Should the skeleton of “the Irish giant” be buried at sea?
BMJ 2011; 343 doi: https://doi.org/10.1136/bmj.d7597 (Published 20 December 2011) Cite this as: BMJ 2011;343:d7597
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The Hunterian Museum will continue to display Byrne’s skeleton: poor arguments for a sad decision
The Hunterian Museum and The Royal College of Surgeons have decided to keep Charles Byrne’s skeleton on display rather than burying him at sea as he wished. Reading Samuel Alberti’s justification is a curious experience.1 This is because our previous publications on related issues have already addressed his concerns.2,3 In what follows we will briefly summarise his arguments and answer each of them in turn.
Alberti’s arguments and our responses.
First argument. Because of the primary sources used in documentation, there is some uncertainty about Byrne’s wishes, although ‘it is likely ... that Byrne was uncomfortable at the prospect of dissection.’
Response. Given that there is good substantiating historical evidence to the contrary, the suggestion that Byrne’s decision to be buried at sea was a reflection of just ‘discomfort’ appears tendentious. He was clearly horrified by the prospect of his body not being intact at burial, as others continued to be throughout the 19th and 20th centuries (e.g. as documented for the 19th century by Richardson in Death, Dissection and the Destitute, which refers specifically to Byrne, and the 20th century by the background to the Human Tissue Act 2004).4
Second argument. The benefit of ‘the value of retention’ outweighs ‘destructive disposal’ (e.g. recent research using DNA extracted from Byrne’s skeleton that demonstrates a genetic link between him and existing families in Northern Ireland).5 Alberti suggests (falsely) that we claim in this regard ‘that all possible scientific benefit has been gleaned (from the skeleton)’, and further that ‘researchers in relevant fields’ dispute this claim, including clinical and other researchers.
Response. Alberti continues to endorse what we have called the ‘anything is possible’ argument in favour of retaining and displaying Byrne’s remains. Such retention, he suggests, is crucial just in case the remains might be of further scientific use. For a refutation of this argument, see our preceding rapid response criticising our critics that elaborates the ‘absurd consequence’ of this position (e.g. the retention of the body parts of huge numbers of decedents).2 Our further argument is that whatever benefit that indeed might come from the retention of Byrne’s skeleton can be achieved in other more morally acceptable ways. For example, future genetic research is possible because we have Byrne’s DNA; future clinical research is equally feasible because of the likelihood that other existing sufferers from acromegaly will be willing to participate. In any case, even if we accept the possibility that Byrne’s skeleton may have some unknown future medical benefit (which we do), this is an argument for its retention; not for its continued display that – however tasteful - disrespects his final wishes and memory.
Third argument. Alberti states (falsely) that we want to replace Byrne’s skeleton with a ‘replica’.3 He further asserts that this would make impossible ‘the experience of studying the authentic remains as part of a coherent historical collection ... where Byrne’s likely discomfort is openly acknowledged.’
Response. This argument simply begs the question. The issue to be decided precisely is whether or not the special circumstances of Byrne’s horror (not ‘discomfort’) of not being buried intact and the specific measures that he adopted to try to circumvent this possibility are morally sufficient to trump the continued display and ‘experience’ of his skeleton. The fact that Byrne’s concerns are adumbrated in information provided with the display cuts no moral ice.6 Assertion is not argument.
Fourth argument. The one piece of research Alberti does cite enabled the identification of ‘individuals who live with the same condition’ as Byrne.5 According to Alberti, some have ‘requested that the skeleton should remain on display.’(No references) He argues that their ‘shared ancestry with Byrne’ trumps our otherwise ‘compelling’ arguments that his burial wishes should be respected.
Response. This is Alberti’s only ostensibly substantial argument. It places importance on individuals with supposed ‘shared ancestry’ who have stated that they agree that Byrne’s skeleton should stay where it is. However, we have again already indicated that when a person dies intestate, as was the case with Byrne, intestacy law assigns a ‘duty to bury’ to a set hierarchy of relatives.2,7 Such law admits conventional familial relatives, not persons with shared ancestry predicated upon distant genetic connections.8 The moral reasoning behind the law seems clear enough.
If so, persons who are currently living, and who have been shown to share a genetic mutation with Byrne that stems from a ‘common ancestor’ who lived up to a potential 3750 years ago, can neither legally nor morally pronounce upon the matter of Byrne’s remains with any more authority than any other member of the general public.5 In the case of Byrne, as far as we know, only one person sharing the gene mutation has come forward publically in favour of retaining the present exhibit.9 The views of this person have insufficient moral and legal weight to counter significant public agreement (e.g. in the poll conducted by the BMJ) that Byrne’s remains ought to be buried at sea or at least be withdrawn from public display.10 This agreement was informed by the arguments in our original paper and, as they unfolded, the rapid responses both for and against our views.
Conclusion
Charles Byrne was a man worthy of respect. Given the medical benefits that his skeleton has already conferred and the feasibility of continued acromegaly research without it, we continue to believe that his burial wishes should be respected. We hope that in the future the Hunterian Museum and Royal College of Surgeons will reconsider their unfortunate decision.
