Death + the Law Death Ethics Suicide

The Right to Die Free in Montana

Montana Court to Rule on Assisted Suicide Case
Kirk Johnson, New York Times (September 01, 2009)

Since July I have been posting stories on Right-to-Die cases in England. Those posts involved Edward and Joan Downes (who traveled together to the Dignitas Clinic in Switzerland to die) and Debbie Purdy who successfully fought a campaign to have England’s assisted suicide law changed.

Now it is America’s turn and in the great state of Montana no less. State motto: Oro y Plata…which means Gold and Silver in Spanish. I know.

I will let the Billings Gazette take the lead, with the August 29, 2009 article, State Appealing District Court Judge’s Ruling Favoring Assisted Suicide:

Robert Baxter, a 76-year-old former truck driver from Billings, spent his last months fighting for the right to hasten his own death.

Robert Baxter

Baxter was the Montana face and only named terminally ill patient in a legal case that sought to legalize physician-assisted suicide; he wanted doctors to prescribe him medication that would bring about his death and end his struggle with chronic leukemia.

Baxter died Dec. 5, 2008, the same day that Helena District Judge Dorothy McCarter ruled that the Montana Constitution protected the right of terminal patients like him to obtain lethal prescriptions from physicians.

This is an interesting case to watch because it involves the Montana State Supreme Court ruling on whether or not assisted suicide is legal. The other two American states with assisted dying laws, Oregon and Washington, both passed those laws by popular vote.

As always, I will keep my eyes on this case.

Death + Art / Architecture

Curious, Morbid, and Gruesome Anatomy in England

Exquisite Bodies: Gruesome wax models go on display
Andy Duckworth, The Guardian (August 24, 2009)

A short post on a really fantastic exhibition at the Wellcome Collection in London. The exhibit, Exquisite Bodies, runs until October 18.


The Guardian ran a short video piece on the exhibit (tagged at the top) and it features Kate Forde, the Wellcome curator who put the exhibition together.

My friend Joanna Ebenstein was the Curatorial Adviser on the exhibit and take it from me: Joanna knows from dead bodies.

Joanna runs the Library of Morbid Anatomy in Brooklyn (on the banks of the lovely Gowanus Canal…) and she also edits the MUST READ Morbid Anatomy blog.

Finally, a WARNING….the Guardian video contains disturbing images…which is totally awesome.

Death + the Economy Death + the Law Death Ethics Suicide

America and End of Life Care: Death, Dying, and Mortality

At the End, Offering Not a Cure but Comfort
Anemona Hartocollis, New York Times (August 19, 2009)

I started and re-started this post on American Health Care reform several times. To watch America’s current Health Care debate (such as it is…) makes me all the happier that I now live in the UK and am covered by the National Health Service. I have no problems with the NHS and I am glad that it exists.

Do Not Resuscitate Tattoo

One part of the NHS that impresses me most is its National End of Life Care Programme. The EOLC Programme’s mission statement provides a succinct mandate:

OUR AIM: To improve the quality of care at the end of life for all patients and enable more patients to live and die in the place of their choice.

What I think is fundamentally important about this NHS program is that it acknowledges the obvious: people die. Indeed, the program was explicitly created to embrace death so that the dying process is made as comfortable as possible for UK residents.

Do No Resuscitate

Herein lies one of the key reasons that I think the American Health Care reform debate is failing: Serious discussions about death, dying, and mortality have been jettisoned. What America needs more than ever, right now, is a National Conversation about dying because until that occurs, health care reform will continue to ignore that one part of human biology that we all share: Death.

And yet, paradoxically, it would seem that this kind of conversation is going on all the time.

The New York Times article at the top offers a lengthy and important discussion on End of Life Care in American hospitals. And NYTimes Health columnist Jane Brody offered this recent piece: End-of-Life Issues Need to Be Addressed.

President Obama made it clear in May that he was interested in a National Conversation about End of Life Care in a lengthy New York Times Magazine interview about the economy.

It is a long(ish) interview, so if you click here you can skip to the bit on Obama’s Grandmother and how her death informed his own thinking about End of Life decisions.

Do Not Resuscitate Bracelet

The problem, of course, is that people rarely talk to their family members about death. To bring home this point, the August 7, 2005 New York Times Magazine featured this article: Will We Ever Arrive at the Good Death?

