There’s a completely legal reason this American dentist has an office full of human heads – Quartz

Jordan Sparks found cryonics while sifting through the Portland State University library as a student in the early 1990s. He was fascinated. He stayed fascinated through dental school, and as a practicing dentist, and while building a dental management software whose success has given him the freedom these days to pursue the dream of a deep-frozen future full time.

There are three places in the US known to store preserved human brains in the hopes of reanimation: Alcor, the sleek Scottsdale, Arizona-based facility currently housing the head of baseball great Ted Williams; the Cryonics Institute, a 41-year-old organization outside Detroit; and Oregon Cryonics, which occupies Sparkss former dentistry office in the capital city of Salem.

Running a do-it-yourself cryonics shop from a former dental practice is not easy or cheap. Sparks has invested in a fleet of scientific equipment, much acquired second-hand, including liquid nitrogen, a fume hood, a CT scanner, microscopes, a vibratome, and a microtome. And then there is this line item: a steady supply of human heads.

About once a week, Sparks receives delivery of a gray plastic bucket containing the head of a person who died a few days earlier in the states of Oregon or Washington. Sparks is the first to admit that his facility isnt ready to offer cryopreservation to the paying public. (He has taken several cases pro bono; more on those later.) To ready himself for that future, he and his team of two assistants practice brain removal, temperature monitoring, and freezing techniques on the heads of recently-expired individuals who almost certainly had no idea a start-up cryonics venture would be their final destination.

He procures his specimens from one of a growing number of for-profit body donation companies, which supply human cadavers and their isolated parts for research and education purposes. In exchange for free cremation of unused remains and the hope of turning a personal loss into a benefit for the greater good, donors sign over to businesses a body that can be sold on for thousands of dollars.

The body donation industry occupies an unusual economic loophole in the US. Its illegal to sell human tissue. But companies that provide free bodies or parts for research are allowed to charge recipients for the expenses incurred obtaining the bodieslike the cost of transport, cremation, and staff time. Businesses set those fees themselves, and theyre not published or regulated anywhere. In practice, the rise of for-profit body donation firms like the one that supplies Oregon Cryonics has created a commercial market for cadavers as robust as that of any other commodity.

Body donations have saved and enhanced countless lives. Cadaver dissection is a cornerstone of medical training. Donated bodies allow experienced surgeons to perfect new techniques without risk to living patients and facilitate research in everything from dementia to automobile safety. But no federal regulation governs the trade, state regulations are patchy, and there are no standards for what counts as legitimate research.

And when it comes to acquiring bodies from these for-profit firms, deep-pocketed private commercial enterprises are often better positioned to get them than the educational or publicly-funded institutions most donors envision when they agree to give to science.

* * *

To be clear right up front: The people whose heads ended up in Sparkss lab did not get there by becoming organ donors. When a person agrees to donate organs by joining a state registry or signing a hospital consent form, he or she enters a tightly-controlled supply chain in which specific organsthe kidneys, lungs, heart, liver, pancreas, and intestinesare recovered from brain-dead donors and transplanted within hours into carefully-matched recipients. Individuals can also consent to donate tissues like bones, skin, and tendons, which can be collected up to 24 hours after death and stored long term.

In the US, the Food and Drug Administration regulates transplantable human cells and tissues. In transplant tissue donation, material recovered from a dead person is surgically implanted into a living person. This can mean new tendons for orthopedic injuries or new heart valves for cardiac disease patients. Donated skin could be used to create skin grafts for burn victims, or in an elective breast or penile enlargement.

Non-transplant tissue donations, which covers whole-body donations, are used only for research and education. The US Food and Drug Administration (FDA) doesnt regulate them. With a handful of exceptions, states dont regulate them. A trade group, the American Association of Tissue Banks (AATB), offers standards and an accreditation program, but membership is voluntary, and only a fraction of the US companies that take whole-body donations have signed on.

