Welcome to the Bioemporium

In 1974, the bioethicist and physician Willard Gaylin published an article in Harper’s with the unsettling title “Harvesting the Dead.” It had recently become possible to keep brain-dead patients on life support for extended periods so that their organs could be removed for transplantation. I use the words patients and life support, but as Gaylin pointed out, if a patient is brain-dead, it isn’t really a patient anymore. It is a cadaver on a ventilator. To distinguish these kinds of cadavers from the cold ones in the morgue, Gaylin proposed that we call them neomorts. And to distinguish a specialized unit used to house neomorts from ordinary hospital wards, he suggested the term bioemporium.

To Gaylin, it was clear that organ transplantation was saving lives. But why stop there? Look at all the hormones a neomort produces. Insulin, growth hormone, estrogen, testosterone—a neomort is a veritable hormone factory. Even better, consider how useful neomorts would be for medical training. Students could practice potentially embarrassing pelvic and rectal exams on neomorts, and surgical residents could use them as practice dummies for hernia repairs and limb amputations.

Neomorts are also ideally suited for medical research. Take, for example, Phase 1 drug trials, in which pharmaceutical researchers test the safety of an experimental drug by giving it to healthy subjects. Such trials are uncomfortable, lengthy, and potentially hazardous. Often the researchers push the dose higher and higher until the subjects start to experience side effects. But if researchers could use neomorts instead, they could administer as much of a drug as they wanted without worry, or even infect a neomort with a virus to test the cure. Researchers could poison neomorts and try out an antidote, administer a carcinogen and test a potentially toxic chemotherapy, or give them an experimental vaccine followed by a deadly infectious disease like Ebola or anthrax—all without endangering the life or health of a conscious subject.

Gaylin’s proposal never really took off: Medical students still practice pelvic exams on living patients, and drug safety is still tested on healthy, conscious subjects. Yet neither has the proposal entirely vanished. In 2021, a surgical team at NYU tested a genetically modified pig kidney by suturing it to the leg of a brain-dead research subject. Shortly afterward, another team of surgeons implanted two pig kidneys into the body of a brain-dead subject at the University of Alabama at Birmingham. Some bioethicists have suggested a similar experiment for childbirth. Noting that the bodies of pregnant women who are brain-dead or irreversibly comatose can be maintained for months before a child is delivered, Anna Smajdor has proposed that brain-dead cadavers could be artificially impregnated and used as gestational surrogates.

Whether Gaylin intended “Harvesting the Dead” as a serious plan or a modest proposal is unclear (he died in 2022 at age 97), but either way, his utilitarian logic is not easy to refute. When I raise his ideas at conferences or in seminars, the response is often an uneasy silence. Many people seem disturbed by the idea of impregnating a brain-dead body or using it to practice limb amputations, yet being able to explain their reactions is another matter. “This whole thing makes me feel squirrely,” they’ll say, “but I can’t really say why.”

Bioethicists often refer to such responses as the “yuck factor”: a gut feeling of disgust or repulsion that a proper philosophical education could put to rest. My diagnosis would be a little different. For me, the point at which each of Gaylin’s proposals feels unsettling is roughly the same point at which it starts to feel degrading. To be degraded is to be reduced in rank—to be lessened, diminished, or demeaned. Adults feel degraded when they are treated like children; workers feel degraded when they are treated like robots; patients feel degraded when they are treated like medical curiosities. Degradation doesn’t necessarily involve people. Sometimes objects are treated in a way that is degrading, such as when a grave is desecrated. The currency of degradation is disrespect. If it is possible to imagine someone or something as deserving of respect, it is usually possible to imagine it degraded when the proper respect is withheld.

Degradation takes many forms, but one of the most familiar ways to degrade something is to commodify it and bring it into the market sphere. This is part of the argument against prostitution, commercial surrogacy, and organ markets. When something is put up for sale—priced, advertised, perhaps discounted for a special summer blowout—it is being valued instrumentally, as a means of generating income. This may seem fine if the good in question is a mattress or a propane grill, but it seems degrading for the kind of good that ought to be valued for its own sake. This is one reason we have adoption agencies rather than baby markets: Treating children as property would threaten their status as human beings.

