Medical specimens and the erasure of racial violence: the case of Harriet Cole.

This article analyses the complex narrative of Harriet Cole, a 36-year-old African-American woman whose body was delivered to the anatomy department of Hahnemann Medical School in 1888. The anatomist Rufus B Weaver used her preserved remains to create a singular anatomical specimen, an intact extraction of the 'cerebro-spinal nervous system'. Initially anonymised, deracialised and unsexed, the central nervous system specimen endured for decades before her identity as a working-class woman of colour was reunited with her remains. In the 1930s, media accounts began to circulate that Harriet Cole had bequeathed her remains to the anatomist, a claim that continues to circulate uncritically in the biomedical literature today. Although we conclude that this is likely a confabulation that erased the history of violence to her autonomy and her dead body, the rhetorical possibility that Harriet Cole might have chosen to donate her body to the medical school reflects the racial, political and legal dimensions that influenced how and why the story of Harriet Cole's 'gift' served multiple purposes in the century and a half since her death.

Rest in Pieces: Body Donation in Mid-Twentieth Century America.

By the mid-1950s, formal body donation programs began to supplant the decades-long reliance on the anatomy acts that made the bodies of the indigent and unclaimed available for medical education and research. By the mid-1980s, nearly all American medical schools relied on voluntary anatomical gifts of dead bodies. Throughout the nineteenth century, a handful of Americans requested through wills, letters, and suicide notes that their corpses be given to doctors and medical schools. The dramatic expansion of American newspapers after the Civil War helped establish bequeathing one's body as an available, albeit eccentric, afterlife. A significant shift in American deathways in the twentieth century, the rise of blood donation and organ transplantation, and a serious decline in the number of unclaimed bodies spurred anatomists finally to accept, and then to promote, this new corporeal philanthropy.

Living Donors and the Issue of "Informed Consent".

This essay considers the issue of informed consent as it arose in the context of 1960s living kidney donors. In one of the earliest empirical inquiries into informed consent, psychiatrists Carl H. Fellner and John R. Marshall interviewed donors about their decision-making process and their experience and reflections on donorship. In their much-cited 1970 paper, the physicians reported that living donors, rather than reaching a reasoned, intellectual, and unemotional decision about donating a kidney (as stipulated in the Ethical Guidelines for Organ Transplantation issued by the American Medical Association's Judicial Council), instead made instantaneous and "irrational" decisions about participation. Fellner and Marshall's studies contributed to the public debate and professional discussion about the moral and ethical dimensions of donorship, even as they challenged the developing consensus on informed consent.

African-Americans with End Stage Renal Disease in the Early Years of Kidney Transplantation.

INTRODUCTION: The first successful kidney transplant in humans was performed in 1954. In the following 25 years, the biomedical, ethical, and social implications of kidney transplantation were widely discussed by both healthcare professionals and the public. Issues relating to race, however, were not commonly addressed, representing a "blind spot" regarding racial disparities in access and health outcomes. METHODS: Through primary sources in the medical literature and lay press, this paper explores the racial dynamics of kidney transplantation in the 1950-1970s in the United States as the procedure grew from an experimental procedure to the standard of care for patients in end-stage renal disease (ESRD). RESULTS & DISCUSSION: An extensive search of the medical literature found very few papers about ESRD, dialysis, or renal transplant that mentioned the race of the patients before 1975. While the search did not reveal whether race was explicitly used in determining patient access to dialysis or transplant, the scant data that exist show that African-Americans disproportionately developed ESRD and were underrepresented in these early treatment populations. Transplant outcome data in the United States failed to include race demographics until the late 1970s. The Social Security Act of 1972 (PL 92-603) extended Medicare coverage to almost all Americans with ESRD and led to a rapid increase in both dialysis and kidney transplantation for African-Americans in ESRD, but disparities persist today.

Caution in interpreting FTIR/ATR spectral intensity values.

We discuss and demonstrate why FTIR/ATR spectra can only be calibrated in wavelength, not intensity, for comparison with other data sets at present. This is because the intensity calibration must remove the instrument response function. To address this problem, we suggest a possible approach.

Seven temperate terrestrial planets around the nearby ultracool dwarf star TRAPPIST-1.

One aim of modern astronomy is to detect temperate, Earth-like exoplanets that are well suited for atmospheric characterization. Recently, three Earth-sized planets were detected that transit (that is, pass in front of) a star with a mass just eight per cent that of the Sun, located 12 parsecs away. The transiting configuration of these planets, combined with the Jupiter-like size of their host star-named TRAPPIST-1-makes possible in-depth studies of their atmospheric properties with present-day and future astronomical facilities. Here we report the results of a photometric monitoring campaign of that star from the ground and space. Our observations reveal that at least seven planets with sizes and masses similar to those of Earth revolve around TRAPPIST-1. The six inner planets form a near-resonant chain, such that their orbital periods (1.51, 2.42, 4.04, 6.06, 9.1 and 12.35 days) are near-ratios of small integers. This architecture suggests that the planets formed farther from the star and migrated inwards. Moreover, the seven planets have equilibrium temperatures low enough to make possible the presence of liquid water on their surfaces.

"Ethics and Clinical Research" in Biographical Perspective.