Its pretty sad. Were not regulated on a federal level whatsoever. We need to be, says Alyssa Harrison, chair of AATBs non-transplant donation committee and executive director of the United Tissue Network, a not-for-profit body donation company with offices in Arizona, Oklahoma, and Florida. Harrisons business is among the handful in the industry pushing for federal regulations. While there are clear economic motivations for an established company to pursue more regulationhigher barriers to entry mean less competitionHarrison says its also in the best interest of a public that assumes such donations are regulated more heavily than they are.

Most non-transplant bodies are used for exactly the kind of productive, legitimate research that donors and their families envision. Donated bodies have led to breakthroughs in the treatment of pain management, inflammatory diseases, and dementia. Government agencies from NASA to the National Highway Traffic Safety Administration to the Department of Defense have used cadavers to test the impact of trauma on human tissue, and commercial agencies have used that research to create everything from safer cars to safer football helmets.

But donors dont get a say in where their gift goes. Its up to the collecting company to decide who gets their bodies. Aeternitas Life, the Portland-based company that provides Sparks his heads, tells donors on its website that tissues and organs are only distributed to recognized and well-respected institutions that have undergone a strict verification and approval process. The criteria for a well-respected institution or strict verification process is up to the company, which has a financial interest in making those definitions as broad as possible.

* * *

Sparks owns the building that Oregon Cryonics occupies. The only other tenant is an orthodontist whose rental space is wedged between Oregon Cryonics administrative offices and its lab. Sparks looked rueful when I asked how the orthodontist feels about the cryonics work. Its temporary, he said. He hopes to break ground on a new headquarters this summer.

A tour reveals signs of the full-service cryonics center Sparks hopes to operate one day. A coffin-sized ice bath sits in a hallway. Down the corridor is a dimly lit room with a hospital bed and a vase of fake flowers. Its reserved for patients who want to take advantage of Oregons Death With Dignity Act, which allows doctors to prescribe lethal drugs to terminally ill patients who request them. Sparks envisions future Oregon Cryonics clients choosing to end their life in the facility so that preservation can begin immediately. No human has chosen to die there yet, but one client euthanized a pet in the room. Sparks froze the animals brain and sent it to Alcor.

There are about a dozen gray buckets stacked on a tile floor. Each contains a brain. A retail refrigerator contains five gray buckets, and those each also hold a brain inside. The difference between the brains on the floor and the brains in the fridge is that the floor brains are anonymously donated specimens obtained for training purposes. The fridge brains were each specifically bequeathed to Sparks by family members of the people who once owned them.

Sparks refers to these brains alternately as patients and charity cases. They came to him days or weeks after their owners deathsan eternity in cryonics, when every passing hour means further brain degradation and diminishing chances of reanimation. They were removed by pathologists or funeral directors at the next of kins request, and brought to Sparks with the desperate hope that technology might one day bring a loved one back.

Sparks tries very hard to talk families out of such donations. He was never the kind of dentist who tried to sell people on brighter smiles, he said, and hes not the kind of cryonicist who peddles in false hopes.

From a practical standpoint, were just not really equipped to be able to deal with patients, he said. Its kind of like the first McDonalds. You have to build everything first, and then you start offering your services. Hes keeping these brains here not because he thinks theyll ever be reanimated, but as a favor to families who werent quite ready to let a loved one go.

Thats not to say the deceased felt the same way. While Alcor and the Cryonics Institute only freeze people who specifically elected to have their remains preserved this way, Sparkss patientswith one exception well discuss in a bitwere preserved at their next of kins request, not their own. On the infinitesimal chance that future technology is able to return consciousness to these brains, their reanimated owners might be extremely surprised to awake from eternal slumber in a refrigerator.

If you revive someone and they say No, I dont want thiswell, theyre welcome to commit suicide if they want, Sparks said. From a pragmatic standpoint, theyre probably going to be grateful and not want to do that.

Another difference between Alcor and Oregon Cryonics is the technology used. At Alcor, brains and bodies are frozen after a long and detailed procedure that begins moments after death. They are preserved in carefully-monitored vats of liquid nitrogen cooled to -196C. Sparks preserved these brains with chemical fixatives and popped them in the fridge.

