eyes on Niels Lynnerup – who is out of frame.

Dr. Anna Tornberg, osteologist at the Department of Archaeology and Ancient History at Lund University, discussed the ethical implications of the Third Science Revolution on research. Her presentation highlighted the importance of keeping an eye on how funding agency priorities and publication strategies impact the research process by imposing a top down perspective on human experience in the past. While these new methods offer a lot of possibilities, they also present new ethical challenges that we must consider.

The workshop was very dynamic and inspiring, as the different presentations offered complementary views on a very current and clear professional challenge. We left feeling that we have only started to explore these complexities and are looking forward to more exchanges of ideas and experiences in the near future.

Meeting at the Ethnographic Museum in Stockholm

Last week (January 26-27) the researchers with Ethical Entanglements met with the advisory board for the project, including Fredrik Svanberg (Nordiska museet, Stockholm), Linda Andersson Burnett (Uppsala University), Olof Ljungström (Karolinska Instititutet), Malin Masterton (Örebro University), and Kicki Eldh (The Swedish National Heritage Board). The meeting was held at the Ethnographic Museum in Stockholm. The project members presented their respective work packages to the board and received invaluable feedback from the board members who represent a range of experiences and expertise that in different ways will enrich the project with perspectives from the museum world and Museology, Medical Ethics, the History of Ideas and Knowledge, Postcolonial Studies, and more broadly from a critical engagement with Humanities and Social Science research and its history.

Abbreviated version of the ppt of the overall project

A lot of the discussions came to focus on the ways in which human remains are positioned on a sliding scale, between object and subject, between lived lives and specimens for sciences, and sometimes between evidence and victim – and how their positioning on the scale changes over time, between cultures and academic disciplines.

visit to the storage area of the Ethnographic Museum, photo: Liv Nilsson Stutz

After the meeting, Mia Broné, objects coordinator for the four National Museums of World Culture (Etnografiska museet, Medelhavsmuseet, Östasiatiska museet, och Världskulturmuseet), presented the work that these museums in different ways have worked intentionally with their collections of human remains, and the rich and complex history of the collections. We finished with a visit to the storage area where we continued to discuss practice and ethics of care.