References
1. Alberti S. The value of historic human remains. BMJ Rapid Response. February 10, 2012.
2. Doyal L, Muinzer T. Bury the ‘Irish Giant’: a rapid response to some critical rapid responses. BMJ Rapid Response. February 1, 2012.
3. Doyal L, Muinzer T. Should the skeleton of “The Irish giant” be buried at sea? BMJ 2011;343:d7597.
4. Richardson R. Death dissection and the destitute. London, Routledge, 1987.
5. Chahal HS, Stals K, Unterländer M, Balding DJ, Thomas MG, Kumar AV, et.al. AIP mutation in pituitary adenomas in the 18th century and today. N Engl J Med 2011;364:43-50
6. See relevant statement by Doyal in film attached to 3 (above). The Giant’s Cause. BMJ Media. www.youtube.com/watch?v=u5sRJgBQyz4.
7. Conway H. Dead, but not buried: bodies, burial and family conflict. Leg Stud 2002;23:423-52.
8. Administration of Estates Act 1925, s.46.
9. See relevant statement by Holland in film attached to 3 (above). The Giant’s Cause. BMJ Media,2011. www.youtube.com/watch?v=u5sRJgBQyz4.
10. Doyal L, Muinzer T. Bury the ‘Irish Giant’: a rapid response to some positive rapid responses. BMJ Rapid Response. February 1, 2012.
Competing interests: No competing interests
The recommendation by Doyal and Muinzer that the Royal College of Surgeons and the Board of Trustees of the Hunterian Collection dispose of the skeleton of Charles Byrne is an articulate contribution to the on-going ethical discussion around the retention of historic human remains (1,2), the majority of which were acquired in ways that would not satisfy twenty-first-century ethical standards. Although the historical evidence is not clear-cut – relying on newspapers and a third-hand account (3) – it is likely, because of the associated stigma, that Byrne was uncomfortable at the prospect of dissection. Having inherited custody of the remains, and there being no legal case to answer, the Board and College have again considered the moral case by comparing any benefit of destructive disposal with the value of retention.
A vivid demonstration of the latter can be found in the outcomes of the research into Familial Isolated Pituitary Adenoma (4) which sparked the authors’ interest in this case. The authors’ suggestion that all possible scientific benefit has been gleaned is not shared by researchers in relevant fields. Benefits include not only tangible clinical outcomes but also the identification of shared genes between Byrne and living communities. Among these are individuals who live with the same condition, who have requested that the skeleton should remain on display. Given their shared ancestry with Byrne, particular credence has been given to these individuals’ wishes.
The authors recommend that the skeleton be removed from publicly accessible display and replaced with a replica. This would deny the Hunterian Museum’s inclusive audiences the experience of studying the authentic remains as part of a coherent historical collection, in the present dignified and informative context (in which Byrne’s likely discomfort is openly acknowledged).
Doyal and Muinzer’s case is compelling. So too, however, is the argument that in accordance with the wishes of genetically connected individuals, Charles Byrne’s remains be retained to advance our understanding of rare conditions and to benefit contemporary communities. In full compliance with the College’s Acquisition and Disposal Policy the skeleton will therefore remain on display. New historical evidence, legislation or research outcomes will of course be monitored.
References
1. Jones DG and Whitaker MI. Speaking for the dead: The human body in biology and medicine. 2nd ed. 2009. Farnham: Ashgate.
2. Alberti SJMM, Bienkowski B, Chapman MJ, and Drew R. Should we display the dead? Museum and Society. 2009; 7 (3): 133-149.
3. Taylor, T. Leicester Square; its associations and its worthies. 1874. London: Bickers.
4. Chahal H, Stals K, Unterländer M, Balding DJ, Thomas MG, Kumar AV, et al. AIP mutation in pituitary adenomas in the 18th century and today. N Engl J Med 2011;364:43-50.
Competing interests: No competing interests
Bury the ‘Irish Giant’: a rapid response to some critical rapid responses
There have been only three negative responses to our BMJ paper. The first and most sustained is by Martin Smith et.al.1 In almost as many words as our own article, the authors initially explain that Byrne’s current skeleton is not chemically identical with the skeleton that Hunter created. So what? The argument is not about the biochemical makeup of his current skeleton but rather concerns the disrespect to Byrne’s memory – his reputation, dignity and privacy – by the continued display of his skeleton in spite of his declared wishes. This includes the immoral circumstances in which his body was acquired by John Hunter.
Inexplicably, the authors compare Byrne’s skeleton with the remains of nameless executed Italian criminals from the 17th century – the Evelyn Tables (not ‘boards’ as stated) also on display with Byrne at the Hunterian Museum. The authors state that their ‘wishes were not considered in dissecting them.’ Given their provenance, we do not know the identities of the individuals involved nor the nature of the crimes for which they were executed and dissected nor anything about their wishes. We do know that Byrne committed no crime and wished to be buried intact.
The authors make a similar point in relation to William Burke, convicted of murder, hung and dissected in Edinburgh in 1829 and whose skeleton is in the Edinburgh Anatomy Museum. Burke was lawfully sentenced for his crime and we do not know what his wishes might have been about the potential fate of his body.2 The same applies to others executed and dissected at the time. Again, none of this applies to Byrne.