Here is the key quote from that article:

As J. Donald Schumacher, president of the National Hospice and Palliative Care Organization, said last April to the Senate Committee on Health, Education, Labor and Pensions, “Americans are more likely to talk to their children about safe sex and drugs than to their terminally ill parents about choices in care as they near life’s final stages.”

Let me be clear that I think that President Obama is delving into an extremely urgent topic but, ironically, he is not the first modern American president to discuss end of life decision making. Oh no. Not by a long shot.

Some of the first presidential statements on death involved Ronald Reagan. In the early 1980’s, President Reagan received a series of reports on death and dying from some totally forgotten (but important) bioethics commissions:

  • Defining Death: Medical, Legal and Ethical Issues in the Determination of Death (July 9, 1981)
  • Deciding to Forego Life-Sustaining Treatment: Ethical, Medical, and Legal Issues in Treatment Decisions (March 21, 1983)
  • So, in a way, President Obama is attempting to carry out a project begun by President Reagan and is actually acting very Reaganesque. But I digress…

    For me, the key reason President Obama has seen his health care debate derailed is that he dared to embrace death. Or, at least, to suggest that end of life care is something that needs to be discussed (on the local and national level) since individuals need to be clear in their own heads about how they want to die.

    And since President Obama is involving himself in this debate, it means that the head of the nation is suddenly speaking out about death and dying. As a result, Obama is acknowledging a much more profound dilemma for modern America: the nation-state (as in America) usually ignores death at all costs.

    At a certain point, the nation can do absolutely nothing about death and instead it focuses on mortality. Death is utterly ignored by the nation because it represents that one, final act that an individual can choose and that beyond a certain point-in-time no life will return. President Obama isn’t anywhere near making statements about who lives and who dies. But he is making it clear that death is inevitable. (I am unfairly paraphrasing Michel Foucault’s comments from his Society Must Be Defended lectures, p. 248).

    That alone, I think, is causing some of the biggest problems.

    Do Not Resuscitate Logo

    All of this is to say, that American health care reform begins and ends with death. And until those discussions occur, America will continue with its current system.

    If you’re interested in making sure that your own end of life requests are followed, then use this information offered by Jane Brody of the New York Times.

    To help people make sound health care decisions and get the care they would want for themselves or their family members as life draws to a close, the National Institute on Aging has produced a comprehensive 68-page booklet, “End-of-Life: Helping With Comfort and Care.” Individual free copies can be obtained through the institute’s Web site,, or by calling 800-222-2225.

cremation Death + Technology Death Ethics Eco-Death

Reduce – Reuse – Recycle – the Dead…

Body Heat
The Economist (August 6, 2009)

Let us all say it together: Reduce – Reuse – Recycle. Now add: Dead bodies. It’s true. Shocking, but true.

A strong case can be made that organ donation, for example, is the noblest form of cadaveric recycling and that the reuse of human organs and tissues to extend life is a huge social good. That said, the dead human body offers up numerous recycling possibilities and many local and/or national governments have turned those postmortem opportunities into actual policies.

Reduce Reuse Recycle

These particular recycling plans focus on transforming the by-products produced through the final disposition of human remains (say from cremation) into new goods. That is a wordy way of saying that the various kinds of Green Technologies running rampant across the globe can also be used on dead bodies.

I am all for it.

The short Economist article at the top is about two different kinds of postmortem recycling. The first section explores the recycling of artificial joint implants (hips, knees, etc.), which can then be re-used in other industries. The left-over metal is melted down and sold to companies that use the different alloys in their own products. These companies often include ones that make joint implants. It’s all a bit circular (…just like the reduce reuse recycle arrows…) but it works. And many of the metal recyclers donate portions of their sales to designated charities.

Artificial Hip Joint

In about three years Denmark’s crematorium association has earned $15,000 from salvaged parts. America is a bit behind both Europe and the UK when it comes to implant recycling but at least one US company in Detroit, MI is making a go of it: Implant Recycling. I like to imagine that Detroit’s economic re-birth will start because of postmortem recycling.

