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D G Jones. Ashgate, 2000, £50, pp 304. ISBN 1754620735
This book is well-timed. Jones has produced a broad-ranging work focused on a novel subject: the cadaver. In this year alone, high-profile media issues have included the non-consensual storage of postmortem examination tissues at Alder Hey; the trial of Dr Heinrich Gross, for killing and storing the brains of children in Austria in the second world war; debate about the medical uses of fetal tissues, and the repatriation and reburial of indigenous remains from museums.
Speaking for the Dead is underpinned by a profound respect for cadavers. Jones makes the claim that respect accorded to persons (and their wishes) extends to their tissues after death. He bases this on both utilitarian and Kantian grounds. Hypothetical arguments—such as that of the “neomort”—flesh out the argument.
Historical examination of attitudes to cadavers provides a context for this work. It is brave and noteworthy to describe explicitly our fearful subjective response to dead bodies. I would unreservedly recommend this chapter alone to medical students commencing dissection. It is a humanising explanation of the heritage and necessity of undertaking postmortem examination and of learning anatomy by dissection.
Jones then advances another strong contention: that the use of unethical research data and results constitutes moral complicity. He discusses contentious research derived from autopsies and war-time experiments, as well as touching on legal issues such as whether the body and its parts can be regarded as property.
The response to indigenous concerns about archaeological findings is powerful. Jones manages to balance, on the one hand, strong arguments for advancing knowledge in science and anthropology, and on the other, the interests of indigenous peoples in respecting ancestors.
The discussion of organ transplantation policies and the incipient ethical dilemmas of new technologies is generally solid, but occasionally fails to accommodate the full range of opinions. Given the broad remit of the field, Jones does well to cover the many hypothetical situations which may be expected.
In discussing brain death, Speaking for the Dead reintroduces the perspective of the cadaver, the person he or she was previously, and other stakeholders. These viewpoints, in defining brain death, frequently become subsidiary to technical neurophysiology and philosophical argument about personhood, selfhood and consciousness. Jones makes more action guiding points, and thus his discussion is more clinically relevant than most other debates about brain death.
Finally, Jones expounds on his particular expertise, embryology, and specifically addresses brain birth. His arguments are based upon careful study and are highly pertinent. I hope they will be heeded.
Speaking for the Dead ranges far more widely than its title would suggest. Gareth Jones has covered a neglected area thoroughly. Moreover, he has integrated myriad tangential ethical problems into his discussion. Ramifications for the fields of research ethics, medical education, anthropology and policy are significant. Questions raised for the future are numerous, and Jones provides a compelling, well argued and consistent framework from which to address these problems. I would recommend this book to a broad audience—laypersons, doctors and philosophers—for its simplicity, eloquence and viewpoint. It is a thought provoking work, and engrossing to read.