Institute of Anatomy – Centre for Evolutionary Medicine Applied Ethics of Ancient Mummy Research: Historical and Theoretical Background Bettina M. Kreissl Lonfat, Niels Lynnerup*, Frank J. Rühli, and Ina M. Kaufmann * Laboratory of Biological Anthropology, Dpt. Of Forensic Medicine, University of Copenhagen, Denmark

Institute of Anatomy – Centre for Evolutionary Medicine Table of Contents I.The emergence of a problem II.Posthumous Harm III.Consequences

Institute of Anatomy – Centre for Evolutionary Medicine Emergence of a Problem o Applied Ethics of Mummy Research: a status o Evidence-based Mummy Research and medical research o The pressure point o Why “treat with respect and dignity” isn’t enough anymore

Institute of Anatomy – Centre for Evolutionary Medicine Applied Ethics of Mummy Research: a status Applied ethics: -defined as: examination of an issue of everyday or professional life from a moral or ethical standpoint or point of view -Has a lot of specialised branches: biomedical ethics, medical ethics, research ethics, ethics of decision-making etc. etc. A completely new field of interest: there is no applied ethics for evidence-based mummy research or research on historical human remains -Philosophical discourse has completely ignored the pressure that has been gradually mounting where invasive techniques ‘use’ human remains for evidence-based research (vs. utilitarism) -Outside of the precise setting of exhibiting or excavating human remains, there is no current discussion or discourse-driven realisation of the problem or solution- seeking

Institute of Anatomy – Centre for Evolutionary Medicine Evidence-based Mummy Research and medical research Research done on mummies and historical human remains is becoming more and more invasive -Probable status progression: the more precise scientific progress will get in terms of diagnostics, the more invasive it will get for mummy research -Probable consequence I: the more progress there is, the more concrete is the advantage and the possible gain for medical research and clinical application -Probable consequence II: the more immediate the clinical application is, the bigger the pressure to do evidence-based research on mummies and human remains

Institute of Anatomy – Centre for Evolutionary Medicine The pressure point The use of human remains in clinical, medical research: 1) Modern use: clearly regulated by a set of laws, rules and protocols -It is regulated what can be used, under what circumstance, when it can be used and what for and by whom 1 -Ex negativo: it is clearly regulated what cannot be used, what cannot be done and by whom 2 ) The use of historical human remains for clinical research is a fairly recent development -no regulations what they can be used for, by whom, and in what projects -Only rule from more descriptive sciences (such as anthropology): “treat respectfully and with dignity” 1 1 For instance guidelines by the Swiss Academy of Medical Sciences for body donations(2008) 2 Society for American Archaeology: Repatriation Policy (online); Principles of Archaeological Ethics (1995) – American Anthropological Association: Code of Ethics (2009) - International Council of Museums: Code of Ethics (2004) – British Association for Biological Anthropology and Osteoarchaeology: Ethics and Standards (online)

Institute of Anatomy – Centre for Evolutionary Medicine Why “treat with respect and dignity” isn’t enough anymore Status of applied ethics of research on human remains has remained at the level of the first initiatives of ethics in museums (ICOM 1 ) or excavation (BAOBA 2 ). Today mummies and human remains are used in invasive procedures such as bone-crushing for aDNA extraction or irradiation for radiological analyses. The medical diagnostic exposure and the physical destruction do constitute a harm that hasn’t existed before and therefore needs to be addressed differently. Postulate: there is something like posthumous harm. And it cannot be solved with already existing theoretical frameworks or ethical guidelines. 1 International Council of Museums: Code of Ethics (2004) 2 British Association for Biological Anthropology and Osteoarchaeology: Ethics and Standards (online)

Institute of Anatomy – Centre for Evolutionary Medicine Posthumous Harm o Posthumous harm o Bodily harm o Personal identity and why it matters o Posthumous interest

Institute of Anatomy – Centre for Evolutionary Medicine Posthumous harm The subject of posthumous harm is ongoing, but still underdeveloped in philosophy. Why? In philosophical anthropology, we start at the principle that a person only exists as long as it lives. If there is no physical basis in a body anymore, the person that once lived, is no more. So, if there is no person that could be the subject of any kind of harm, how can something like posthumous harm exist? For Kant 1 for instance posthumous harm can only ever be construed out of harm for the living and by extension be applied to the dead. Harm and thus posthumous harm can be dealt in two ways: a) against the bodily integrity of a person b) against their personal identity 1 The Metaphysical Elements of Ethics, Preface. 1783

Institute of Anatomy – Centre for Evolutionary Medicine Posthumous harm: a) Bodily integrity As defined by the Universal Declaration of Human Rights, The US Constitution, the International Covenant of Civil and Political Rights etc. and later formalised 1, the right to bodily integrity guarantees the integrity of a human body. -everyone has a right to decide over their own body (where to go, what to do etc.) -that nobody has the right to destroy that integrity or right. All cultures have a certain set of rules and guidelines when it comes to dealing with human remains and the bodily integrity of these remains. Postulate: willingly destroying, dismembering or using parts of a body of human remains does constitute a posthumous harm. 1 Cf. among others: Martha Nussbaum, Sex and Social Justice. Oxford UP, ; Women and Human Development: The Capabilities Approach (2000).

Institute of Anatomy – Centre for Evolutionary Medicine Posthumous harm: b) Personal identity and why it matters Personal identity: what makes the unity of a person from one point in time to another? Various answers from Stoics, Epicurus 1, Locke 2 to today 3 : –stages of continued existence o Bodily continuity (always the same body in time) o Continuous memory (memories as one constituting part of identity) One can stipulate a certain continuity of a person even after death either through collective memory (or through the preservation of their body). Thus, here posthumous harm can aim: o a person’s good name o their reputation o their secrets 1 Epicurus, Letter to Menoeceus, in Saunders, J., Ed., Greek and Roman Philosophy after Aristotle. 2 Essay on Human Understanding, Book II, XXVIII: On Identity and Diversity 3 Such as Bernard Williams, Problems of the Self (1973), Derek Parfit, Reasons and Persons (1984), Thomas Nagel, The View from Nowhere (1986), Sydney Shoemaker, Personal Identity (1984) etc.

Institute of Anatomy – Centre for Evolutionary Medicine Posthumous interest If we accept the concept of posthumous harm, then we must accept the concept of posthumous interest of a person. In the case of historical human remains, these posthumous interests are transferred to us (researchers, curators, stakeholders etc.) in the form of duties. These duties are directly derived from the fields of posthumous harm and the pressure point (absence of an ethical framework) o bodily integrity  unity of body, peace of death (i.e. protection of gravesites) o protection of personal identity  respect of reputation, name and history  patient rights today in a clinical setting

Institute of Anatomy – Centre for Evolutionary Medicine Consequences

Institute of Anatomy – Centre for Evolutionary Medicine Consequences Obligation to: o preserve and protect bodily integrity, personal identity whenever possible o reflect on posthumous harm, posthumous interests, invasiveness vs. appropriateness, stakeholders Outlook: o Formulation of a framework to further ethical discourse for research on historical human remains o Protect historical human remains as a research object o Protect current and future research on mummies and historical human remains

Institute of Anatomy – Centre for Evolutionary Medicine Acknowledgements Mäxi Foundation, Zürich