Degradation is one of a number of related English words—such as disgrace, dishonor, or debasement—that describe the variety of ways in which something or someone can be brought low. Unlike desecration or defilement, degradation doesn’t always imply that something sacred has been violated. Yet it does suggest the contamination or deterioration of a moral ideal. Like debasement, degradation sounds like a word from a 19th-century novel, perhaps in connection to an old-fashioned vice like drunkenness, gluttony, or sexual promiscuity. To say that a man has debased himself is to imply that he has lowered himself in a way that offends both morality and good taste. Often it suggests behavior that a person should be ashamed of, but isn’t.

Exactly what constitutes degrading treatment of a brain-dead body can be difficult to parse, not least because of the unusual position the corpse occupies in our culture. It is no longer a person, yet it is closely connected to one; it is not exactly property, yet it has instrumental value; it has deep personal meaning, yet from the moment of death it is handled completely by paid professionals working behind closed doors. Virtually every culture has developed ritualized ways of expressing respect for the dead body, but in ours the default setting for respect is whatever the individual wishes. Perhaps it will be possible to use brain-dead bodies instrumentally and preserve some measure of respect for them. But if past experience is any guide, our moral attitudes toward brain-dead bodies will be shaped less by conscious choice than by the forces of the market.

If you were a mortician in 1902, visiting Milwaukee for a meeting of the National Funeral Directors Association, you would have witnessed an early marvel of American embalming technology. His name was Bisga Man. Although Bisga Man had been dead for three months, he did not lie in a coffin. Instead, he sat upright in an ornate, high-backed chair: legs crossed, rigid as a pole, a newspaper folded in his lap. His blank stare and tweed jacket gave him the look of an anesthetized banker.

Bisga Man was the star feature in an exhibit of preserved human body parts intended to advertise Bisga Embalming Fluid, a product developed by two instructors at the Chicago College of Embalming. According to a report in The Casket, a trade journal for morticians, Bisga Man was “one of the most remarkable specimens of embalming ever produced in this country.” By “remarkable,” The Casket meant “remarkably lifelike.” If the purpose of embalming is to prepare a corpse to be seen, the promise of Bisga Embalming Fluid was to prepare it to be seen in an altogether new way: so pink and vivid that it no longer looked like a corpse. John Troyer, the former director of the Center for Death Studies at the University of Bath, has described the appearance of Bisga Man as “unnaturally alive,” a phrase that captures both the hyperreality of the embalmer’s art and the weirdness of posing a dead man in a wingback chair.

Bisga Man represented the culmination of a long technological arc. Until the mid-19th century, the job of disposing of dead bodies in America fell to family members and close friends. They would “lay out” the body, wash it, shave it if necessary, dress it in a shroud, and place it in a coffin, which was usually made by a local carpenter. The family would keep the body in the home for one to three days, often in a designated room such as the parlor, where there would be a vigil or wake.

That changed with the development of embalming. Prior to the Civil War, embalming was a medical technique mainly used to preserve cadavers for dissection. But in the 1860s, when an unprecedented number of young American men met their deaths on distant battlefields, embalming made it possible to preserve their bodies for the long journey home. Later it allowed funeral services to be delayed longer so that mourners could travel to the ceremonies. Of course, embalming also required skills and equipment that could be provided only by trained specialists. So by the early decades of the 20th century, the care of the corpse was no longer a ritualized family affair. It was a commercial endeavor conducted by professionals.

At the heart of this endeavor was the idea that the corpse should be publicly displayed. As Troyer points out, the invention of the daguerreotype in 1839 made possible the rise of “death photography,” allowing anyone to view a corpse at any time. Death photographers typically posed the deceased in a style and setting that suggested a deep sleep, an aesthetic later mimicked by morticians when mechanical embalming techniques allowed the body to be displayed for longer periods. By 1920, it was possible for a Boston mortician to advertise, “For composing features, $1. For giving the features a look of quiet resignation, $2. For giving the features the appearance of Christian hope and contentment, $5.”

