Ethical futures in biological anthropology: Research, teaching, community engagement, and curation involving deceased individuals.

Although ethical reforms in biological anthropology have gained ground in recent years, there is still a scarcity of ethical standards for work involving historical documented collections (HDCs) at US museums and universities. These collections of deceased individuals were created in the late 19th to mid-20th centuries under anatomy laws that targeted socially marginalized communities and allowed for the dissection of these individuals without their consent. Due to the extensive information associated with the individuals and made available to researchers, these collections have served as foundational resources for theory and methods development in biological anthropology into the 21st century. Recognizing the need for ethical guidelines for research, teaching and training, community engagement, and curation involving HDCs, we held a workshop called "Ethical Futures for Curation, Research, and Teaching in Biological Anthropology" on November 15-17, 2021. Here we summarize the conversations and major points of consensus among the workshop participants on these topics in order to advance these ethical considerations more broadly across the field.

American Association for Anatomy recommendations for the management of legacy anatomical collections.

Collections of human remains in scientific and private institutions have a long tradition, though throughout history there has often been variable regard for the respect and dignity that these tissues demand. Recent public scandals around the use of human remains, coupled with an increasing community awareness around accountability in such instances, forces scholars to confront the ethical and moral concerns associated with these collections. This includes specific focus on the acquisition, storage, use, and disposition of these remains, which were often collected with no consent and with little knowledge, or concern, about the individual or their respective culture and practices surrounding death and postmortem treatment. As a response, the American Association for Anatomy convened a Legacy Anatomical Collections Task Force to consider these issues and to develop recommendations to assist those working with these tissues in education, research, and museum collections. This has culminated with the development of Recommendations for the Management of Legacy Anatomical Collections. The recommendations provide both an ethical foundation and practical considerations for the use, storage, and disposition of legacy collections of human tissues, and deliver guidance for establishing appropriate management and oversight, investigating provenance, and engaging with communities of care. While these Recommendations are considered a living document which will change over time as ethical principles concerning human tissue evolve, they currently represent 'best practice' recommendations that can guide researchers, teachers, and museum associates as they consider the future of legacy anatomical collections in their care.

Structural violence and institutionalized individuals: A paleopathological perspective on a continuing issue.

Past and present institutions (e.g., state and public hospitals, assisted living facilities, public nursing homes) have struggled with structural issues tied to patient care and neglect, which often manifests in the form of fracture trauma, and may explain why institutionalized individuals are at higher risk for this injury. Six hundred individuals from the Robert J. Terry Anatomical Collection born between 1822-1877 were examined to investigate hip fracture prevalence. Analysis of associated records and documentary data, including death, morgue, and census records, revealed that 36.3% (n = 218) of these individuals died in institutions such as the St. Louis State Hospital, City Infirmary, and Missouri State Hospital No. 4. Of the institutionalized individuals, 4.3% had evidence of hip fracture, significantly higher than the non-institutionalized (2.3%). Records revealed that many hip fractures were suffered around the time of death in state hospitals and were preventable, resulting from structural issues tied to understaffing and underfunding. Forensic and clinical literature, as well as current news media, indicate that structural violence in the forms of underfunding and understaffing continues to manifest as hip fractures harming institutionalized individuals today. This paper demonstrates how an anthropological perspective using paleopathological analysis sheds light on the chronicity and time depth of this issue, with the aim of driving public policy to entrench the equitable care of institutionalized people as a human right.

Twenty-first century bioarchaeology: Taking stock and moving forward.

