I had no better luck in a subsequent conversation with Mr. Howard C. Raether, executive secretary of the National Funeral Directors Association (to which the great majority of funeral directors belong), and Mr. Bruce Hotchkiss, vice president of that organization and himself a practicing undertaker. In this case, our conversation was recorded on tape. I asked what health hazard is presented by a dead body which has not been opened up, for purposes of either autopsy or embalming.
MR. RAETHER: Well, as an embalmer, Bruce, aren’t there certain discharges that come from the body without it having been opened up?
MR. HOTCHKISS: Yes, most assuredly from—orally—depending upon the mode or condition preceding death.
Then I asked, “Can you give any place, then, where the public health has been endangered—give us the place and the time?”
They could not. We talked around the point for several minutes, but these two leaders of an industry built on the embalming process were unable to produce a single fact to support their major justification for the procedure. I told them what Dr. Carr had said about embalming and public health. “Do you have any comment on that?” I asked. Mr. Raether answered, “No; but we can take a look-see and try to give you some instances.”
When the results of the look-see arrived, eight weeks later, in the form of an impressive-looking document titled “Public Health and Embalming,” I was surprised to find that it was the work not of a medical expert but of Mr. Raether (who is a lawyer) himself. The approach was curiously oblique:
I confronted some teachers in colleges of mortuary science with the opinion of your San Francisco pathologist that embalming in no way lessens the spread of communicable disease. Their first reaction was “who is he, what is his proof?” And, rightly so. Then they add that it is not contended embalming destroys all microbes.
What iscontended? We are not told. An authority is cited that seems vaguely irrelevant. It is recommended that I read Public Health in Boston, 1630– 1822; I am assured that the dean of the American Academy of Funeral Service “has documented proof,” but no further evidence is offered. This reminds me of the old trial lawyers’ maxim: “When the law is against you, argue the facts; when the facts are against you, argue the law; when the law and the facts are against you, give the opposing counsel hell.”
A health officer, in the single reference to a source outside the funeral industry, is quoted as advancing a startlingly novel argument for embalming. It is efficacious, he declares, not only from a public health standpoint but “from the standpoint of man’s ages-long concern with life after death,” a proposition that is hard to argue against.
The only specific information offered Mr. Raether by spokesmen for the National Funeral Directors Association (NFDA)—to support the contention that embalming has value as a sanitary measure—concerned “the procedures followed at the famous Mayo Clinic, where they have a standing rule that no autopsy shall be conducted on a body unless that body is embalmed—unless they need tissue immediately. This is a standing rule for the protection of doctors and pathologists who might be working with the body.”
Unversed though I am in the procedures of doctors and pathologists, this sounded very strange to me. I wrote to the clinic in question to ask if it was true. Their answer: “Unfortunately, it appears that Mr. Raether has been misinformed concerning the attitude of the Mayo Clinic toward the embalming of bodies. We have no rule which requires that bodies be embalmed before an autopsy is performed. It is true that frequently bodies are embalmed prior to the performance of an autopsy, but this is done more for the convenience of the funeral directors than because of any insistence on our part.”
Kenneth V. Iserson is a professor of surgery and director of the bioethics program at the Medical School of the University of Arizona. After twenty years in practice treating dying patients and counseling professionals and families about sudden death, he realized, when preparing an ethics paper on teaching with donated remains, that there were huge gaps in his knowledge about what happened to dead bodies. He was prompted to investigate, and the results of his exploration were published as Death to Dust: What Happens to Dead Bodies?(Galen Press, 1994).
Dr. Iserson’s massive, comprehensive volume is easily the best work on the subject that has appeared in recent years, and it is written with a fluency that makes it accessible to the lay reader as well as the professional.
He was initially stymied by what he felt was a cover-up by a funeral industry that systematically conceals its methods. He says now, in words which have a familiar ring to me, “At the time I was writing, I had to work with several Deep Throats.”
Like Dr. Carr, Dr. Iserson has no patience with the argument that embalming is necessary because of the health hazard posed by unembalmed bodies. He quotes with approval Dr. Carr’s discussion with me, adding that the Arizona Auditor General’s Office, in a review of funeral industry practices, concluded that “the public health risks associated with the disposal of human remains are minimal”; also, a Canadian health minister, “Embalming serves no useful purpose in preventing the transmission of communicable disease.”
The clincher for Dr. Iserson is the acknowledged failure of embalmers universally to apply measures for their own protection. If embalmers are not concerned about protecting themselves, he reasons, what message does that send to the public about the claim that embalming is necessary as a public health measure? The true purpose of embalming, he suggests, is to facilitate an open-casket funeral—with the emphasis on casket. Embalming, he suggests, is a procedure that boils down to sales and profits.
The only “authoritative” voice the industry has been able to produce in rebuttal belongs to one John Kroshus, identified only as having a connection with the University of Minnesota’s program of mortuary science. Mr. Kroshus is quoted in Funeral Monitor(April 1996) as denouncing “the book” (again a phrase familiar to me) by posing the question: “If embalming is taken out of the funeral, then viewing the body will also be lost. If viewing is lost, then the body itself will not be central to the funeral. If the body is taken out of the funeral, then what does the funeral director have to sell?”
I could not have put it better.
In a curious, perhaps inevitable, reversal, the decades spent persuading the public that embalming is a sound public health measure have come back to haunt the funeral folk. Angrily protesting new Occupational Safety and Health Administration (OSHA) regulations that end the practice of dumping bodily wastes and embalming fluids down drains or in Dumpsters, one mortician, according to Mortuary Management, ridiculed the “illogic of it all.” It seems, he claims, “that waste from dead people is now deemed to be more dangerous than that which comes from the living.” He goes on to protest that not one case of infection has been reported as resulting from the longstanding practice of dumping bodily wastes and embalming fluids down sewers.
If the public health benefits of embalming are elusive, ten times more so is the role of “grief therapy,” which is fast becoming a favorite with the funeral men. Trying to pin down the meaning of this phrase is like trying to pick up quicksilver with a fork, for it apparently has no meaning outside funeral trade circles. Although it sounds like a term picked up from the vocabulary of psychiatry, psychiatrists of whom I inquired were unable to enlighten me because they had never heard of it.
“Grief therapy” is most commonly used by funeral men to describe the mental and emotional solace which, they claim, is achieved for the bereaved family as a result of being able to “view” the embalmed and restored deceased.