Author Mark Harris, whose book Grave Matters: A Journey through the Modern Funeral Industry to a Natural Way of Burial is a good primer on eco-friendly burial, has one of the best photos that I have ever seen of a hip replacement post-cremation. Note how the metal hip replacement glows red amongst the remains:

Hip Replacement in the Crematorium

The second section of the Economist article discusses a topic that I am actually working on: recycling crematorium heat. Regulations require crematoriums to filter toxic substances from waste gases by cooling them from around 800°C to 180°C. Crematoriums capture the excess energy from this process and send the “waste heat” into building heating systems.

I remember explaining this concept a few years ago to a group of American college students. A few of them were aghast, to say the least. In early January 2008, officials at the Dukinfield Crematorium near Manchester, England announced that they would, indeed, begin capturing the crematorium’s exhaust, filter it, and then re-use it to heat the building. The always excitable Daily Mail ran a predictably over-the-top article on the plan: Crematorium to keep mourners warm by burning bodies of loved ones.

But, as even the Mail admits, not one person in the surrounding community (or in the Anglican Church for that matter) complained about the plan.

So here is the big lesson (and I learned it with the aforementioned students): when people understand that the heat being captured and re-used is already being produced vis-a-vis cremation, and that the same excess, potentially useful heat would otherwise go to waste, they are agreeable to the whole concept.

Indeed, the Haycombe Cemetery and Crematorium on the southern edge of Bath (near the University of Bath where I work) has a state-of-the-art facility capable of heat recycling. Haycombe’s Manager, the always good humored Rosemary Tiley, will gladly give a tour of the facility and/or the public can visit during one of the crematorium’s Open Days.

The larger question to ask about crematorium heat recycling, however, is how any surplus energy (after the local needs are met) could/can be channeled to the national grid? That is the next leap. Cremation rates in the UK are high: 72% nationally (the US cremation rate is currently at about 33% but growing) so making use of the crematoriums in this way makes sense.

Everything that I am writing today may seem a bit crass and bit too Soylent Green but a good public education plan goes a long way in explaining why these programs are socially useful.

In fact, cemetery planners in Santa Coloma de Gramanet, Spain (near Barcelona) have installed solar panels on the mausoleums to collect energy. It’s a great plan to help produce electricity for local homes and since most cities (large, medium, and small) have cemeteries in their vicinity, this might just work in other places. The Spanish authorities effectively explained the merits of the program and the public got behind it.

Not everyone is a fan of these Green burial initiatives. Evangelical Christian leader Chuck Colson, he of Nixon Administration infamy, lambasted an early 2009 article on Green Burial technologies. Colson offered a special commentary in his BreakPoint Ministries column on the absurdity of eco-burial concerns. I firmly believe that Colson missed the entire point of the Slate article but so it goes.

So let us all say it together one more time: Reduce-Reuse-Recycle…

Death + the Economy Death + the Law Death Ethics

Death and the Economy (redux): More and More Unclaimed Bodies in County Morgues

Death in the Recession: More Bodies Left Unburied
Alison Stateman, Time Magazine (August 07, 2009)

News stories about unclaimed dead bodies, accumulating in morgues across America, continue to pop up. Death Ref Librarian Kim found this one and I decided to post it. What makes this particular Time article slightly different than the other articles I have already posted on the unclaimed body phenomena is this: it discusses the problem from coast to coast. This is not an isolated, geographically contained problem.

When unprecedented numbers of unclaimed dead bodies stop filling county morgues, then I’ll believe that the American economic recession is in retreat.

Cemeteries Death + the Economy

Death and the Economy: California Cemetery in Foreclosure…

Final Resting Place, In Foreclosure
Theresa Vargas and Michael Williamson, Washington Post, (August 4, 2009)

Just when it seemed that news about the US economy and Death could not get any odder (and/or sadder), I came across the following blog post. Two writers employed by the Washington Post, Theresa Vargas and Michael Williamson, run a blog called Half a Tank: Along Recession Road and they are documenting how the recession is altering everyday life. Their posting on an Imperial Valley, California, cemetery in foreclosure is both predictable and astounding.

Cemeteries in foreclosure are not entirely new but it doesn’t happen all that frequently, either. Usually, cemeteries fall into disrepair because the owners stop the upkeep and/or the living relatives of the deceased have also died and no one comes to the cemetery.

