Confronting the Cadaver: The Denial of Death in Modern Medicine

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Abstract

A cultural hermeneutic interpretation of the cadaver in the history of medicine is examined in light of a body of evidence, including historical data on cadaver dissection, qualitative analyses of medical students working with cadavers, responses during a panel discussion on experiences in a gross anatomy course, and interviews with the creator of Body Worlds, Gunther von Hagens. The evidence is analyzed and found to support the conclusion that medical education works implicitly to manage death anxiety through a set of defenses which conceal the nothingness of death.

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References

  1. Adams-Greenly, M. S., Sr., & Moynihan, R. T. (1983). Helping the children of fatally ill parents. American Journal of Orthopsychiatry, 53(2), 219–229.CrossRefGoogle Scholar
  2. Amaral, D. G., & Adolphs, R. (2015). Living without an amygdala. New York: Guilford.Google Scholar
  3. Bach, D. R., Hurlemann, R., & Dolan, R. J. (2015). Impaired threat prioritization after selective bilateral amygdala lesions. Cortex, 63, 206–213.CrossRefPubMedPubMedCentralGoogle Scholar
  4. Becker, E. (1973). The denial of death. New York: Simon & Schuster.Google Scholar
  5. Bloch, B. (2000, July 29). Exhibit with corpses makes us look inside ourselves. Missoulian. Online: http://missoulian.com/entertainer/exhibit-with-corpses-makes-us-look-inside-ourselves/article_9e939c51-3715-57fc-bbdd-2dfb1fc272e6.html.
  6. Boyle, M., & Carter, D. E. (1998). Death anxiety amongst nurses. International Journal of Palliative Nursing, 4(1), 37–43.CrossRefGoogle Scholar
  7. Burns, L. (2000). Gunther von Hagens’ Body Worlds: Selling beautiful education. The American Journal of Bioethics, 7(4), 12–23.CrossRefGoogle Scholar
  8. Counts, D. A. (1984). Revenge suicide by Lusi women: An expression of power. In S. Tiffany (Ed.), Rethinking women’s roles: Perspectives from the Pacific. Berkeley, CA: University of California Press.Google Scholar
  9. Davis, M., & Whalen, P. J. (2001). The amygdala: Vigilance and emotion. Molecular Psychiatry, 6, 13–34.CrossRefPubMedGoogle Scholar
  10. Ehlers, A., Margraf, J., Roth, W. T., Taylor, C. B., & Birbaumer, N. (1988). Anxiety induced by false heart rate feedback in patients with panic disorder. Behaviour Research & Therapy, 26(1), 1–11.Google Scholar
  11. Epstein, S., & Roupenian, A. (1970). Heart rate and skin conductance during experimentally induced anxiety: The effect of uncertainty about receiving a noxious stimulus. Journal of Personality & Social Psychology, 16(1), 20–28.Google Scholar
  12. Fox, A. S., Oler, J. A., Tromp, D. P. M., Fudge, J. L., & Kalin, N. H. (2015). Extending the amygdala in theories of threat processing. Trends in Neuroscience, 38(5), 319–329.Google Scholar
  13. Fuster, J. M. (2002). Frontal lobe and cognitive development. Journal of Neurocytology, 31(3), 373–385.CrossRefPubMedGoogle Scholar
  14. Greenberg, J., & Arndt, J. (2011). Terror management theory. In P. A. M. Van Lange, A. W. Kruglanski, & E. T. Higgins (Eds.), Handbook of theories of social psychology: Collection: Volumes 1 & 2 (pp. 398–415). Thousand Oaks, CA: Sage.Google Scholar
  15. Greenberg, J., Solomon, S., & Pyszczynski, T. (1997). Terror management theory of self-esteem and cultural worldviews: Empirical assessments and conceptual refinements. In M. Zanna (Ed.), Advances in experimental social psychology (Vol. 29, pp. 61–139). San Diego, CA: Academic Press.Google Scholar
  16. Hafferty, F. (1988). Cadaver stories and the emotional socialization of medical students. Journal of Health and Social Behavior, 29(4), 344–356.CrossRefPubMedGoogle Scholar