The authors then argue that we need not respect Byrne’s wishes because Hunter committed no crime at the time in acquiring his skeleton through bribery. We never claim that he did, at least in relation to his practice of acquiring what we describe as ‘unauthorised exhumed bodies’ from grave robbers.‘Authorisation’ in this context relates to ignoring declared wishes of decedents and/or their families at the time. We never suggest, as the authors imply, that then or now human bodies have the legal status of property. Indeed, an entire section of our BMJ paper argues as much. Our argument for Byrne’s burial is moral and not legal.
Hunter knew Byrne’s specific wishes and chose to disrespect them. Unlike the authors seemingly suggests, this was wrong then and it is perfectly possible for people to recognise as much now over two hundred years later. Some moral values have changed historically since Hunter’s time; others have not. Were this not the case, we could not now make sense of much of 18th century (or earlier) literature where a range of rights and wrongs are articulated that we believe would be equally so today. The authors should not embrace such dangerous historical relativism.
They then claim that contemporary ‘relatives’ identified in Chahal et al.’s study of Byrne’s genetic links have indicated that their wish that Byrne’s skeleton remain on display should trump his own wishes while alive.3 The fact that individuals have been discovered to have the same gene mutation as Byrne’s neither legally nor morally gives them the status of relatives.4 Even if it did, the conclusion of the authors would not morally follow in the face of Byrne’s specific wishes. The contemporary Museum and College Guidance makes clear that at present, morally and legally, in circumstances where there is disagreement between actual relatives and the known views of the donor decedent, those of the latter should prevail.5 Morally, why not in the past, especially given the specificity of the information that we have about Byrne?
Changing argumentative gears, the authors employ an untenable slippery slope argument, maintaining that ‘If Charles Byrne’s remains are to be buried, the same standards should be applied to all pathology museum collections in the UK, acquired before the era of consent.’ This is not true. Moreover, his burial would not ‘impact considerably on the teaching of pathology in the UK’. Most of the exhibits in such museums are anonymous or are there by the specific consent of donors. They are not comparable in historical and moral background to Byrne’s skeleton. Also the issue is not, as the authors suggest, our concerns about the technical or aesthetic quality of its display. We have never explicitly or implicitly indicated such worries. Indeed, we believe the opposite.
Another of the author’s conclusions is that Byrne’s skeleton might generate even more medical benefits than those we specifically acknowledge in our paper. This, they argue, is reason enough to trump his wishes. We cannot go back in time and thus must be grateful that such benefits have occurred. However, the moral clock concerning Byrne’s remains has been dormant for too long and should begin ticking now. This is because we now have Byrne’s DNA for future genetic related research and we now have willing sufferers from acromegaly who will volunteer for other forms of research. One has apparently volunteered on film to donate his skeleton for display!6 We also now have other techniques for non-invasive investigation of Byrne’s skeleton before it is buried.7 Other potential medical uses of his skeleton remain unspecified by the authors.
Therefore, their argument reduces to the belief that ‘anything is possible’. But since the same argument can be used of the skeleton of anyone (who may have known or unknown illnesses), it leads to the absurd consequence of trying to collect and store them all ... just in case. Who will obtain the consent; who will create the skeletons; where will they be stored and for how long? The mind boggles. The rapid response of Richard Wilcox to our paper faces the same problem and for the same reason.8
More briefly, we conclude with the rapid response of Stephen Milligen.9 He claims to be a real stickler for proper referencing, although his response has none! After declaring Byrne’s reputation to be insignificant compared to that of Patrick Cotter, another contemporary ‘Irish Giant’ (no references), Milligen rightly says that there is plenty of information about Byrne on the internet (no examples). However, he strangely claims that we do not use it. In fact, many of our references were taken from the net, either directly (e.g. reference 3) or through links to newspapers (e.g. reference 5) or other documents or academic articles (e.g. references 10,4).
However, by far our most important reference (reference 8) is Wendy Moore’s acclaimed biography of John Hunter and her excellent chapter on Byrne, full of enough primary and secondary sources to satisfy even Milligen, if he has read it.10
Then strangely, having first berated us for our lack of references, he cites several of them which have ‘called for Byrne’s body to be removed from the Hunterian’, referring to their lack of consensus as to what should be done with it. Surely, the best move in such circumstances is to act on Byrne’s original request for intact burial. Milligen offers no substantial moral argument otherwise.
Milligen also berates us for indicating that Hunter had a pecuniary motive in acquiring Byrne’s skeleton in relation to his museum. Readers should read Moore on this and remember that anything that enhanced Hunter’s reputation as a surgeon, scholar and teacher of anatomy – like his famous museum - was bound to generate more funds. Indeed, Milligen himself indicates that Hunter was in need of money. Perhaps with a careful reading of Moore, he would be aware of just how much.
The authors criticising our work present no reasonable arguments against burying the skeleton of Charles Byrne at sea, as he wished and for which we have argued.
References:
1. Smith M., et.al. Should the skeleton of the “Irish giant” be buried at sea? BMJ Rapid Response. December 29, 2011
2. This is what is known as the ‘substituted judgement’ argument and is by no means accepted in the relevant ethical and legal literature.
3. Chahal HS, Stals K, Unterländer M, Balding DJ, Thomas MG, Kumar AV, et.al. AIP mutation in pituitary adenomas in the 18th century and today. N Engl J Med 2011;364:43-50.