Today, of course, paying a mortician to take care of a corpse seems no stranger than paying a nanny to take care of a child or paying a home-health aide to take care of an elderly parent. A task once seen as a moral duty and an expression of love has become commodified—a job to be outsourced to paid professionals. And although commodification may have come with social costs, most of us are satisfied with the trade-off. The death of a family member is a traumatic event that comes with a disconcerting array of social and legal expectations. Most people are glad that preparing the body for a funeral service is no longer among them.

How did the early funeral directors avoid the taint of commerce? They came to a simple but profound realization: Commerce can provide meaningful rituals of its own. Along with the new technology of embalming, for instance, came the ritual of viewing the body. A similar transformation took place with floral arrangements, coffins, cemetery plots, headstones, and hearses, all of which were monetized and incorporated into the formalized customs of the funeral. And whereas many people see funeral arrangements as expensive, even exploitative, nobody really argues that they are degrading. Just the opposite, in fact. Part of what people are buying from the funeral industry is a guarantee that the dead body will be treated with respect.

Yet once a good or practice has moved to the market sphere, it becomes subject to commercial norms. According to those norms, status often marches hand in hand with money. If you concede that it is morally acceptable to buy and sell sex, you also submit to a system in which visiting a high-priced escort at the Ritz-Carlton is superior to a 15-minute encounter in the alleyway behind a Greyhound station. So when it became possible to buy mortuary services, it was no surprise that expensive funerals soon became a status symbol and the inability to afford one became a mark of shame. That the tide seems to be turning back now with the middle-class preference for cremation and green funerals is less a rejection of the market than a predictable shift in consumer taste.

Such is the logic of consumer capitalism. Once we cross the boundary into the market sphere, it doesn’t take long for us to grow accustomed to our surroundings. Fashions change, and so do markers of status. Practices that once seemed degrading, profane, or disrespectful eventually come to seem ordinary. I can still remember the shock I felt in 1985 the first time I saw a credit card sign in a doctor’s office. Today pharmaceutical companies advertise their drugs on television, patients have been rebranded as “clients,” and entire medical schools are named for corporate executives. The notion that I was dismayed by any of this strikes my children as comically old-fashioned, as if I were a Victorian gentleman scandalized by modern bathing costumes.

Even this sense of shock can be monetized. Take, for instance, Body Worlds, the boundary-pushing science exhibit developed by the German anatomist Gunther von Hagens. Like Bisga Man, Body Worlds was made possible by a new technology—in this case, plastination, a process that replaces the fat and water in the body with plastics. The product is a hardened corpse that does not decay. Von Hagens displayed skinned, dissected corpses in poses intended to be entertaining and instructive: kicking a soccer ball, pirouetting like a ballerina, rearing up like the Lone Ranger on a giant dissected stallion. After opening in Tokyo in 1995, Body Worlds went on to break attendance records all over the globe.

Von Hagens marketed Body Worlds as the latter-day equivalent of a 19th-century medical museum: an educational science exhibit that would reveal the secrets of human anatomy to the general public. An ethics advisory committee called Body Worlds a “ground-breaking educational exhibition” and a “gold standard for the field.” But the real allure of the exhibit was the way it violated an invisible boundary between the sacred and the profane, promising visitors the frisson of seeing a dead body that was not lying in a casket. Von Hagens even posed some of the corpses in ways designed to get a laugh. One held his liver out in front of him, like a waiter holding a tray. Another looked like a flasher opening his raincoat: his torso butterflied like a chicken, a fedora perched on his head, his dissected genitalia dangling between his legs. In 2009, von Hagens introduced an exhibit in which two plastinated corpses were posed having sex in front of a mirrored wall.