Sparks is a pragmatic cryonicist. Current technology is nowhere close to reanimating a preserved brain, he says. Hes also in the camp of cryonicists who say theres no point in freezing whole corpses. Any future scientist that can reanimate a brain can probably build an artificial body.

Sparks is interested in protecting what he calls the memories stored in our synapses. He imagines a time when it will be possible to run a computer model of a cryopreserved brain thats able to translate the person within: the skills, personality, and memories its owner possessed in life. For now hes focused on perfecting the technique of freezing and preserving brains for that far-off future.

* * *

One recent gray afternoon in Salem, the team gathered around a stainless-steel surgical table in Oregon Cryonics lab. A mans head sat in a gray bucket on a bed of pebble-sized ice chips like the ones in hotel ice makers. The head protruded from the bucket from the nose up, eyes closed, with an expression like a relaxed bather who has just come to the surface for air.

Attended by two gloved employees wearing surgical gowns and protective goggles, Sparks picked up a cranial drill and bore a hole into the top of the head, which shook as if vigorously objecting. He then inserted three long, blue temperature probes: one on the brains surface, one 5 cm deep, and another at 8 cm. The goal is to measure the rates at which different parts of the brain cool.

We wouldnt do this on a patient because it would be causing damage to a brain, Sparks explained. This is the only way we can get the information. Then he put the donated head in a Ziploc baggie and placed it in a waiting CT scanner.

* * *

Aeternitas Life, the company supplying donated heads to Oregon Cryonics, opened for business in December 2015, two and a half years after founder and president Fineas Lupeiu graduated from Portland State University at age 18. Now 22, Lupeiu runs one of four businesses licensed in Oregon to deal in whole body donations. (Oregon Cryonics is one toothe legal designation lets them directly accept bodies of people wishing to be cryopreserved.)

The companys name is a play on eternity, in the way an individual is able to live on, Lupeiu said by phone. I think its Latin or something.

The business has accepted more than 100 donors so far. Lupeiu handles all the bodies himself, equipped with a bachelors degree in general science and a year of work each at a body donation company and a transplant tissue bank. Definitely procuring tissue the first time, its kind of a weird experience, Lupeiu said. Its an amazing thing to hold a brain or a heart or a pair of lungs. The fascination takes over the weirdness of it fairly early on.

Aeternitas distinguishes itself from its two competitors in Oregon by accepting bodies the others wontpeople with obesity, for example, or with amputated limbs. As long as the donor had no communicable diseases, were able to accept basically anyone, Lupeiu said.

Sparks was one of his first clients. Lupeiu started following Oregon Cryonics in college and got in touch after launching his business. He is proud of Aeternitass relationship with Oregon Cryonics and its role in facilitating what he sees as valuable research on the brain. He was once able to provide Sparks with a head only a few hours after its former owner died. (The donor had registered in advance, which speeds up the process; otherwise, it takes a few days.)

There are two types of body donors: people who arrange to donate their own bodies in advance of their deaths, and those whose next of kin make those arrangements after death. The first kind actively seeks out a company like Aeternitas. The second hears about such businesses from hospices, funeral directors, or other providers Lupeiu has built relationships with.

There is a powerful incentive for families to go with body donation: companies pay for all expenses associated with the bodys transportation and cremation. The average cremation in the US costs $1,100. Given that two thirds of Americans say theyd have trouble coming up with $500 in cash in an emergency, its an expense for which many families are unprepared.

As to who gets the bodies: Aeternitass client approval process includes running a background check, looking at the businesss website, seeing if the researcher has published, and doing site inspections when possible, Lupeiu said. He has watched experiments at Oregon Cryonics himself and is satisfied that its the best use to which Aeternitas Life can put the brains in its inventory.