4.Mackay J. Halsbury’s laws of England. 2005;50:444, 452, 459-60
5. Royal College of Surgeons. Museum acquisition and disposal policy. www.rcseng.ac.uk/museums/docs/acquisition_disposal_policy_05.pdf Section 5.3.
6. See Brendon Holland’s statement in the BMJ film, The Giant’s Cause.
7. Charlier P. On the importance of naming the body (or the bones). BMJ Rapid Response. December 28,2011.
8. Wilcox R.Should the skeleton of “the Irish giant” be buried at sea? BMJ Rapid Response. December 29, 2011.
9. Milligen S. Should the skeleton of the “Irish giant” be buried at sea? BMJ Rapid Response. January 7, 2012
10. Moore W. The knife man. Blood, body snatching and the birth of modern surgery. Bantam Books, 2006:397-428.
Len Doyal
Emeritus Professor of Medical Ethics
Queen Mary, University of London
Thomas Muinzer
Lawyer
Queens University of Belfast
.
Competing interests: No competing interests
Bury the ‘Irish Giant’: a rapid response to some positive rapid responses
We are gratified by the mainly positive endorsements of our arguments that have been printed in the BMJ rapid responses submitted thus far. We are equally gratified by the degree to which BMJ voters mostly agreed either with our conclusion, or that Byrne’s skeleton should be removed from display, in the recent poll hosted at the BMJ website. On the last count that we saw before voting ceased, 55.6% (310) voted for burial at sea;13.17% (74) for removal from display and being kept for research; and 31.55% (176) for the status quo. At the very least, this should be an indication to the Hunterian Museum and the Royal College of Surgeons that a large body of informed medical opinion has deep reservations about the continued public presentation of Charles Byrne’s skeleton in the museum.
It was a source of immense satisfaction that Wendy Moore, John Hunter’s acclaimed biographer, agreed with our conclusion. This was of particular importance for us because of the degree to which our understanding of the history of the story of the relationship between Byrne and Hunter was so influenced by her outstanding work. Our standard response to those who would question the historical and evidential credibilty of our understanding of the relationship between Byrne and Hunter is simply to read Moore’s excellent book.1 It was a source of equal satisfaction to get such a resounding and unqualified endorsement from Raanan Gillon, the internationally esteemed expert on medical ethics.2
Of course, we were also delighted by the high level of critical reflection demonstrated by other positive contributions from medical professionals. For example, Mark W Davies interestingly suggests that given Hunter’s cutting edge greatness in so many ways (an endorsement with which we totally agree), had he been alive today he too would have rejected his previous actions, accepting that Byrne’s skeleton should be disposed of as he wished.3 Peter Toon arrives at the same conclusion through stressing that the central moral argument is not about Byrne’s skeleton but Hunter’s flagrant and self-centred disregard of Byrne himself.4 Toon stresses the importance of this against the background of what he describes as cross cultural agreement about ‘respect for the bodies of the dead…along with respect for people’s wishes about intimate matters.’ He also rightly points out that that if buried at sea, Byrne’s coffin should not be made of a toxic material like lead! We thank him for pointing out that our argument as stated might be seen to lead to this silly conclusion.
From the perspective of forensic anthropology, Philippe Charlier provides a qualified agreement for Byrne being buried at sea.5 In so doing, he challenges the view that following Byrne’s wishes would entail unacceptable further scientific loss because, among other things, 3D conservation is possible ‘... of all anatomical details with huge ultra-structural precision’.
Finally, in discussing a similar case to Byrne’s in Ireland, Desmond O’Neil eloquently expands our arguments.6 He maintains that ‘exposure of generations of medical students to bodies displayed against the dead person’s clear pre-mortem wish is unlikely to promote due sensitivity’ about the moral and legal importance of respect for autonomy. In the experience of one of us (Doyal) in teaching ethics and law to medical students over a long period, anything that denudes such sensitivity is incompatible with successful medical education and with the future quality of the clinical care that it is supposed to facilitate. For this reason, when students dissect bodies for educational reasons, their anatomy tutors insist that respect is shown to them and to their decedents. When students are caught doing otherwise, the price can and should be high. The top of the list of the reasons for such respect is consent: the fact that such decedents volunteered their bodies for educational purposes. How is such sensitivity to be sustained in the Hunterian Museum when visiting students view Byrne’s skeleton with a proper understanding of its origin? O’Neil reinforces his argument with reference to the respect for Jeremy Bentham’s memory and his choice through University College in London displaying his body (as much as is practically feasible) as per his instruction. We doubt that this institution would continue to do so if it were discovered that his original instructions were a forgery and in contravention of his real wishes!
Such historical wishes are morally important and in the case of Byrne, the Hunterian and The Royal College of Surgeons should respect them. He should be buried at sea.
References:
1.Moore W. The knife man. Blood, body snatching and the birth of modern surgery. Bantam Books, 2006:397-428.
2.Gillon R. Re: Should the skeleton of “the Irish giant” be buried at sea? BMJ Rapid Response. December 30, 2011.