In 1974, when Gaylin published “Harvesting the Dead,” the concept of brain death was only six years old. The criteria were formalized in 1968 by an ad hoc committee at Harvard Medical School. Yet even then the concept was intertwined with the need for transplantable organs. Surgeons had performed the first transplant from a brain-dead donor five years earlier. The Harvard committee declared that if someone’s brain is permanently nonfunctional, the person is “for all practical purposes” dead—even though the heart is beating, the hair is growing, and the subject may occasionally raise its arms and drop them across its chest, a reflex known as the “Lazarus Sign.”

The state of being “dead” and the state of being “dead for all practical purposes” are not quite the same thing; if they were, we wouldn’t need the term brain-dead. Yet the concept is critical for the support of organ transplantation. The Australian philosopher Peter Singer has famously called brain death “a concept so desirable in its consequences that it is unthinkable to give up, and so shaky on its foundations that it can scarcely be supported.” Noting the instrumental rationale for the concept, the anthropologist Margaret Lock has suggested that a more apt phrase would be as-good-as-dead.

Outside the culture of medicine, in which the concept of brain death is firmly established, the moral status of brain-dead bodies is not nearly so settled. For example, when a French doctor performed a nitrous oxide experiment on a brain-dead subject in 1988, he was vilified. ‘‘I find it revolting that in this country these types of experiments on human beings are considered,” the French minister of health said. A similar response greeted Anna Smajdor’s suggestion that brain-dead women could be artificially impregnated and used as gestational surrogates. Commentators found the proposal “outrageous,” “dehumanizing,” and “dystopian.”

To many people, brain death seems like a fate worse than death itself: the body trapped in a liminal state, not exactly alive but not exactly dead, suspended in a cool, sterile web of medical machinery. We are taught from an early age to treat other human beings with respect, and we have customs and rituals for the respectful treatment of the dead body. But how to treat the brain-dead body with respect remains a troubled question decades after the diagnosis was established. At least part of the reason is because we remain unsettled about the place of brain death within larger frameworks of meaning that extend beyond the language of individual rights and personal autonomy.

Two decades ago, a team led by the cultural psychologist Jonathan Haidt presented students at the University of Virginia with a series of hypothetical scenarios designed to test moral reasoning. In one scenario, a research assistant in a pathology lab sees a cadaver that is about to be cremated. Although the research assistant is a vegetarian who believes it is wrong to kill animals for food, she is disturbed by the thought of perfectly edible meat going to waste. So she cuts off a piece of muscle from the cadaver, takes it home, and cooks it for dinner. Haidt asked the students: Is there anything wrong with this?

Not many of the students were willing to defend cannibalism, yet they struggled to explain why it was wrong. They were just as puzzled by other hypothetical scenarios. In one, an adult brother and sister decide to have sex—only once, in secret, using birth control. In another, after a pet dog is accidentally killed, family members add its meat to a tasty stew and eat it for dinner. These actions struck the students as reprehensible in ways that they couldn’t easily express. As Haidt writes, the students were “rendered speechless by their inability to explain verbally what they knew intuitively.” Haidt calls this “moral dumbfounding.”

In most parts of the world, Haidt contends, morality can be mapped onto one of three axes: individualism, community, and divinity. Moral concepts such as rights, liberty, justice, and tolerance come from the ethic of individualism. The purpose of these concepts is to protect the interests of individuals as they pursue their needs and desires. Concepts such as duty, authority, and patriotism come from the ethic of community. These help preserve the social fabric by protecting collectives such as families, armies, and nations. But it is from the ethic of divinity that we get concepts such as desecration, defilement, and degradation. The ethic of divinity sees the person as a spiritual being who is connected to a sacred or natural order; living in accordance with these moral concepts maintains that order and protects the soul from being degraded. Often these notions are tied to rules regarding the body: eating, menstruation, sexual activity, and the treatment of the corpse.

The reason educated, liberal westerners are morally dumbfounded by Haidt’s scenarios is because many of us reason almost exclusively along a single axis: the ethic of individualism. On this axis, a moral violation typically involves cruelty, unfairness, or dishonesty. But violations such as cannibalism, bestiality, and incest are offenses against norms of purity or sanctity. To the extent that there is a moral problem with eating the flesh of a human corpse, it is that the act feels like a defilement, a violation of the respect a dead body should be accorded. There is a reason the term desecration is used in law to describe illicit interference with a dead body or a grave. The actions are transgressions against some notion of the sacred.