Henry K. Beecher (1904-1976) played an important role in the development of bioethics. His 1966 article "Ethics and Clinical Research" in the New England Journal of Medicine intensified concern about the welfare of patients participating in clinical research, and his leadership in the 1968 Harvard Ad Hoc Committee on Brain Death redefined the determination of death. Beecher deserves, and even demands, explanation and explication. This essay offers a biographical perspective on the Harvard professor. In addition to his early life and education in both Kansas and Boston, the essay explores how Beecher's experiences in World War II and in the new geopolitical realities of the Cold War shaped his views about the ethical dilemmas of clinical research.

A combined transmission spectrum of the Earth-sized exoplanets TRAPPIST-1 b and c.

Three Earth-sized exoplanets were recently discovered close to the habitable zone of the nearby ultracool dwarf star TRAPPIST-1 (ref. 3). The nature of these planets has yet to be determined, as their masses remain unmeasured and no observational constraint is available for the planetary population surrounding ultracool dwarfs, of which the TRAPPIST-1 planets are the first transiting example. Theoretical predictions span the entire atmospheric range, from depleted to extended hydrogen-dominated atmospheres. Here we report observations of the combined transmission spectrum of the two inner planets during their simultaneous transits on 4 May 2016. The lack of features in the combined spectrum rules out cloud-free hydrogen-dominated atmospheres for each planet at ≥10σ levels; TRAPPIST-1 b and c are therefore unlikely to have an extended gas envelope as they occupy a region of parameter space in which high-altitude cloud/haze formation is not expected to be significant for hydrogen-dominated atmospheres. Many denser atmospheres remain consistent with the featureless transmission spectrum-from a cloud-free water-vapour atmosphere to a Venus-like one.

Temperate Earth-sized planets transiting a nearby ultracool dwarf star.

Star-like objects with effective temperatures of less than 2,700 kelvin are referred to as 'ultracool dwarfs'. This heterogeneous group includes stars of extremely low mass as well as brown dwarfs (substellar objects not massive enough to sustain hydrogen fusion), and represents about 15 per cent of the population of astronomical objects near the Sun. Core-accretion theory predicts that, given the small masses of these ultracool dwarfs, and the small sizes of their protoplanetary disks, there should be a large but hitherto undetected population of terrestrial planets orbiting them--ranging from metal-rich Mercury-sized planets to more hospitable volatile-rich Earth-sized planets. Here we report observations of three short-period Earth-sized planets transiting an ultracool dwarf star only 12 parsecs away. The inner two planets receive four times and two times the irradiation of Earth, respectively, placing them close to the inner edge of the habitable zone of the star. Our data suggest that 11 orbits remain possible for the third planet, the most likely resulting in irradiation significantly less than that received by Earth. The infrared brightness of the host star, combined with its Jupiter-like size, offers the possibility of thoroughly characterizing the components of this nearby planetary system.

Transforming educational accountability in medical ethics and humanities education toward professionalism.

Effectively developing professionalism requires a programmatic view on how medical ethics and humanities should be incorporated into an educational continuum that begins in premedical studies, stretches across medical school and residency, and is sustained throughout one's practice. The Project to Rebalance and Integrate Medical Education National Conference on Medical Ethics and Humanities in Medical Education (May 2012) invited representatives from the three major medical education and accreditation organizations to engage with an expert panel of nationally known medical educators in ethics, history, literature, and the visual arts. This article, based on the views of these representatives and their respondents, offers a future-tense account of how professionalism can be incorporated into medical education.The themes that are emphasized herein include the need to respond to four issues. The first theme highlights how ethics and humanities can provide a response to the dissonance that occurs in current health care delivery. The second theme focuses on how to facilitate preprofessional readiness for applicants through reform of the medical school admission process. The third theme emphasizes the importance of integrating ethics and humanities into the medical school administrative structure. The fourth theme underscores how outcomes-based assessment should reflect developmental milestones for professional attributes and conduct. The participants emphasized that ethics and humanities-based knowledge, skills, and conduct that promote professionalism should be taught with accountability, flexibility, and the premise that all these traits are essential to the formation of a modern professional physician.

Let the dead teach the living: the rise of body bequeathal in 20th-century America.

America's medical schools have long used human cadavers to teach anatomy, but acquiring adequate numbers of bodies for dissection has always been a challenge. Physicians and medical students of the 18th and 19th centuries often resorted to robbing graves, and this history has been extensively examined. Less studied, however, is the history of body acquisition in the 20th century, and this article evaluates the factors that coalesced to transition American society from body theft to body donation. First, it describes the legislation that released the unclaimed bodies of those dying in public institutions to medical schools for dissection, thereby effectively ending grave robbery. Then it discusses midcentury journalistic exposés of excesses in the funeral industry-works that were instrumental in bringing alternatives, including the previously unpopular option of body donation, to public consciousness. Finally, it examines the rise of body transplantation, the Uniform Anatomical Gifts Act of 1968, and the subsequent state of willed-body programs at the turn of the 21st century. Body-donation programs have gradually stabilized since and currently provide most of the bodies used for dissection in American medical schools. Relying as they do on public trust, however, these programs remain potentially precarious and threatened by public scandals. Whether American medical schools will receive enough bodies to properly educate students in the future remains to be seen.