  17. Halford, W. K., Cuddihy, S., & Mortimer, R. H. (1990). Psychological stress and blood glucose regulation in Type I diabetic patients. Health Psychology, 9(5), 516–528.Google Scholar
  18. Heidegger, M. (1962). Being and time (J. Macquarrie & E. Robinson, Trans.). New York: Harper & Row.Google Scholar
  19. Horne, D. J., Tiller, J. W., Eizenberg, N., Tashavska, M., & Bidale, N. (1990). Reactions of first-year medical students to their initial encounter with a cadaver in the dissecting room. Academic Medicine, 65, 645–646.CrossRefPubMedGoogle Scholar
  20. Jones, A. B., Moga, D. N., & Davie, K. A. (1999). Transforming end-of-life care for the 21st century: The hospice vision. Journal of Palliative Medicine, 2(1), 9–14.CrossRefPubMedGoogle Scholar
  21. Kane, A. C., & Hogan, J. D. (1986). Death anxiety in physicians: Defensive style, medical specialty, and exposure to death. OMEGA—Journal of Death & Dying, 16(1), 11–27.Google Scholar
  22. Khalsa, S. S., Feinstein, J. S., Li, W., Feusner, J. D., Adolphs, R., & Hurlemann, R. (2016). Panic anxiety in humans with bilateral amygdala lesions: Pharmacological induction via cardiorespiratory interoceptive pathways. The Journal of Neuroscience, 36(12), 3559–3566.CrossRefPubMedPubMedCentralGoogle Scholar
  23. Laird, J. D., & Lacasse, K. (2014). Bodily influences on emotional feelings: Accumulating evidence and extensions of William James’s theory of emotion. Emotion Review, 6(1), 27–34.CrossRefGoogle Scholar
  24. Leder, D. (1990). The absent body. Chicago, IL: University of Chicago Press.Google Scholar
  25. LeDoux, J. E. (2000). Emotion circuits in the brain. Annual Review of Neuroscience, 23, 155–184.CrossRefPubMedGoogle Scholar
  26. Leiderman, D. B., & Grisso, J. A. (1985). The Gomer phenomenon. Journal of Health and Social Behaviour, 26, 222–232.CrossRefGoogle Scholar
  27. Lief, H. I., & Fox, R. C. (1963). Training for detached concern in medical students. In H. I. Lief, V. F., Lief, & N. R. Lief (Eds.), The psychological basis of medical practice. New York, NY: Harper Row.Google Scholar
  28. Maltsberger, J. T., & Buie, D. H. (1980). The devices of suicide—Revenge, riddance, and rebirth. The International Review of Psycho-Analysis, 7, 61–72.Google Scholar
  29. McNeill, M. (2017). Abracadaver. Paraphilia Magazine. Online: http://www.paraphiliamagazine.com/periodical/abracadaver/.
  30. Meng, L. (2002). Rebellion and revenge: The meaning of suicide of women in rural China. International Journal of Social Welfare, 11(4), 300–309.CrossRefGoogle Scholar
  31. Menzies, N. B. (1960). A case study in the functioning of social systems as a defence against anxiety: A report on a study of the nursing services of a general hospital. Human Relations, 13, 95–121.CrossRefGoogle Scholar
  32. Nesse, R. M. (2004). Natural selection and the elusiveness of happiness. Philosophical Transactions-Royal Society of London Series B Biological Sciences, 359, 1333–1347.CrossRefGoogle Scholar
  33. Nia, H. S., Lehto, R. H., Ebadi, A., & Peyrovi, H. (2016). Death anxiety among nurses and health care professionals: A review article. International Journal of Community Based Nursing and Midwifery, 4(1), 2–10.PubMedPubMedCentralGoogle Scholar
  34. O’Carroll, R. E., Whiten, S., Jackson, A., & Sinclair, D. W. (2002). Assessing the emotional impact of cadaver dissection on medical students. Medical Education, 36, 550–554.CrossRefPubMedGoogle Scholar
  35. Passingham, R. E., & Wise, S. P. (2012). The neurobiology of the prefrontal cortex: Anatomy, evolution, and the origin of insight. Oxford: Oxford University Press.CrossRefGoogle Scholar