Although the word desecration suggests an offense against God, there are secular equivalents as well. Burning the American flag is sometimes described as desecration, especially by social conservatives. Many Americans on the left would feel a similar sense of violation if the Minnesota Boundary Waters were turned into an industrial waste site, or if a pharmaceutical company began using Martin Luther King Jr.’s “I Have a Dream” speech to market Ambien. Almost everyone has some institution, place, or figure for whom admiration borders on awe and reverence. I remember talking to an English friend who was offended by a comedy sketch making fun of David Bowie.

Often our reaction toward violations of sanctity or purity is not mere condemnation but disgust. We might denounce burglary and fraud, but we feel viscerally repulsed by necrophilia or child sex trafficking. Offenses against these norms seem to extend beyond wrongs to individual victims and to pollute society as a whole. Think, for example, of the collective impulse to destroy the houses where violent sex offenders have tortured and killed their victims, or when people say they need to take a shower after seeing or reading an account of an especially twisted crime. It is as if a moral stain must be removed before order can be restored.

What makes violations of sanctity or purity difficult to articulate and justify—at least for many of us in the West—is that they are no longer explicitly supported by any larger conceptual scaffolding. Words such as desecration and debasement sound archaic and prudish, even reactionary. Faced with a conflict between emotion and reason, many people feel that the only appropriate response is simply to change their minds and admit that their gut feelings were wrong. When one of Haidt’s interviewees was presented with the case of a man who has sex with a supermarket chicken before consuming it, he replied, “It’s his chicken, he’s eating it, nobody is getting hurt.” What the interviewee did not say (but may have felt) is that a man who has sex with a dead chicken has degraded himself, even if he enjoyed the experience.

Such judgments are a form of what the philosopher Charles Taylor calls “strong evaluation”—a judgment of better or worse (or higher or lower) that stands independent of one’s own tastes, desires, and preferences. It can be a narrowly moral judgment, such as condemning a practice as cruel or unfair, but it can also be much broader. To tell someone that he is wasting his life is not exactly a moral condemnation as typically understood, but neither is it a casual expression of personal preference. It appeals to a larger framework of meaning within which a human life can be judged a success or a failure.

It is within this larger framework of meaning that judgments about degradation get their purchase. Taylor calls it “spiritual”; others might prefer the term “existential.” Either way, it is the framework within which we might speak of a life as having meaning or purpose. To say that someone has degraded himself by having sex with a chicken carcass or eating the flesh of a cadaver is to make a judgment about the place of such actions in an admirable human life and the way such a life should end. No one’s rights have been violated when a dead body is displayed having sex, but to feel uneasy about the display is more than just a “yuck factor.” It is the sense that the bodies on display have been degraded, even if the reasons why are difficult to articulate.

“My attitude towards him is an attitude towards a soul. I am not of the opinion that he has a soul,” Ludwig Wittgenstein writes in The Philosophical Investigations (tr. by G. E. M. Anscombe). By an “attitude towards a soul,” Wittgenstein was referring to the stance that is implicit in our relationships with other human beings. Some aspects of this stance are explicitly moral—for example, the notion that other human beings have rights and that they are accountable for their actions. But other aspects are close to custom or habit, such as the idea that people should be addressed by name rather than a number, or that they should eat at a table rather than from a bowl on the floor, or that they deserve a funeral when they die. An attitude toward a soul is usually less a matter of conscious deliberation than the background for that deliberation. We simply take the attitude reflexively, in accordance with how we have been taught and what the situation seems to demand.