He tells donors and their families that bodies may be used for research on the preservation and structure of the brain. He does not say that the long-term goal of that research is cryopreservation, nor that the researcher has no formal training in neuroscience. We dont specifically mention the organization, he said. We dont feel that would be appropriate, just in terms of protecting the privacy of where the donation goes and protecting our clients.

Both he and Sparks declined to divulge the exact amount Lupeiu charges per head. Sparks said he pays in the high hundreds or low thousands of dollars for each specimen. Lupeiu concurred, saying each one was a few thousand. Alyssa Harrison at the AATB says thats in line with industry norm, but its hard to find anyone in the body-donation industry who will share specifics when it comes to costs. Even the otherwise forthcoming Harrison says politely but firmly that the figures body donation firms charge for their services are not publicly available.

The Uniform Anatomical Gift Act, first passed in 1968 and revised several times since, prohibits buying or selling human tissue in the US. The law reflects an instinctive revulsion to the idea commoditizing the human body, and its also meant to level the playing field of public health: if organs were priced according to market demand, only the rich could afford organs. It is legal, however, for procurers to charge recipients of human bodies or tissues a fee to cover expenses like transportation, cremation, staff time, and disease testing.

But if those expenses arent made public, and no auditing agency is making sure theres a legitimate relationship between expenses incurred and fees charged, the prohibition on charging for bodies is a totally meaningless regulation, said Todd Olson, a retired professor of anatomy at New York Citys Albert Einstein College of Medicine. In other words, human bodies and their parts exist in a curious economic space in the US: legally they are not allowed to have monetary value, but in practice they most certainly do.

To my knowledge, the United States is the only country that has seen the development of legal entrepreneurial ventures supplying cadavers for medical education and research, wrote Michel Anteby, an associate professor at Boston Universitys Questrom School of Business in a 2009 Economic Sociology article entitled A Market For Human Cadavers in All But Name? He went on:

Arguably, our grandparents, parents, and friends are not being traded on an open market Quite the contrary, US law ensures that sufficient protection is in place so that this could never happen. However, the ability to legally acquire a cadaver and reimburse a supplier for procuring costs is an important step in creating a market infrastructure. It is a market where the goods are not priced, but the services are.

As in any goods and services market, those with more money are at an advantage. Right now its the profit driving distribution, not the benefit to humanity, Olson said. I can tell you right now that there are medical schools across the country that are really unable to teach neuroanatomy because of the difficulty in acquiring human brains.

* * *

Legally, its sufficient for companies to tell donor families that their gifts can be used for any purpose, anywhere. Ethically, bioethicists and industry leaders say, thats not enough.

If a researcher has in mind something that a family probably wouldnt have imagined, its not adequate for the family to consent to doing, quote, anything, said Robert Veatch, a professor of medical ethics at Georgetown University. Since 1988 hes been on the board of the Washington Regional Transplant Consortium, which oversees all organ donations in the Washington, DC metropolitan area.

To most scientists, tissue is tissue is tissue. Families dont see it that way, Veatch said. Certain parts of the bodyheads, hands, and uteruses in particularhave emotional significance for donors that other parts dont, Veatch said. For consent to be meaningful, donors or their families should be specifically informed if those are going to be used. And if the nature of the research is unusual, donors or their families should know that too, Veatch said. Some people might object to cryonics on religious or other grounds. In the absence of government regulation, companies should take it upon themselves to make that information available, and not just to families who think to ask.

Harrison concurs. As an example, she says, her company doesnt currently provide donor bodies to the military for ballistics testingwhich is a real use for cadaversbut if it did, that would be in its donor contract. I feel like you should be as explicit as possible, she said. We use the words disarticulation and dismemberment because I want my families to be completely comfortable that your loved one will be dismembered for the purpose of education.

Aeternitas takes a less direct approach. Their donor contract is vague (pdf). While Lupeiu says he would provide more information to any family that asked directly, he has never told anyone in explicit terms that a donors head may be used to carry out experiments in cryonics. When describing specific procedures the body undergoes after donation, he prefers to use less direct terms: for example, appendages are recovered, not removed.