Oddly, the last two days have seen similar cemetery stories in both the Washington Post and the New York Times. On Monday, August 3, the New York Times ran the following article: With Demise of Jewish Burial Societies, Resting Places Are in Turmoil.

I expect that more and more of these cases will pop up in the coming years. Family members die. Money comes and goes. Younger generations are no longer taken to the grave sites.

For what it is worth, I do not think that these stories are all that terrible. I like to imagine what future archaeologists will say when they uncover these abandoned burial grounds.

That, for me, is the future for forgotten cemeteries. We, the living, have no control over what stories our dead bodies will tell.

Death + Crime Death + the Law Death Ethics Suicide

Important Right-to-Die Court Decision in the UK

Debbie Purdy wins ‘significant legal victory’ on assisted suicide
Afua Hirsch, The Guardian (July 30, 2009)

An important turn today for UK Assisted Dying supporters (which is about 62% of the public…). Debbie Purdy successfully argued that it would be a violation of human rights for her to not know whether her husband would be prosecuted for accompanying her to the Swiss clinic Dignitas, where she wishes to die if her multiple sclerosis worsens.

Debbie Purdy and Omar Puente

The Purdy case is important and it will presumably force a change in UK law. As it currently stands, the UK’s 1961 Suicide Act decriminalizes suicide if you kill yourself. But any person whom:

aids, abets, counsels or procures the suicide of another, or an attempt by another to commit suicide, shall be liable on conviction on indictment to imprisonment for a term not exceeding fourteen years.

What that aiding, abetting, counseling, and procuring entails is really ambiguous. It is all so unclear that UK Prosecutors have been declining to press charges against families that accompany, say, a loved one to die in the Dignitas Clinic.

For an extremely thorough history on the Assisted Dying debate in the UK, see the Guardian’s Assisted Suicide page.

I discussed much of this information a few weeks ago in a Death Reference Desk post about the recent deaths of Edward and Joan Downes.

Since the Downes’ deaths and that discussion, I came across the following article: ‘Romantic’ death may idealize suicide: critics. Maybe. But I’m not so convinced. If anything, what Edward and Joan Downes chose to do was die and to die together. It was an act of love, to be sure, but I’m not ready to call it romance.

They chose death over a biological life neither one of them wanted to live.

It is absolutely acceptable to choose death. And family members and/or friends who want to assist in that choice should be able to do so without fear of the law.

But LOOK OUT: Scotland might beat England to the punch. Scottish MPs are discussing a change to Scotland’s own assisted suicide laws.

And Scottish MP Margo MacDonald is leading a fierce charge.

Death + Art / Architecture

Death and Art: Walking on Eggshells by emma PERRY at 50a Contemporary Art Space, Cumbria UK

Walking on Eggshells
A New Art Exhibition by emma PERRY
50a Contemporary Art Space (and online)
South Street
Egremont, Cumbria

Attention all Death Reference Desk readers in the UK: you do not want to miss the newest art exhibition by emma PERRY. Her newest project, Walking on Eggshells, is a mixed-media installation that critiques modern representations of death. Emma is currently working on her Master’s Degree in Death & Society at the University of Bath and is one of my Advisees. I find her work really engaging and worth a visit. But hurry up. The exhibition is only up until August 1.

Walking on Eggshells

Here is some more information on Emma and her work:

Emma Perry was born in Ashton under Lyne, Lancashire. She obtained a BA (Hons) Fine Art at Cumbria Institute of the Arts and continued her studies and achieved an MA in Contemporary Fine Art in 2007. Emma is currently studying again, for an MSc in Death & Society at the University of Bath, but continues to produce work in Lancashire. Since the late 1990s her creative output has involved a variety of media such as installation, sculpture, film, photography, performance and olfactory pieces. Her work explores issues surrounding death and how it can be represented and perceived by society. Emma Perry’s work is often confrontational, controversial but always engaging and thought provoking, and allows for the once taboo subject of death to be seen in a new light.

