New Delhi: In the second week of December 2024, a couple from the holy city of Haridwar lost their daughter to a heart ailment less than three days after her birth. 

After some hesitation, they decided to donate their baby girl’s body to medical research and education. The donation may have been the youngest-ever body donation in India—some at the NGO that persuaded the parents towards donation said—an event of great sorrow and hope for her parents.

“I lost my daughter before I could feel her properly,” the mother, identified as Nancy, 10-class-pass home-maker, was quoted as saying in The Hindu. 

“By donating her body, I am making her immortal,” said the mother. “She will serve a greater cause for mankind, which we couldn't do.”

The little girl had not been named by her parents, but some from the NGO that guided the parents called her Saraswati, after the Hindu goddess of knowledge. 

“This baby girl, too, will help in making (sic) students learn the anatomy of an infant,” Rajesh Maurya, a doctor in the anatomy department of the Doon Medical College, to which the body was donated, told The Hindu. 

This incident is a reminder of the larger legal and policy framework around such body donations in India, and this analysis examines if it ensures and safeguards donor dignity, balancing it against the larger and growing demand for cadavers for medical education and training. 

The answer: It currently does not.

Empty Dissection Tables

Anatomy, the study of structure of the human body, is one of the fundamental subjects taught at medical colleges. Practical demonstrations primarily involve dissection of cadavers or dead human bodies procured by the medical colleges or hospitals in accordance with the law. 

India has  731 medical colleges that admit more than 100,000 students every year. The guidelines of the Medical Council of India (MCI) prescribe that every medical college needs to provide one cadaver for every 10 students. That allows them to comfortably stand around a dissection table and watch an instructor demonstrate medical procedures. 

There have been reports of medical colleges providing only one cadaver for every 50 students, or five times more than the prescribed standards. This hampers student understanding of spatial anatomy of the human body, prevents them from obtaining hands-on surgical skills, and denies them the opportunity to develop empathy and respect for the human body. 

Performing and practicing incisions and dissections on a cadaver also exposes students to the natural anatomical variations that they may come across in their practice and, most importantly, enables them to understand the real-life significance of their work. 

A shortage of cadavers results in denial of these experiences to the students. 

The Cadaver Trade

Rising instances of medical negligence and violence against healthcare workers is reflective of the widening trust deficit between patients and physicians. 

The failure to inculcate empathy, and sensitise students at medical colleges adds, so to say, insult to injury. The lack of cadavers, which may appear to be a logistic and marginal problem, in effect strikes at the fundamental purpose of medical education.

Further, since medical colleges are bound by MCI guidelines, they are forced to buy cadavers from neighboring states, and that costs anywhere from Rs 25,000 to Rs 100,000 per body. 

This is not only commercialisation of the dead, but it also makes medical education inequitable because private medical colleges with more money can buy cadavers at higher prices. That aggravates the shortage of cadavers for institutions that cannot afford to buy them as easily.

Considering the shortage and unequal availability of cadavers in medical institutions, a more robust law addressing the procurement and distribution of cadavers would be useful.

Inconsistent Laws

Medical institutions located in different states get cadavers in accordance with their respective state Anatomy acts. These acts broadly provide for the legal framework for body donations for medical research and training nationwide. 

The first one among these was the Bombay Anatomy Act, 1949 (now known as the Maharashtra Anatomy Act) Several states later passed their own anatomy acts, such as Jammu and Kashmir in 1959 and Karnataka in 1957. Yet, as this 2020 study pointed out, no state anatomy law defines a donor or addresses the issue of transport of anatomical material. 

Most of these laws outline procedures to use unclaimed bodies. None of them provide for inter-state transport of surplus cadavers or from one institution to another. 

Existing state laws mainly provide procedures that medical colleges, hospitals and research institutions must follow to use unclaimed and voluntarily donated bodies as cadavers.

All state laws require authorised officers to be informed about unclaimed bodies, so that approved institutions, including medical colleges and hospitals, can use them as cadavers. Yet only 10 states have a provision for body donation, according to a 2020 study. 

Except in Gujarat, Maharashtra, and Odisha, other state anatomy laws are silent on the disposal of bodies. No state law except Maharashtra’s says anything about the dignified disposal of bodies in accordance with the religious persuasion of the deceased.

Among the states that allow body donation are Karnataka, Maharashtra, Kerala, Uttar Pradesh and Odisha. The acts of only six states have been amended over the last half century.

There is a yawning gap between demand and supply of cadavers across various states and between government and private institutes. For instance, Karnataka  reportedly  received only 700 cadavers, as against the requirement of 900 over the last three years, while some colleges in Rajasthan only have 6 cadavers for about 200 medical students.

