INTRODUCING THE LIVING CADAVER: A NEW CONCEPT IN MEDICAL ETHICS
II. DEAD IN MOST OF THE MEANINGFUL SENSES OF THE WORD
A. A LIVING CADAVER IS LEGALLY DEAD.
A LIVING CADAVER IS SOCIALLY DEAD.
A LIVING CADAVER IS ECONOMICALLY DEAD.
III. BUT A BRAIN-DEAD BODY IS STILL BIOLOGICALLY ALIVE.
IV. POSSIBLE MEDICAL USES FOR A LIVING CADAVER
A. ORGAN AND TISSUE TRANSPLANTS
B. TESTING NEW SURGICAL PROCEDURES AND DEVICES
C. MEDICAL RESEARCH TOO RISKY TO TRY ON LIVING
1. TESTING NEW ARTIFICIAL
AND OTHER MEDICAL DEVICES
2. TESTING NEW DRUGS FOR
INTENTIONALLY GIVEN TO THE LIVING
D. PRACTICE SURGERY FOR SURGEONS-IN-TRAINING
E. ANATOMICAL STUDY
FOR THE EDUCATION OF
DOCTORS, DENTISTS, & NURSES
USES OF BRAIN-DEAD
by James Leonard Park
INTRODUCING THE LIVING CADAVER:
A NEW CONCEPT
IN MEDICAL ETHICS
How do we make progress in medical ethics?
Someone proposes some change of principle or practice,
such as allowing brain-death to count as full death.
The first response is always: "No No No!"
"It has never been done before!"
After the first shock of rejection has passed,
then the pros and cons of the new idea can be examined rationally.
For example, 3 decades ago brain-death was proposed
as an alternative means of determining human death.
Now, in the advanced parts of the world,
brain-death is routinely used for declaring death.
The lay public does not always understand or agree,
but the medical profession now fully accepts brain-death
as a valid set of criteria for determining human death.
Human cloning will be another change in medical
The initially response has already been heard:
Many voices have been raised saying that
we will never allow
this means of human reproduction.
It has never been done before.
It violates established medical ethics and traditional religion.
But before the end of the 21st century,
we will probably have human beings alive
who were created by cloning
rather than by other means
We will be able to see that a clone is a biological twin born several
—as the result of new reproductive
(Ordinary twinning is an accident of
How long will it will take, how much discussion will
before the concept of a 'living cadaver' will be accepted
—first by the
medical profession and later by the lay public?
Delays in acceptance might depend
on how the idea of a 'living cadaver' is treated in the mass media
and on how strong the organized resistance becomes.
Brain-death was quietly accepted by the medical world
without much public discussion or controversy.
Human cloning will probably be more debated in public.
And the idea of a 'living cadaver' might be even more controversial.
A living cadaver is the biological body of a human
whose mind has permanently ceased to function.
We must be 100% certain that
consciousness will never return to this
before it can be declared
dead and then used as a living cadaver.
If there is even a sliver of
doubt about the permanent unconsciousness,
then medical and/or surgical steps must be taken
that will guarantee that this body will never have another
thought or emotion.
In addition, we should have written statements of
from the first persons who donate their bodies as living cadavers.
Such legal declarations will show that the donor
fully understood the concept of a living cadaver
and fully agreed to have his or her body used in this way
—after consciousness was
over forever and death
was officially declared.
I am volunteering to have my body used as a
after I am finished with my life.
And I have already executed the necessary document
showing that I fully understand this donation of my body after my
Also this essay explains even more fully my informed consent.
My Advance Directive for Medical Care
contains the relevant authorizations:
See Answer 21: I Wish to Donate My Whole Body as a Living Cadaver.
My Advance Directive also refers to the article you are reading
for further elaboration of the idea of using living cadavers for
So, this idea of a living cadaver is not merely an
I am willing for my body to be used as a living cadaver,
even if I am the first person
to make such a donation.
And, initially, I would not expect random bodies to be used as
Only we few people who voluntarily
take the initiative
to offer our bodies for the following uses in medicine
will have our donations accepted.
And after you have finished reading this article,
you can decide whether or not you would like to donate your
to be used in the following ways in medical research
If you have already decided to donate your cadaver after death,
allowing it be be used as a living
after your consciousness has
gone out forever
(and after death is
officially declared using established criteria)
will not be experientially
different for you.