  36. Peters, L., Cant, S., O’Connor, M., McDermott, F., Hood, K., Morphet, J., & Shimoinaba, K. (2017). How death anxiety impacts nurses’ caring for patients at the end of life: A review of literature. The Open Nursing Journal, 7, 14–21.Google Scholar
  37. Pyszczynski, T., Greenberg, J., & Solomon, S. (1999). A dual-process model of defense against conscious and unconscious death-related thoughts: An extension of terror management theory. Psychological Review, 106(4), 835–845.CrossRefPubMedGoogle Scholar
  38. Robbins, B. D., Tomaka, A., Innus, C., Patterson, J., & Styn, G. (2008). Lessons from the dead: The experiences of undergraduates working with cadavers. OMEGA: Journal of Death and Dying, 58(3), 177–192.Google Scholar
  39. Rodrigues, S. M., LeDoux, J. E., & Sapolsky, R. M. (2009). The influence of stress hormones on fear circuitry. Annual Review of Neuroscience, 32, 289–313.Google Scholar
  40. Semendeferi, K., Armstrong, E., Schleicher, A., Zilles, K., & Van Hoesen, G. W. (2001). Prefrontal cortex in humans and apes: A comparative study of area 10. American Journal of Physical Anthropology, 114(3), 224–241.CrossRefPubMedGoogle Scholar
  41. Servaty, H. L., Krejci, M. T., & Hayslip, B., Jr. (2007). Relationships among death anxiety, communication apprehension with the dying, and empathy in those seeking occupations as nurses and physicians. Death Studies, 20(2), 149–161.CrossRefGoogle Scholar
  42. Singer, C. (1917). Studies in history and method by science. Oxford: Clarendon Press. Online at Project Gutenberg: http://www.gutenberg.org/files/46572/46572-h/46572-h.htm.
  43. Singer, T., Critchley, H. D., & Preuschoff, K. (2009). A common role of insula in feelings, empathy and uncertainty. Trends in Cognitive Sciences, 13(8), 334–340.CrossRefPubMedGoogle Scholar
  44. Sorensen, R., & Iedema, R. (2007). Advocacy at end-of-life: An ethnography of an intensive care unit. International Journal of Nursing Studies, 44(8), 1343–1353.CrossRefPubMedGoogle Scholar
  45. Sorensen, R., & Iedema, R. (2009). Emotional labour: Clinicians’ attitudes to death and dying. Journal of Heath Organization and Management, 23(1), 5–22.CrossRefGoogle Scholar
  46. Stemmler, G., Heldmann, M., Pauls, C. A., & Scherer, T. (2001). Constraints for emotion specificity in fear and anger: The context counts. Psychophysiology, 38, 275–291.CrossRefPubMedGoogle Scholar
  47. Stone, P. R. (2011). Dark tourism and the cadaveric carnival: Mediating life and death narratives at Gunther von Hagens’ Body Worlds. Current Issues in Tourism, 14(7), 685–701.CrossRefGoogle Scholar
  48. Tolle, S. W., Elliot, D. L., & Hickam, D. H. (1984). Physician attitudes and practices a the time of patient death. Archives of Internal Medicine, 144(12), 2389–2391.CrossRefPubMedGoogle Scholar
  49. Van den Berg, J. H. (1978). Medical power and medical ethics. New York: W.W. Norton & Co.Google Scholar
  50. Von Hagens, G., Tiedemann, K., & Kriz, W. (1987). The current potential of plastination. Anatomy and Embryology, 175(4), 411–421.CrossRefGoogle Scholar
  51. Woo, Y. W., Kim, K. H., & Kim, K. S. (2013). Death anxiety and terminal care: Stress among nurses and the relationship to terminal care performance. The Korean Journal of Hospice & Palliative Care, 16(1), 33–41.CrossRefGoogle Scholar
  52. Zaki, J., Davis, J. I., & Ochsner, K. N. (2012). Overlapping activity in anterior insula during interoception and emotional experience. NeuroImage, 62(1), 493–499.CrossRefPubMedGoogle Scholar

Copyright information

© The Author(s) 2018

Authors and Affiliations

  1. 1.Department of PsychologyPoint Park UniversityPittsburghUSA

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