This article presents outcomes from a Workshop entitled "Bioarchaeology: Taking Stock and Moving Forward," which was held at Arizona State University (ASU) on March 6-8, 2020. Funded by the National Science Foundation (NSF), the School of Human Evolution and Social Change (ASU), and the Center for Bioarchaeological Research (CBR, ASU), the Workshop's overall goal was to explore reasons why research proposals submitted by bioarchaeologists, both graduate students and established scholars, fared disproportionately poorly within recent NSF Anthropology Program competitions and to offer advice for increasing success. Therefore, this Workshop comprised 43 international scholars and four advanced graduate students with a history of successful grant acquisition, primarily from the United States. Ultimately, we focused on two related aims: (1) best practices for improving research designs and training and (2) evaluating topics of contemporary significance that reverberate through history and beyond as promising trajectories for bioarchaeological research. Among the former were contextual grounding, research question/hypothesis generation, statistical procedures appropriate for small samples and mixed qualitative/quantitative data, the salience of Bayesian methods, and training program content. Topical foci included ethics, social inequality, identity (including intersectionality), climate change, migration, violence, epidemic disease, adaptability/plasticity, the osteological paradox, and the developmental origins of health and disease. Given the profound changes required globally to address decolonization in the 21st century, this concern also entered many formal and informal discussions.

Intersectionality and trauma analysis in bioarchaeology.

Intersectionality, the theory named by Kimberlé Crenshaw, outlines how multiple elements of an individual's social identity overlap to create and preserve societal inequalities and discrimination. Recently bioarchaeology's engagement with intersectionality has become increasingly explicit, as the field recognizes the lived experience of multiple axes of an individual's identity. Evidence of trauma can remain observable in an individual's skeleton for years, making it an ideal subject of study for intersectional analyses in bioarchaeology. Using contrasting case studies of two individuals who died in hospitals and were unclaimed after death, we explore the theoretical and methodological application of intersectionality to investigations of accidental and interpersonal trauma. Differences in identities and structural inequalities affect bone quality and health outcomes. As we demonstrate, a broken bone is the intersecting result of biological, histomorphological, sociocultural, and behavioral factors. This approach allows for a better acknowledgement of the inherent complexity of past lives, elevating and amplifying previously silenced voices. In this way, intersectionality in bioarchaeology demands social justice.

Osteoporosis, osteomalacia, and hip fracture: A case study from the Terry collection.

OBJECTIVE: This case study describes a perimortem hip fracture in a documented individual from the Robert J. Terry Skeletal Collection. The purpose of this paper is to comprehend how co-occurring conditions contributed to fracture risk and to understand the effect of the injury on this individual. MATERIALS AND METHODS: A 73-year-old female from the Terry Collection with a fracture of the left proximal femur was assessed macroscopically, and images were taken with a Keyence VHX-2000 digital microscope. Documentation concerning the individual's history and contemporary treatment of hip fractures was explored. RESULTS: Assessment demonstrated impaction of fractured elements occurred as a result of the inferior displacement of the femoral head into the femoral neck. Eburnation and hinge fractures are present on the fracture margins. Bending deformities of the sacrum, sternum, and ribs indicate underlying osteomalacia. No evidence of surgical intervention was observed. CONCLUSIONS: Both osteomalacia and osteoporosis contributed to overall fracture risk in this case, which demonstrates how complex underlying factors can interact to increase the probability of fracture, and influence post-fracture mortality. SIGNIFICANCE: This report is the first case study, to date, of a healing hip fracture in which the circumstances of the fracture and the medical history of the individual are known. LIMITATIONS: To fully investigate osteoporosis, bone mineral density for this individual should be compared with others in the collection. SUGGESTIONS FOR FURTHER RESEARCH: The effect of co-occurring conditions on fracture risk should be explored in the wider Terry Collection, and in other skeletal collections.

Perimortem fracture manifestations and mortality after hip fracture in a documented skeletal series.