II. DEAD IN MOST OF THE MEANINGFUL SENSES OF THE WORD
A. A LIVING CADAVER IS
It used to be very easy to draw the line between the
living and the dead.
But modern medical technology has created many in-between
The most widely recognized of these is brain-death.
When most of the functions of the whole brain have ceased forever,
a doctor can declare the patient legally dead.
This is often done in preparation for organ or tissue transplants.
It might be legally and politically helpful to use
the concept of brain-death.
Even tho the general public does not fully understand or accept
we have several years of experience with this concept in the medical
Perhaps the living cadaver would have to meet the same criteria
now used for declaring brain-death.
And if there is some uncertainty concerning any of the tests for
further medical steps such as drugs or surgery could be completed
so that everyone would be satisfied that this body is now brain-dead.
The time and date of death are recorded by the
doctor who declares death.
Thereafter the body is treated with the respect due to human remains,
but the person whose
body it was
has no further rights or responsibilities as a human being.
The official death-certificate shall be completed by the doctor in
and it will record the date of death as the day when death was
And all laws that depend on separating the living from the dead
will now classify this
individual as dead.
All medical care ends,
along with payment by every form of health-care insurance.
(However, 'life-supports' will still be used
to maintain the biological functions still present in the living
Informed consent is no longer required for future procedures.
Ownership of the living cadaver passes to the medical institution.
In every legal meaning, this
human individual is now dead.
B. A LIVING CADAVER IS SOCIALLY DEAD.
The family will go ahead with their plans for a
funeral or memorial service,
even if the body is being kept 'alive' on machines
for the purpose of keeping its organs as viable as possible for
When we speak of people who have lived on the
surface of the Earth,
we always distinguish between the living and the dead.
For a living cadaver, the following practices should proceed
The newspaper obituary page reports the death.
If the person whose life is now over was married,
then that marriage automatically comes to an end
as happens whenever one spouse dies.
And the surviving spouse is free to marry again if he or she wishes.
As far as every social
meaning of death is concerned, this person is
C. A LIVING CADAVER IS
When a living cadaver is declared dead,
then several economic implications follow:
If the person was still being paid a salary
by some company, agency,
individual, or organization,
then all such income and benefits cease—including health-care
If there is any death benefit
to be paid by any kind of life-insurance,
that payment will be made immediately.
of the individual goes into effect:
His or her assets will be distributed as described in a will or trust.
If any form of
pension was being paid,
those payments end immediately—as they do with any death.
Or benefits begin to be paid to survivors
as specified in the pension plan.
Even more important for the practice of using living
the health-care dollars
that were paying
for the medical care of this
patient now come to an end.
Health-care dollars are never spent on the dead.
The cost of maintaining the living cadaver passes immediately
to the medical institution that now has legal possession of the body.
This switch-of-payer should be handled exactly the same way
that teaching hospitals pay to maintain dead cadavers.
All economic activities in which living persons may
have now ended for this dead individual.
A BRAIN-DEAD BODY IS STILL BIOLOGICALLY ALIVE.
A living cadaver is dead in all of the senses just
legally dead, socially dead, & economically dead.
But on the biological level, the living cadaver is still functioning
in all dimensions except those related to consciousness.
The living cadaver will never have another thought or emotion.
If there are physical responses to external stimuli,
these will only be reflex actions,
having no connections with a brain that is able to experience pain, etc.
Thus, it will be possible to conduct many kinds of
on an organism that is really a human body
without the possible harms
that might come from human experimentation.
Because the living cadaver is still biologically
it will be kept in a hospital bed with all of the usual 'life-support'
necessary to keeping its biological functions working.
But, as said before, the economic costs of supporting this body
will now be borne in the same ways that dead cadavers are maintained.
If it would be helpful to the family and/or the
the living cadaver could be
officially declared brain-dead
if it meets all of the criteria for such a declaration of death.
This individual has now died,
even if some 'vital' functions are maintained by tubes and machines.
POSSIBLE MEDICAL USES FOR A LIVING CADAVER
ORGAN AND TISSUE TRANSPLANTS
The least controversial uses of this new kind of
will be conventional organ and tissue transplantation.
When the living cadaver has a heart or lungs still fully functional,
then these can be harvested from the living cadaver
and transplanted into living persons
who will soon be dead if they do not get new organs.