We stayed away from that type of language in our terms and conditions. The way that weve worded it is a lot softer than, say, Youre separating different parts of the body and such, Lupeiu explained. The companys terms state that the body may undergo extensive preparation and long-term preservation upon donation. The most graphic line about the process is: In most cases, an open casket viewing or embalming is not compatible with donation.

People who arrange to donate their own bodies tend to be more comfortable with an anything-goes approach and with explicit details of the process, several people in the industry said. But for families who choose to donate a loved ones bodya decision often made while stressed and grieving, potentially under financial pressureit can be distressing to learn the messy reality of donation after the fact. Veatch served as an expert witness in a 1998 trial in which a Florida mans family won a judgment against a tissue bank after the mans head was discovered in a local incinerator; the court agreed that the family had been inadequately informed about the way their loved ones body would be used.

The FDA tightened regulation of the transplant tissue industry in 2005 after several high-profile cases in which patients sickened and died after receiving bacteria-infected donor tissues. The agency waved off Quartzs questions about tissues donated for educational purposes, saying that donations not for therapeutic purposes are outside the agencys scope. But the thorniest questions in non-transplant donation are of ethics, not public health. This is part of the reason its so hard to regulate the industry, Harrison said. How much information should be offered up front, when families have such different levels of familiarity with the donation process and different levels of comfort with the details? What qualifies as an unorthodox use of the human body?

In the case of Oregon Cryonics, some potential donors might be tickled to learn that their brains or those of loved ones helped advance the remote possibility of life after death. Others might object, and others still indifferent. But most in the industry agree that, at the very least, they should have the choice.

* * *

Oregon Cryonics lab technician Laura Jackson opened a gray bucket and gently removed a mans head. The team shaves specimens upon arrival, and there was stubble on his cheeks and scalp. She lifted the head and placed it on a laboratory work surface, where it faced the front of the room with an expression between repose and surprise. With a scalpel and bone saw, Jackson methodically remove the scalp and skull to reveal the brain underneath. The pieces of bone dropped into a waiting trash can with the sound of seashells clinking in a bowl.

Once the brain was isolated, the remains of the mans head would be driven across town to an unlikely storage facility: the offices of Open Dental, where Sparks brother is now CEO. Sparks led me through rows of cubicles where 110 employees take tech support calls. He unlocked a door and we entered a high-ceilinged room housing a stainless steel vat of liquid nitrogen along one wall and a chest freezer on another.

The freezer contains stacks of gray buckets holding the excess skin, bones, and tissues of the donor heads. Stickers on the buckets indicate the donors identifying numbers. When the freezer is full, Sparks will take the contents to a local crematorium. Its standard procedure at Aeternitas Life and other body donation firms to return to the donors family the ashes of remains cremated once donated parts have been removed. Whoever ends up with those parts is responsible for cremating any other unused tissue, but they dont give those ashes to the families. Sparks hasnt decided yet where to scatter the ashes. Probably at a cemetery, he said.

The vats another story. It contains the deep-frozen brain of the only Oregon Cryonics patient who specifically wanted cryopreservation, for which his estate paid Sparks $25,000. Sparks used to keep the vat at Oregon Cryonics, he explained, but the building is wood-framed, and its a fire risk. Yes, the employees in his call center know whats on the other side of the door in their office, he said. But hes the only one with the key.

The man was registered with the Cryonics Institute in Michigan, but after he died suddenly at his home, his body was not discovered for several days. The Cryonics Institute would no longer take him. By the time the mans partner arranged to ship the brain to Salem, it had decomposed to the point where Sparks believes that, even if memory retrieval becomes a real thing, itll be impossible for this patient.

On the chance hes wrong, however, Sparks is honoring the mans wishes. The brain will stay where it is, in a stainless steel cooking pot in a vat of liquid nitrogen at a software companys call center, until a better future comes calling.

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There's a completely legal reason this American dentist has an office full of human heads - Quartz

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