3. Davies M. Re: Re: Should the skeleton of “the Irish giant” be buried at sea? BMJ Rapid Response. December 29, 2011.
4. Toon P. Re: Should the skeleton of “the Irish giant” be buried at sea? BMJ Rapid Response. December 23, 2011.
5. Charlier P. On the importance of naming the body (or the bones). BMJ Rapid Response. December 28, 2011.
6. O’Neill D. Re: Should the skeleton of “the Irish giant” be buried at sea? BMJ Rapid Response. December 21, 2011
Competing interests: No competing interests
Other responses to the Doyal and Muinzer article have discussed the medical implications of their claims I chose to look at the historical foundation of their argument. Charles Byrne was a notable Irish giant, but his career was very short and there is little biographical information recorded about him. Unfortunately because of generic exhibiting titles Byrne has been attributed an exaggerated reputation and relevance which in reality belonged to Patrick Cotter, a contemporary Irish giant whose career spanned several decades. It is not unreasonable to say that Byrne’s sole notoriety comes from John Hunter’s pursuit of his skeleton and the subsequent study by medical researchers.
Much of what is known about Byrne comes through either newspaper reports or information collected by gentlemen scholars and medical researchers over the past 200 years. If Byrne’s body had not been acquired he would probably have been forgotten like the majority of other giants who were exhibited in the 17th and 18th centuries. Most of the information gathered is easily accessible via the internet, and as a consequence would have been available to authors of the article had they chosen to use it, but they did not. This is a significant part of Byrne’s reputation which they want to have restored.
I am not exactly sure what areas of expertise the authors of the article can lay claim to but it is not law, medicine or history. Crass observations are scattered throughout the article such as “Where there is such agreement about respect for choice, its moral foundation is more or less the same as it was in Byrne’s time,” a totally inaccurate observation; and when discussing Hunter’s display of the skeleton “He hid it for four years before it became a key feature of his museum, generating badly needed funds.” His was this done? Hunter’s museum was a private collection and for decades after his death there was limited public access to his collection. But the authors implication suggests that Hunter sought to profit from the giants misfortune ignoring the well known reality – that Hunter spent so much money trying to acquire the giants body that he had to borrow money, allegedly £500 which was a massive sum and one that he never recouped. Byrne’s skeleton has been an object of wonder and fascination for centuries and when displayed in the Hunterian museum the skeleton performs a number of educational functions, it is not a tacky spectacle. I have visited the Hunterian several times while researching about Irish giants and been impressed by the design of the museum the way in which the exhibits are displayed. It has been arranged and implemented by professional people who are aware of the ethical issues involved in displaying human specimens.
It is deeply ironic that Doyal and Muinzer conclude their article: “At the very least, we suggest that more complete information is provided about the background of the acquisition and display of Byrne’s skeleton so that visitors can make a more informed judgement about the moral implications and appropriateness of its continued display.” Ironic because the author do not seem to have made much attempt to understand the background to Byrne and his life themselves. Any attempt to promote an informed debate about Byrne should at least be based on an understanding of his life and medical condition.
I take issue with the assertion that it was Byrne’s ‘original desire’ to be buried at sea. The idea is nonsense. Byrne, like most of his contemporaries were illiterate. He left no journals or letters that I have been able to locate. The reason why Byrne arranged to have his body buried at sea was simply because he wanted to prevent his body being stolen by Hunter’s agents. It is far more likely that if given a choice he would have preferred his body to be returned to his hometown, or some such place that he considered his home.
Citing others who have called for Byrne’s body to be removed from the Hunterian Doyal and Muinzer cite Hilary Mantel (an author of fiction who’s award winning book The Giant O’Brien would not have been possible without Hunter’s obsessive pursuit), a folksinger (John Malcom), a poet (Moyra Donaldson) and Michael Brennan who has conducted a one-man campaign to have Byrne’s remains returned to Ireland. None of these share the same opinion about what should happen to the giant’s skeleton, and Brennan wants the remains returned to the Republic of Ireland (a country that Byrne did not originate from). While it is true that there is a need for ethical oversight to regulate medical practices there is no compelling argument in the article. The case for removing Byrne’s skeleton has not been made and perhaps it is better that Byrne stays where he is for now, more to protect him from the actions of well wishers than from those who manage the Hunterian museum.
Competing interests: No competing interests
Yes ! Great paper, QED. Let's hope the recommended action is taken.
Raanan Gillon (raanan.gillon@imperial.ac.uk)
Competing interests: No competing interests
We write this response as biological anthropologists (sometimes referred to as “osteoarchaeologists”). Essentially, we are experts in the analysis of the skeletal remains of past people, which are the most direct link we have to past human culture and experience. We take issue with Doyal and Muinzer’s article calling for the burial at sea of Charles Byrne’s skeleton on a number of grounds.
First, a philosophical question engaged with by archaeologists and anthropologists much more often than by clinical medical practitioners is how much of a body needs to be present for remains to qualify as a “body”? For example, only a skull, a metacarpal or a single tooth might represent the material remains of a given individual excavated archaeologically. If the remains of Charles Byrne were similarly sparse, we wonder if he would now be receiving the level of attention his case is currently experiencing. The reality is that what remains of Charles Byrne is the mineral component of one body system. The organic component of his skeleton (largely composed of collagen fibrils) will have begun to slowly denature since his bones were first exposed and will continue to decompose gradually into the future. The component of bone that survives is largely the 70% or so composed of hydroxyapatite –the crystallized form of calcium that gives bone its strength. In this respect the bones on display are not Charles Byrne’s “body”, but rather a part of it that retains the form of the whole in a way with which people can more readily engage, not least perhaps because a skull has a face.