The premise of “Harvesting the Dead” is that we should take the same attitude toward a brain-dead body that we do toward a donated cadaver. Yet when Margaret Lock interviewed North American nurses, she found that not a single one was able to think of the brain-dead body as simply a cadaver. This was not because they had any difficulty accepting brain death as a diagnosis. Yet if they happened to be taking care of an unconscious patient who was later declared brain-dead, the declaration of death did little to change their attitudes. The anthropologist Lesley Sharp documented a similar dynamic at work in Strange Harvest, her ethnography of organ transplantation. According to Sharp, relatives of a brain-dead organ donor usually respond to the body of their loved one as if the person is still present, speaking to and caressing the body up until the moment when it is taken to surgery.

Contrast that with the bluntly instrumental attitude taken by employees of organ procurement organizations (OPOs), which are responsible for obtaining and evaluating organs for transplantation. According to Sharp, organ procurement specialists do not refer to donors as “patients” and rarely use a patient’s name. Instead, they simply say “he” or “she.”  Instead of “life support,” they use phrases like “mechanical support” and “artificial support.” They measure the quality of a brain-dead body by how many organs can be harvested, with the ideal being a “nine-organ donor.”

To see the body in such a starkly instrumental way is not the result of malice or ill will. Organ procurement is emotionally draining and demands enormous sensitivity. Its very nature makes the process extraordinarily difficult: a grieving family, the pressure of time, the brutality of organ and tissue retrieval itself. But there is no avoiding the fact that the brain-dead body is being used instrumentally as a source of salvageable parts. Many organ procurement specialists have to remind themselves that their work serves a larger social good.

OPOs take care to emphasize the altruistic nature of organ transplantation. Organs are “donated,” not sold; donors “give the gift of life.” Yet behind the language of altruism lies a very profitable business. In 2022, the global transplantation market was valued at $8.5 billion. And though there is no legal market in the United States for most human organs, the same is not true of human tissue—such as bone, cartilage, and eyes—which is collected and sold by tissue banks. In 2012, a National Public Radio investigation estimated the market value of a single human body at roughly $80,000 or more.

Unlike organ recovery, which is a skilled procedure performed by surgeons, human tissue is harvested by technicians using crude instruments like hammers and metal wedges. Tissue salvagers pull out the large bones from arms and legs and replace them with plastic or wooden pipes. They split open the chest to get to the heart valves, and they peel veins from the inside of the skin. To remove the skin, they use a dermatone, a specialized instrument that one salvager describes as “kind of a cross between a cheese grater and an electric razor.” Some companies offer their salvagers financial incentives and prizes for recovering as much tissue as possible. At one such company, called Allograft, this prize for skin recovery was known as “The Golden Dermatone.”

The sudden shift in attitudes—from seeing people as patients to seeing them as organ and tissue donors—can be hard for caregivers to navigate. Margaret Lock interviewed a Canadian physician who, as a resident in the 1970s, spent a morning trying to save the life of a young boy. When the boy was declared brain-dead, the physician was then required to assist the transplant team in opening the boy up and removing his organs. The doctor’s physical revulsion was so intense that he left the room and vomited. He described the experience as the worst moment of his medical career.

The notion of degradation typically depends on a hierarchy of value. In 1956, when the sociologist Harold Garfinkel introduced the concept of a “status degradation ceremony,” he had in mind rituals of public denunciation: stripping military officers of their rank, pronouncing a prison sentence on a convicted offender, having a security guard escort a fired employee out of a building. The purpose of such rituals is to express moral indignation. Yet that purpose can be fulfilled only if there is an agreed-upon status hierarchy within which the target of the ceremony can be lowered. When there is no shame in being fired, sentenced, or expelled, no status degradation will follow.

Hierarchies themselves are culturally and historically contingent. A marker of high status in one culture is a marker of low status in another; just compare the difference in how the elderly are revered in China or Japan with the way they are treated in the United States. Status can also change dramatically over time. The status of the clergy in Western cultures has declined over the past 200 years while that of scientists has risen. And when status hierarchies are flattened—as they were in the United States when legal rights were extended to women, racial minorities, and gay people—the degradation associated with crossing a boundary dissipates. Not so long ago, many white Americans saw school integration and interracial marriage as degrading. But when the status hierarchies associated with race began to crumble, what was once seen as degradation began to look like moral progress.