OBJECTIVE: Unhealed hip fractures are underrepresented in the archaeological record, suggesting that better identification criteria are required. This paper evaluates whether a sample of documented perimortem hip fractures displayed classic perimortem features and which features may facilitate better identification of such fractures in the archaeological record. MATERIALS: Ten individuals from the Robert J. Terry Anatomical Skeletal Collection with documented hip fractures and intervals of survival. METHODS: We observed the skeletal remains macroscopically and with a Keyence VHX-2000 digital microscope at a range of 5x to 100x magnification. RESULTS: 90% of the individuals and 64% of the fragments had identifiable perimortem features; hinging was the most consistent feature. Eburnation was found in two individuals who died 13 days after sustaining a hip fracture. CONCLUSIONS: This study underscores the importance of examining fracture margins for evidence of hinging. Eburnation may be added to the list of potential perimortem fracture identification criteria. SIGNIFICANCE: Identifying perimortem trauma unequivocally remains challenging. Using collections with documented perimortem fractures aids in determining which criteria are most likely to appear in archaeological human bone. LIMITATIONS: The fracture location patterning (70% intertrochanteric) may be the result of sample selection. SUGGESTIONS FOR FUTURE RESEARCH: Further intensive comparative investigation with the Hamann-Todd Collection would elucidate patterns further.

Patterns of trauma and violence in 19th-century-born African American and Euro-American females.

Trauma and violence has been a topic of interest to biological anthropologists. This study examined the presence of trauma, including interpersonal violence, in a sample (n=256) of African American and Euro-American females of low socioeconomic status, born from 1800 to 1877, from the Terry Collection. Individuals were statistically analyzed according to ancestry (African American and Euro-American), birth (Antebellum, Civil War, Reconstruction), and birth status (Enslaved Black, Pre-Reconstruction White, Liberated Black, Reconstruction White) cohorts to determine if differences in trauma and fracture patterning existed between African Americans and Euro-Americans. Results indicated that there were significant differences. African American females had higher rates of cranial, nasal, and hand phalanx trauma and Euro-Americans had larger frequencies of hip and radial fractures. This variation in fracture patterning could have been the result of intimate partner violence, interpersonal violence, osteoporosis, or accidental injury. Historical research revealed that many of these women were inmates in mental hospitals, further suggesting that the observed trauma may have been the result of interpersonal and structural violence induced by institutionalization.

Race, health, and disease in 19th-century-born males.

This study analyzed skeletal health disparities among African American and Euro-American males of low socioeconomic status born between 1825 and 1877. A total of 651 skeletons from the Cobb, Hamann-Todd, and Terry anatomical collections were macroscopically examined for skeletal pathologies related to dietary deficiencies and disease. Individuals were separated into age, ancestry, birth (Antebellum, Civil War, Pre-Reconstruction, and Reconstruction), combined ancestry/birth, enslaved versus liberated, and collection cohorts. These groups were statistically evaluated using ANOVA and χ(2) analyses to determine if age, ethnic, and temporal differences existed. Results indicated that African Americans, especially those born during Reconstruction, had significantly higher frequencies of tuberculosis (P = 0.004) and treponematosis (P = 0.006) than Euro-Americans. Historical sources are important in contextualizing why these different ethnic and temporal patterns were present, pointing to environmental conditions related to enslavement, postliberation migration to the industrialized North, crowded urban living conditions, and poor sanitation.

Cultural patterns of trauma among 19th-century-born males in cadaver collections.

Comprehending violence among bioarchaeological and historical groups is a topic of recent interest among biological anthropologists. This research examines trauma among African American and Euro-American males of low socioeconomic status born between 1825 and 1877. A total of 651 male skeletons from the Cobb, Terry, and Hamann-Todd anatomical collections were macroscopically evaluated for skeletal trauma, based on the presence of fractures and weapon-related wounds, and statistically analyzed according to ancestry, birth (Antebellum, Civil War, Reconstruction), combined ancestry - birth, and collection cohorts. Results indicated that African Americans and Euro-Americans expressed ethnic differences in regard to interpersonal violence. To interpret these disparities, documentary data were used to reconstruct the socioeconomic and cultural environment of these individuals. This research emphasizes the importance of evaluating skeletal data within the context of class, culture, and environment so that behavioral patterns observed in the skeleton can be better understood.