In this respect it may be salient to note that there have been no calls to bury the Evelyn boards also on display at the Hunterian Museum. These 17th-century anatomical preparations (possibly the oldest in Europe) consist of other body systems, arterial, venous and nervous, fixed to flat boards for teaching purposes. It is likely that these preparations were extracted from the bodies of executed criminals whose wishes were not considered in dissecting them. However, the present authors are aware of no campaign to rebury these faceless two-dimensional arrangements of nerves and blood vessels. It would seem that bones enjoy a special position in ethical debates that is generally denied to other components of the body.
A further point is that Charles Byrne is not unique. Human bones form part of museum displays throughout the world, some of which are those of individuals whose identities are known. For example, the skeleton of William Burke the infamous ‘resurrectionist’ has been displayed in the Edinburgh University Anatomy Museum since shortly after his execution in 1829. It is reasonable to suggest that in relation to his manner of death and subsequent treatment that Burke’s wishes were “known”, or at least can be reasonably assumed. It is unlikely that Burke would have wished that 25,000 people would attend his hanging to watch him die in public. Nor is he likely to have been pleased to have his naked body exhibited to the many thousands who paid to file past him shortly after his death (1). Burke was then publicly dissected, whilst, famously, pieces of his skin were removed by medical students and used to bind a book that remains on display with his bones. A similar argument could be put forward for the burial of Burke’s bones on the basis that what was done to him would be regarded as “barbaric” by modern standards. However, this would do nothing to change the fact that these things happened.
In fact, the current display helps to demonstrate the opposite- that these things did happen in the past, but no longer occur due to changes in human perceptions instilled in legal and professional standards that are part of the historical process. These activities were accepted- and justified- in the past, more often than not by the opprobrium attaching to the criminally convicted, whether we would find them guilty today or mete punishment in the same way or not. No matter how earnestly we might apologize for these acts perpetrated by others now long dead, Burke cannot be “un-hanged” or “un-anatomized”. Rather, these remains aptly demonstrate that actions are part and parcel of the social and cultural contexts in which they occur. This is an important object lesson for those wishing to protest against violations of and protection for civil liberties.
Doyal and Muinzer (2) argue that Hunter used grave robbers to provide him with "unauthorised exhumed bodies". This is anachronistic as there was no legal authority required for exhumation before the passing of the Anatomy Act in 1832. Hunter may have been immoral by today's standards, but it is not appropriate to imply that his methods were at that time illegal. Then, as now, there was no property in a corpse, and it was only in the 19th century that disturbance of buried remains became a statutory offence. Virtually all specimens added to pathology museums in the 1700s and 1800s were against the wishes of the person from whom they were dissected. The bodies were either acquired by grave robbers, carried off from the gallows for dissection as added- and publicly condoned- punishment, or the poor who died in workhouses and were unclaimed by relatives (3). If Charles Byrne’s bones are to be buried, the same standards should be applied to all pathology museum collections in the UK acquired before the era of consent. Such a move would impact considerably on the teaching of pathology in the UK. The dissection of bodies, an activity that was deemed illegal and sacrilegious in preceding centuries, served to instruct many thousands and formed the basis of modern medicine. There is no adequate substitute, replica or computer-generated, for studying actual bodily remains, especially those that are unusual.
Doyal and Muinzer (2) correctly assert that Byrne did not wish his body to fall into Hunter’s hands, but they go no further in considering why he felt so strongly about this. Byrne lived at a time when people felt strongly that one’s body must remain ‘intact’ in order to be resurrected at the Day of Judgement. Dissection was therefore feared, particularly on the grounds that it would deny an individual the chance of entering Heaven. As the post-mortem fate of criminals, dissection also carried great social stigma. On these grounds a strong argument can be made that what Byrne wished so desperately to avoid was dissection. Of course Hunter’s actions in regard to Byrne’s body were wrong and today would be illegal. But, regardless of modern opinion we cannot change what happened. Like Burke, Charles Byrne cannot now be “un-dismembered”. In this context the proposition of being buried at sea to avoid dissection is a very different one from actually being cut up by Hunter, only to finally have one’s remains dropped into the sea as disarticulated bones centuries later. Such an alternative proposition would be closing the stable door 200 years after the horse had bolted and, although modern commentators might claim to be able to gauge Byrne’s opinion, he remains intractably silent on the matter. We are unable to ask Charles Byrne about how he might feel were his bones to survive two centuries to a time when attitudes towards disability and difference would be vastly different and when those who engaged with his remains did so in a spirit of empathy and respect, rather than entertainment. A further point that is conspicuous by its absence from Doyal and Muinzer’s article is that the relatives of Byrne who have been identified by Chahal et al.’s (4) study have expressed a wish for Byrne’s skeleton to remain on display at the Hunterian Museum. Any future decision regarding Byrne’s remains should take this point into consideration.