Despite its contingency, however, the feeling of violation that accompanies degradation can be profound. For an extreme example, consider the degrading ways in which American soldiers treated prisoners at Abu Ghraib prison during the war in Iraq: stripped naked and photographed, stacked in human pyramids, forced to simulate sexual acts. The force of degradation as an offense against human dignity was reflected in the deep sense of shame that many Americans felt when photographs of the Abu Ghraib prisoners were made public. It is for this reason that the Geneva Conventions prohibit not just torture and acts of cruelty but also “outrages upon personal dignity, in particular humiliating and degrading treatment.” This prohibition extends to the treatment of dead bodies, which the Geneva Conventions prohibit from being “mutilated” or “despoiled.”

The depth of such violations can be measured by the moral injury experienced by at least some of those who have engaged in it. In Achilles in Vietnam, the psychiatrist Jonathan Shay writes that American soldiers in Vietnam who desecrated corpses later struggled with those memories even more than they did with their exposure to combat. One soldier had intrusive memories every Christmas about “this dead [guy] we hung on a tree with a big banner that said ‘Merry Fucking Christmas.’ ” Another had flashbacks about mutilating a corpse. As much as the soldiers were haunted by the act of killing, they were haunted even more by dishonoring the bodies of the dead.

Soldiers who desecrate the corpse of an enemy do it to express their contempt. This brute fact separates the action morally from the damage that accompanies organ and tissue harvesting. Yet in the early days of transplantation, surgeons had to deal with the accusation that they were disrespecting the bodies of the dead. “To the butcher of Groote Schuur Hospital,” read a letter sent to Christiaan Barnard shortly after he performed the first heart transplant in Cape Town in 1967. The sheer success of transplantation has done much to change public attitudes, but so too has the development of practices that emphasize the higher moral purpose of organ harvesting while hiding its more mercenary aspects: walls of honor for those who volunteer, privacy protocols to shield the practices from public view, a vocabulary of altruism to obscure the financial stakes. In this way, the public’s understanding of organ harvesting has been transformed.

In Infinite Jest, David Foster Wallace imagines a dystopian future in which the government has sold naming rights for time, such that years have become known by the names of their corporate sponsors: “The Year of the Tucks Medicated Pad,” or “The Year of the Depend Adult Undergarment.” In 1996, that read as satire. Twenty years later, KFC paid a couple $11,000 to name their baby after Colonel Sanders, and an online casino gave a Utah woman $10,000 to have “GoldenPalace.com” tattooed on her forehead. Willard Gaylin’s neomorts may have sounded fantastical in 1974, yet we now live in a country where it is possible to order a human head on the Internet for $640.

If such a transformation in social attitudes could happen for organ harvesting, it could also happen for other uses of the body. If it did, the concept of the neomort would no doubt be accompanied by a set of customs and rituals designed to disguise and soften what occurred in the medical setting. The difficulty is predicting what would be lost. It is possible that future generations might look back on pre-neomort times with a sense of longing, in the way that we might remember an old-growth forest before it was turned into a golf course, or the way the characters in the 1973 film Soylent Green remember naturally grown vegetables. But it is also possible that they would see the changes as a reasonable sacrifice in light of the goods produced: risk-free drug testing, shame-free pelvic exams, more babies for those incapable of childbearing.

Nor is it impossible that a latter-day Gunther von Hagens might do for neomorts what was once done for plastinated corpses. Body Worlds for the brain-dead would walk the same thin line that von Hagens navigated in 1995: close enough to medical reality to produce a shiver, yet far enough away to feel safe. The faces of the neomorts could be obscured while their internal organs are displayed. Perhaps visitors could view the neomort’s digestive system through a porthole, like the “cannulated cow” at the Arkansas State Fair. Other exhibits might be interactive: Visitors could inject the neomort with epinephrine to increase the heart rate or diuretics to increase the production of urine. Critics will be shocked and scandalized, of course, but defenders will assure us we are seeing a landmark in educational instruction, the “gold standard” for the field. Over time, our objections will slowly fade into the past.