Posthumous Affairs

Throughout the 19th and 20th centuries, it was common practice in Europe and the US to rob the graves of the destitute, victims of war crimes, inmates of concentration camps and people of colour. 

Laws governing the acquisition of cadavers for medical training legally sanctioned such practices and allowed the use of corpses of executed convicts, paupers, and inmates of psychiatric institutions for dissection and medical training.

Anatomists and medical institutions predominantly relied on unclaimed bodies when scientific methods for record keeping and identification and communication technology were non-existent. 

In the 21st century, using a body for cadaveric dissection without regard to the wishes and dignity of the person involved are anachronistic. 

although, there are now legal and constitutional mandates that allow the dead to have a right to determine posthumous affairs and be treated with dignity, there is substantial ambiguity, as Article 14 reported in October 2024.

In August 2024, a woman called A N Anu petitioned the Kerala High Court to preserve her terminally ill husband's reproductive cells for assisted reproduction, although a law governing artificial reproductive technology required written consent. 

The lack of planning for postmortem affairs, and the absence of clear laws governing many cases have led to ethical dilemmas being answered in court, rather than Parliament, unlike other countries, many of which have strict regulations or ban posthumous reproduction.

Laws & Bodies

With the rise in quality of life of individuals, growth of health and security measures and rapid technological developments, a fall in the numbers of unclaimed bodies is evident in India and across the world. 

The shift in philosophical and practical considerations around cadaveric dissections require laws that focus on consent and dignity to promote awareness around body donations. 

Such laws can provide a robust but smooth mechanism for recording the wishes of potential donors and devising safeguards to ensure that norms of consent and dignity are at the heart of the process. 

The immediate steps towards that direction may include providing a mechanism for voluntary body donations in state laws, defining the eligibility and pre-conditions for being a donor and requiring state governments to begin awareness programs and social incentives to encourage individuals to bequeath their bodies.

That humans must be treated with respect and dignity even after death has been made clear in court rulings, under the ambit of Article 21 of the Constitution—the right to life and liberty.

In 1995, the Supreme Court held that the “right to dignity and fair treatment under Article 21 of the Constitution is not only available to a living man but also to his body after his death”.

In a 2002 public interest litigation, the Allahabad High Court said while the law had not so far defined a person to include someone who was dead, bodies had rights that could not “be detached” from them, even if they are “denuded of life”.

The high court said that the word and expression ‘person’ in Article 21 “would include a dead person in a limited sense and that his rights to his life which includes his right to live with human dignity, to have an extended meaning to treat his dead body with respect, which he would have deserved, had he been alive subject to his tradition, culture and the religion, which he professed”. 

Transferring this respect to scientific handling of bodies is quite another matter and would appear to require a concerted effort from union and state governments, beginning with data on bodies.

Data After Death

Given the imbalance in numbers of cadavers across states and institutions, a uniform database for record keeping and inter-state co-ordination is vital for equitable re-distribution. 

A robust database can promote transparency by documenting the consent of the donor, ensuring that such consent is free and informed. Accurate records also help institutions track how donated bodies are used, ensuring that they are used strictly for medical education. 

Such clear laws send out positive signals to the public at large, encouraging more individuals to step forward and sign up for body donations.

Except Delhi, Gujarat, and Maharashtra, no other state anatomy laws provide any guidance on record-keeping, a lacunae that makes the process opaque.

Despite the impermanence of the body, people are concerned how it is treated after death, often concerned that it may not be treated with dignity, as this 2016 study noted. 

“...it is clear… that there is awareness of high level (sic),” said the study. With “proper (public) motivation & guidance” about body donation,  the scarcity of bodies for medical students can be overcome, it said.

A Call For Change

In 2013, the Anatomical Society of India passed a resolution calling for a uniform and comprehensive national law governing body donations in line with modern medical and educational practices. 

Nothing was done to implement this resolution.

Various factors, including a lack of awareness, religious beliefs, and fears around mistreatment of the body, are responsible for the scarcity of cadavers across India. 

The country clearly needs legislation that provides a robust scientific and transparent framework for body donations with consent at its heart. This will not only advance the intrinsic constitutional goal of respecting the dignity of all persons, it will also achieve the instrumental goal of fixing the mismatch between demand and supply.

In the long-haul, it will be useful to completely do away with the use of human cadavers for dissections, in order to circumvent the ethical, philosophical, and constitutional challenges. 

But this would only be possible when the technology to store a high-resolution, three-dimensional copy of body organs and tissues in the virtual space develops to its fullest. 

Until the dead cease to teach skills to prospective doctors, it is only right that they be treated with the dignity they are owed.

(Anchal Batheja is a research fellow with the health team at Vidhi Center for Legal Policy, New Delhi.)

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