The position that once research has been “finished” there is no reason to retain human remains any longer has been used repeatedly (and erroneously) to argue for the reburial of archaeological skeletons. However, this notion misrepresents the nature of research. Research is a cyclical process where old conclusions are revisited periodically and new techniques and questions emerge over time. If the same argument had been made after Cushing’s 1909 (5) study of Byrne’s skeleton, then Chahal et al.’s (4) study based on Byrne’s DNA, which Doyal and Muinzer (2) describe as “important” could never have happened. Moreover, we have much more to learn about the effects of endocrine disorders on bone structure and even more about their interaction with genetic predispositions that are as numerous as the individuals affected. Therefore, every skeleton is a storehouse of evolutionary life history. Making claims that “we already know everything worth knowing” about any area in science is a guaranteed way to be proved wrong at a later date. It is certain that the discovery of DNA is not the last scientific development that will ever be made in relation to the human body.
Doyal and Muinzer also imply that respect can only be achieved by reburial. This is a common fallacy aired in such discussions, but not one expected of lawyers or professors of medical ethics. The insidious implication of these statements is that continued display of the skeleton is intrinsically disrespectful and undignified. In fact, the current presentation of collections at the Hunterian Museum was recognised with a Gulbenkian Prize in 2007 (see: http://www.thegulbenkianprize.org.uk/2006/shortlist1.htm). This acknowledges the displays to have been formulated in a very tasteful and care-inspired environment that permits viewing and study by the general public. This allows better appreciation of the body and informs modern and individual notions of health and well-being that are ever more important under the stresses of modern life. One way of showing respect for people is to try to learn about their lives and experiences. Having visited the Hunterian Museum and the Royal College of Surgeons we cannot think of a more dignified repository for this important skeleton, or greater respect than can come from serving humankind by continuing to contribute to advances in medical science.
Modern medical ethics have been conceived to protect the interests of living people as we move forward as a society. Attempting to apply such values retrospectively to the remains of individuals who died centuries ago (for example citing the 2004 Human Tissue Act and modern debates on organ donation) is simply inappropriate and will ultimately achieve nothing. As L. P. Hartley (6) said, “The past is like a foreign country –they do things differently there.” Apologizing for the deeds of others long dead will serve only to salve the consciences of the living whilst having no effect on the deceased. In short, we cannot change the past, but it is fundamental to learn from it. We can only change the future and dropping Charles Byrne’s bones into the sea will help no one –not even Charles Byrne and certainly not future generations.
Literature Cited
1. Gordon, R.M. The infamous Burke and Hare: serial killers and resurrectionists of 19th century Edinburgh. McFarland and Co, 2009.
2. Doyal L, Muinzer T. Should the skeleton of “the Irish giant” be buried at sea? BMJ 2011; 343 doi: 10.1136/bmj.d7597.
3. Mitchell P.D., et al . The study of anatomy in Britain from 1700 to the early 20th century. Journal of Anatomy. 2011;219: 91-99.
4.Chahal H. et al. AIP Mutation in Pituitary Adenomas in the 18th Century and Today. New England Journal of Medicine 2011;364:43-50.
5. Cushing H. The pituitary body and its disorders: clinical states produced by disorders of the hypophysis cerebri. J.B. Lippincott, 1912.
6. Hartley L.P. The Go Between. H. Hamilton, 1953.
Competing interests: No competing interests
Old bones: new views?
If bones could speak, John Hunter might today agree with Doyal & Muinzer that the Irish giant should finally be buried at sea in accordance with his wishes. Two centuries ago 'The Founder of Scientific Surgery' strove tirelessly (& boldly) to make surgery better for patients: he looked to the future. We have no reason to believe that his commitment to progress & professionalism would be any different today; when for a surgeon it is as important to 'do the right thing' as it is to 'cut the right thing'. We are certain that such a great man, in this 'age of consent', would be keen to remain at the 'cutting edge': he would surely respect wishes more than curiosities.
Ben Lake
Mark W Davies DA(RCS) FFA RCS
Royal Liverpool & Broadgreen University Hospitals NHS Trust.
Email: securemark@mac.com
No external funding and no competing interests declared.
Competing interests: No competing interests
The ethical problem with the bones of Charles Byrne [1] is almost that of all human remains conserved in public collections or displayed in museums or opened institutions. In a close future, the choice will have to me made by curators between a global conservation of all (or quite of all) anthropological collections, and their systematic restitution to original communities or families.
Can we use inappropriate conditions of acquisition of the bones/skeleton/body as an argument for such a restitution? For art items, the answer is “yes” (restitution being to the country where the artefacts were stolen, even centuries ago) [2]. But human body parts or cadavers are not art items, even if particularly old (archaeological collections, for example, or isolated bones).
Maybe the only one element that will permit to argue for a restitution or not, will be the name of the individual, highlighting the importance of forensic and multidisciplinary identification processes for such “artefacts” [3]. If one can name the body (and if its descendants ask for a repatriation or for religious ceremonies such as inhumation, cremation or buried at sea), no one authority will ethically be able to go against this moral will.
Are such restitutions a synonym of complete disappearance of data for the future generations? Not necessary. Modern technologies exist permitting a complete 3D conservation of all anatomical details with a huge ultra-structural precision (for example photogrammetry [4]). A complementary sampling for further analyses is also possible, without destroying or mutilating the remains.