Walking on Eggshells

And here is more information on the exhibition:

The exhibition Walking on Eggshells is on display at 50a Contemporary Art Space, South Street, Egremont, Cumbria. For those unable to attend the exhibition Emma plans to allow a wider audience to experience her work at their leisure. The work is available to view online; Emma invites you sit down to spend some time viewing her work and leaving comments, thoughts and sharing your reactions on her website at: The comments left both in the art space and the website will assist Emma in her research for her current dissertation in which she is exploring the relationships between non-traditional art spaces in the context of her art practice.

Make some time to see the exhibition in person or online. It is worth the time.

Death + Art / Architecture Monuments + Memorials

Minneapolis Event: Death and Memorial Tattooing Lecture by John Erik Troyer, Ph.D.

Free Public Talk: Death and Memorial Tattooing
When: Wednesday, July 29, 7:30pm – 9:30pm
Where: West Bank Social Center, 501 Cedar Avenue South, Minneapolis 55454 (above the Nomad World Pub)

Ok. So it’s a little weird to promote my own talk this way on the Death Reference Desk, but as many people know I am called to perform… to the DANCE….

Tattoo for Jean Troyer

For this talk, I will present some new research on Death and Memorial Tattooing. I am interested in how people choose to remember/memorialize a dead person and/or pet with a tattoo. I will be joined at this talk by Awen Briem, Minneapolis tattoo artist extraordinaire, and the tattooist who has inked six of my seven tattoos. Since 1994, and through several tattooing sessions, we have spent A LOT of time discussing memorial tattoos. You have to talk about something while the needle works…

In late June, I presented some of this research at the Envisaging Death: Visual Culture and Dying symposium at the University of Birmingham, England. My talk was entitled A Labor of Death and a Labor Against Death: Memorial Tattoos in Late Modernity — I can promise that this talk on Wednesday night at the West Bank Social Center will be a lot of fun. Awen and I both want the audience involved in our discussion of Memorial Tattoos.

Feel free to e-mail me with any questions:
And check out Awen’s amazing Tattooing Blog.

Yours in Death and Tattooing….

— John Troyer

cremation Death + the Economy Death Ethics

Death and the Economy: Unclaimed Corpses Accumulate at the LA County Morgue

More bodies go unclaimed as families can’t afford funeral costs
Molly Hennessy-Fiske, Los Angeles Times (July 21, 2009)

This LA Times article (sent to me by my friend Karyn) is a sad and predictable explanation of how the American economic recession is affecting the poor. In a nutshell, next of kin do not have the available funds to collect either a dead body and/or the postmortem cremated remains.

In yesterday’s Death Ref commentary on the New York Times home burial article, I mentioned that unclaimed bodies in county morgues are a much better gauge of economic stress than people choosing to bury a deceased loved one at home. The LA Times piece explains this point in much more detail than the short article I posted on Ohio county morgues dealing with the same situation.

Albert Gaskin, LA cemetery caretaker, examines cremated remains of unclaimed bodies

Inevitably, the unclaimed cremated remains accumulate and over time cemeteries, crematoriums, and funeral homes become inadvertent store houses for the remains. It is worth noting that this photo (taken by Anne Cusack and which I grabbed from the LA Times article) shows Evergreen Cemetery caretaker Albert Gaskin sorting through massive shelves of unclaimed cremated remains.

Those boxes are all unclaimed, cremated bodies.

And given enough time, many institutions that store the remains change owners, close down, and/or simply disappear. Unless there is a mass burial at some point, those unclaimed human remains sit on the shelves and in the worst case scenarios are forgotten about and then re-discovered.

Death Ref co-founder Kim found a remarkable photography series by David Maisel and it explores one of these lost-then-rediscovered sites. It is a collection of photos of unclaimed created remains, stored in copper canisters, at a (now) shut down Oregon psychiatric hospital. Maisel calls the images the Library of Dust.

Library of Dust, indeed.

Cemeteries Death + the Economy Funeral Industry

Home is Where the Dead Body Is

Home Burials Offer an Intimate Alternative
Katie Zezima, New York Times (July 21, 2009)

Tuesday’s New York Times featured a front page article — FRONT PAGE — on people who choose home burials for a deceased love one. Economic concerns are given as a key reason for any upsurge in home burials, because they do tend to be less expensive than traditional funeral services. The contemporary practice of home burial (where the body is kept in a private home so that family and friends can see it before burial or cremation) is not new and it most certainly predates the current economic recession. A strong case can be made that ‘home burials’ are actually a return to a more common 19th and early 20th century funereal practice. That said, I want to focus on the current trend reported by the Times.