Since most organ-transplants will cause the living
cadaver to cease living,
this use of the living cadaver might actually be among the last uses.
After vital organs are removed, the living cadaver will become
—unless it is
placed on life-support machines that replace the vital
This could be part of the planned medical experimentation,
since new forms of
life-support should first be tried on bodies
that cannot suffer any harms.
Because the living cadaver will already be in a
it should be very easy to coordinate organ transplants.
The organs will be kept alive
in the living cadaver
until they are needed by the recipient.
Actually, there will probably be several patients
prepared to receive the transplantable organs.
And because these transplants can be planned weeks
all the necessary testing for tissue matching, etc. can be done
and the patients who will receive the living organs can be carefully
contrast somewhat with the current emergency process
of selecting recipients when an organ-donor dies unexpectedly.
B. TESTING NEW SURGICAL PROCEDURES AND DEVICES
Medical science and technology make advances every
Whenever a new kind of operation is proposed by a surgeon,
it is essential that this new method of repairing a human body
be tried on living bodies that cannot be harmed
before it is used on patients who are hoping to recover.
Right now animals
are used for testing new surgical
which can yield large amounts of useful information.
But no animal body is
precisely the same as a human
After animal testing proves that the new procedure can work,
then it should be tested on living cadavers before it is used for
As a side benefit, advocates of animal rights
because fewer animals
will be needed for testing new medical procedures.
And these advocates can decide to donate their own
bodies to science
with the knowledge that their donations will reduce the use of
C. MEDICAL RESEARCH TOO RISKY TO TRY ON LIVING SUBJECTS
Every form of medical research must ultimately be
tried on human bodies.
Many brave individuals volunteer their bodies each year for medical
And all such medical experimentation is carefully controlled
to make sure that the volunteers will not be harmed by the research.
Elaborate committee-systems oversee medical research on human
(And these same committees must approve
the first uses of living cadavers.
After living cadavers are routinely used in medical research,
there will be separate committees overseeing such uses of brain-dead
Perhaps committees now controlling the uses of dead cadavers
will have their scope expanded to cover living cadavers.
And here again, any precedent of using brain-dead bodies might be
Have some research committees already approved
medical procedures using
brain-dead but still
When a new drug or other treatment is first
we do not know all of the possible side-effects.
And if the toxicity of the drug might prove too harmful,
it would be better to test it on a living cadaver than on a living
The drug might kill the living cadaver, which would be very useful to
And if the new drug proves to do more harm than good,
we would not want to lose a human life in the process of testing it.
Thus, whenever a human-experimentation committee
turns down a request to use human subjects in medical research,
the scientists will next turn to living cadavers
as possible means to do the very risky research.
NEW ARTIFICIAL ORGANS
medical devices such as artificial hearts and lungs
need to be thoroly tested before they are used in living patients.
A living cadaver would be an ideal way to test a new artificial heart.
For example, a new internal mechanical heart
could be implanted in the living cadaver I will donate.
Then careful observations can be made to see
how well it works and what problems turn up.
When implantable devices are invented to regulate bodily processes,
these should first be tested in human bodies that cannot be harmed.
If a new drug-delivery system works in a living cadaver,
that will be evidence that it might be safe enough to use in living
Even mundane devices such as new artificial joints
should first be tested in living cadavers
to see how well a human body tolerates the surgery
and the after-effects of having an artificial part.
NEW DRUGS FOR DISEASES
GIVEN TO THE LIVING CADAVER
One problem of ordinary medical research to treat
is finding people with that disease to use in testing.
And when we do have people who are actually suffering AIDS, for example,
there might be so much damage already done to the body
that it is difficult to isolate the effects of a new treatment.
But when a living cadaver has been donated to
it could be given a disease intentionally
in order to test the new treatment in a controlled situation.
We would never consider intentionally giving diseases to human subjects.
At least we would never give medical volunteers very dangerous diseases.
But the most serious diseases of the human race
cancer, Alzheimer's disease—
could be experimentally introduced or created in a living cadaver
in order to learn everything possible about the course of the disease
and the efficacy of various risky treatments that should be tried.
Every scientist who is working
on one of the dread
diseases that befalls the human race
would be glad to have biological organisms on which to do early research
that is definitely too
dangerous to try on living human subjects.