In France, the recent official restitution process of all toi moko (18th to early 20th c. Maori mummified head) to New Zealand has been the occasion of a complete (and never made before) study of these human remains, at the origin of a much better knowledge about their origin, preparation, signification, utilization and – it is a paradox – conservation. In fact, the decision of restitution or inhumation of such “human artefacts” can be an occasion of a “second life” and ultimate study before any complete physical (but not scientific) disappearance. It is the occasion of instilling life and activity in sleeping and antiquated collections, and have an ethical step.
References
1. Doyal L, Muinzer T. Should the skeleton of “The Irish giant” be buried at sea? BMJ 2011;343:d7597.
2. International Council Of Museums (ICOM), Code of ethics for museums (adopted in 1986, lastly revised in 2004), chapter 7, 2006.
3. Charlier P, Huynh-Charlier I, Poupon J, et al. Multidisciplinary medical identification of a French king’s head (Henri IV). BMJ 2010;341:c6805.
4. Ebert LC, Thali MJ, Ross S. Getting in touch. 3D printing in forensic imaging. Forensic Sci Int 2011;211(1-3):e1-6.
Competing interests: No competing interests
Re: Should the skeleton of “the Irish giant” be buried at sea?
I viewed the concept of ‘rapid responses’ more as a ‘letter to the editor’ than an academic endeavour, so I did not include any references. Furthermore I do not believe that anything I said required a reference since I was not quoting statistics or the opinions of anyone else. I found many of your comments about my response to be condescending and not appropriate for an academic discussion.
Perhaps I should have made it clear that I found the references you gave to be superficial and insubstantial. There is much better material available and you attempt to make the circumstances and choices faced by Byrne into a simple choice that reflects only part of the truth. As for your most important reference Wendy Moore is an expert on John Hunter, not on Irish giants. I have read her book, especially the chapter on Byrne which, in my opinion, is not the best piece on the giant. I also dismantled her bibliography and tracked down all of her sources for my own work. Her book was interesting and she did a good job of trying to evoke the culture and society in which Byrne and Hunter existed. Try Jan Bondeson’s essay in ‘Cabinet of Curiosities’ for better information on Byrne (another medical researcher).
For the last few years I have been compiling a manuscript about Byrne, Cotter, Magrath and numerous Irish giants of the 18th and 19th centuries. My interest is primarily in the representation of the giants in popular culture but also draws on much social history. As a consequence of my work I could provide hundreds of references, but that would not really be the point of my criticism. Many of those references are by medical men who took an interest in the rare condition which caused abnormal overgrowth. My work is my own way of trying to respect the memories of the dead giants. By trying to give them a real biography and a social and cultural backdrop and identify their significance. For this reason I believe you have picked Byrne’s because he is a symbolic target. I made no moral arguments in my comments, I just responded to the comments in your paper.
My reason for claiming that Byrne was not the most significant of the Irish giants is obvious from Francom and Musgrave’s ‘Irish Giant’ (1976). An excellent book, well written, thoroughly researched and sympathetic, and I think the authors were medical professionals. Byrne’s life was short and his career lasted only a few years most of it being in London. At that time fame was fleeting and there was another Irish giant exhibiting in London at the same time as Byrne (who was not Cotter) who is all but forgotten (except by me). In contrast to Byrne, Cotter’s career lasted for several decades during which time he toured widely throughout the British Isles and he became the iconic Irish giant of popular culture. The lives of all of the show giants were badly documented and for many years there was much confusion about the careers of Byrne and Cotter (and at times Cornelius Magrath also), was which and whose remains were in the Hunterian museum. During World War Two, when the Hunterian was bombed and many exhibits were destroyed Byrne’s remains were not highly valued by either the medical profession or the public, but times change and it seems now everyone wants a piece of him.
As I noted before and I will try to note again. Byrne was dying and he was terrified of the body snatchers and John Hunter. I do not dispute that at all. No one that I have found has an account that suggests anything different. Everyone with any sense in the late 18th and early nineteenth century was frightened by the prospect of being dissected and when John Hunter boasted that he could have any body he wanted he was not joking. My point is that it should be remembered Byrne’s his request, his ‘advanced decision’, was an extreme response to an extreme situation. It was because of this and only this did he wanted his body to be disposed of at sea. Burial at sea was not a normal practice, but he knew that if he was buried anywhere on land Hunter would try to acquire his remains. So, as a consequence, he picked the one place that would put him beyond Hunter’s reach. There is no reason to believe that if had been given a choice this would have been his preferred option for burial. I maintain that, in line with common practice at the time, he would have aspired to being buried in the ground, at a place he felt was his home. To dump his body at sea seems to be more of an insult than a memorial.
I am not a scientist, and I hope some day science will have made as much use as possible of Byrne’s skeleton to the benefit of others who suffer from acromegaly, and when that happens I hope he will be buried in a respectful manner with some sort of memorial to commemorate his existence. When a decision about his final resting place is made I hope it will be a considered and humane one. Pending a properly informed debate, Byrne’s skeleton is much safer where it is.
Competing interests: No competing interests