In August 2004, for example, Public Television’s POV documentary film series aired a really fantastic home burial documentary entitled A Family Undertaking. The POV documentary follows different groups of families (each with a dying relative) and shows how the home burial is prepared. All of the families involved demonstrate time and time again how the home burial choice is a labor of love.

The fundamentally important part of any home burial is to understand what the local state law says about dead bodies. I say the following with complete sincerity (and as the son of a Funeral Director): most people are capable of handling their own funerals. Here is the most important information to know: 1.) what kinds of permits are required to transport dead bodies, 2.) who signs which pieces of paperwork, and 3.) what the local state law says about the final disposition of the body.

Final disposition is a fancy way of saying burial or cremation or any other legally sanctioned form of dead body disposal. Some states give more time than others for final disposition, it depends. Here is the key: ALL American states put their laws online and it is fairly easy to key word search ‘dead body’ or ‘corpse’ to see what the local law states.

The Times article also suggests that the renewed interest in home burials is another sign of economic stress. I’m not so sure. I agree that home burials do cost less than a full-on funeral home funeral, but I’m not convinced that economics really drives it. Economic concerns might function as a catalyst but it seems to me that many people choose home burial because it feels more meaningful.

I think that a better gauge of economic duress is this: the increase in unclaimed bodies in county morgues. These are situations where the next of kin cannot afford to pay the various burial costs so they leave the body in the morgue and local officials take care of the corpse.

All of this is to say, that as individuals begin to choose more and more varied forms of final disposition we will see increasing funereal variation, such as home burials. On the one hand, I totally understand this practice and support it. On the other hand, I really enjoy the classic 19th century cemeteries found across America and I would never turn away a chance to be buried in one. Quick aside: the New York Times ran a wonderful article a few days ago on the land surveyor at Green-Wood Cemetery in Brooklyn.

The funniest part of the New York Times article is towards the end. It discusses how Maine carpenter Chuck Lakin makes handmade wooden coffins that can also double as bookshelves or display shelves… until death calls.

Chuck Lakin, coffin builder

Just by chance, a friend of mine sent me the following link this week on Coffin Shelves: Furniture for Life (and Death).

Coffin Shelves for Life

I am a total believer in multi-use coffins.

Death + Technology Death + the Law Death Ethics

Re-thinking the Definition of Death in Canada

Ethicist Seeks Law to Say When Dead Is Truly Dead
Tom Blackwell, National Post (July 16, 2009)

How and when an individual is determined to be dead is a persistent bio-ethical, medical, and philosophical debate. I came across this article on the debate in Canada and I think that it highlights a common set of points for any modern nation which uses life support machines. First and foremost, the entire debate about the definition of death is a human-made problem. The use of life support machines in the 1970s suddenly meant that individuals who might have normally died from heart failure could suddenly be kept alive for long periods of time, although artificially. The person might not be conscious and could have brain damage from a prolonged absence of oxygen but that same person’s heart might still beat.

Before the advent of life support machines, the heart stopped beating and the person died. Once it became clear that the human heart could be kept artificially beating, bio-medical attention turned towards a definition of death using brain activity. If the brain is not fully functioning, then most of what we call the “person” is also dead. This then led to debates (which continue today) about whether Whole Brain or Partial Brain criteria should be used to determine death. Philosophically, this is an interesting point: where is the “person” located in the modern body, the heart or the brain?


I am skipping through decades of debate with this particular post but it is most certainly an issue that Death Ref will continue to present. Here, too, is an interesting aside on the topic. Right before President George W. Bush left office, the President’s Council on Bioethics (which President Bush created in November 2001 and President Obama has since disbanded) released this report: Controversies in the Determination of Death: A White Paper by the President’s Council on Bioethics.

It’s a long report but worth reading. The President’s Council on Bioethics upheld the use of brain death criteria and suggests that the determination of death in America remain neurologically based. Given the intense social, legal, and political battle over Terri Schiavo during the beginning of President Bush’s second term, this is a most intriguing finding.