Living cadavers would be ideal for all such dangerous research.
D. PRACTICE SURGERY FOR SURGEONS-IN-TRAINING
Every surgeon who is now operating on living human
was trained using dead cadavers first.
They had to learn how the cut and sew using dead flesh.
And there was no realistic way to test the after-effects of the surgery.
But living cadavers would be ideal ways to learn surgery.
The body is identical in every way to a living human patient
—except there will be no return to
consciousness after the operation.
However, because this cadaver is still living biologically,
all of the benefits and harms of the surgery can be observed
as they would happen in a regular human body.
If this use of living cadavers becomes routine,
then every surgeon-in-training will move up from practice on dead
to doing real-life surgery
on living cadavers,
where they can see the living results of their efforts.
The living cadaver will either heal as planned
or suffer some unwanted damage due to the surgery.
The remaining biological functions of the living cadaver might come to
because of some surgical mistake or failure.
Obviously, it is better for beginning surgeons
to learn from their mistakes on living cadavers
than for living patients to
suffer because of their inexperience.
Every surgeon must have a first operation.
Why not allow practice surgery to be performed
on a human body that cannot be harmed—a living cadaver?
E. ANATOMICAL STUDY
EDUCATION OF DOCTORS, DENTISTS, &
Every doctor, dentist, or nurse must learn his or her art
by handling real human bodies.
They must study how the body fits together by dissecting dead cadavers.
A certain amount of human anatomy can be learned from books
and other visual aids such as pictures and videos,
but the best way to understand a human body is to handle it.
Dead cadavers have long been educational tools for
It was first a controversial practice
because people rejected the idea of cutting into dead bodies.
And sometimes the means of obtaining dead cadavers was unsavory,
such as digging up the newly dead in the middle of the night.
But now enough people are donating their bodies for
such anatomical study
by students being trained in the medical sciences.
However, even more realistic than cutting into a dead body
to see how the parts work together
would be to do anatomical
study on a living body—a living cadaver.
This would allow the medical student to see the organs in action.
Anatomical study would probably be the last use of a living
because dissection will prevent most future uses of the living cadaver.
But after it has been thoroly studied by students
who will later be treating living persons,
the living cadaver can finally be laid to rest.
And if it seems wise, a living
cadaver can be preserved as a dead
after its last vital functions have ceased.
After all biological functions have stopped,
the now-dead cadaver could still be as useful
as all of the other dead cadavers being studied.
After all such uses, the remains of the remains will
and the ashes will be returned to the relatives of the donor.
Once these elementary uses for living cadavers have
then a never-ending series of new experiments will be proposed.
Whenever we need to know something more about the human body
or test something to treat medical problems,
we can first turn to living cadavers donated by public-spirited persons
who are happy to be of service even after they are dead.
Created February 2, 2006; revised
12-15-2007; 5-31-2009; 9-15-2009; 5-8-2010; 11-4-2010; 3-12-2011;
12-13-2012; 1-24-2013; 8-5-2014; 1-21-2015; 1-19-2016;
James Park is an independent philosopher
with deep interest in medical ethics,
especially the many issues surrounding the end of life.
As said in this essay, he would like to donate his own body as a living
Medical Ethics and Death are two of the seven doors
to his website called "An Existential Philosopher's Museum":
This essay has now
become a chapter in
Medical Ethics at
the End of Life.
Here are a few related essays:
Marks of Personhood:
Discussing Degrees of Mental Decline .
Directives for Medical Care:
24 Important Questions to Answer
for Life-Ending Decisions
Will this Death
be an "Irrational Suicide" or a "Voluntary Death"?
Will this Death
be a "Mercy-Killing" or a "Merciful Death"? .
Methods of Choosing Death .
Why Giving Up
Water is Better than other Means of Voluntary Death .
Death by Dehydration:
Safeguards to Make Sure it is a Wise Choice .
of Brain-Dead Bodies .
How Dead Do You Have to Be?
Books on Voluntary Death
Books on Preparing for Death
on Terminal Care
Books on Helping Patients to Die
Go to the Right-to-Die
Go to the Book
to discover 350 book reviews
organized into 60 bibliographies.
Return to the DEATH
Go to the Medical Ethics
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essays by James Park,
organized into 10 subject-areas.
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