I am a long distance runner, a sport which often simulates conversation with other runners during gruelling training sessions past Fort Klapperkop and around the hills of Waterkloof and Groenkloof in South Africa. Too often, a stranger asks me the ill-fated and often uncomfortable question of “so, what do you do for a living?”
I am likely to reply that “I am an anthropologist”. The word, itself, conjures up thoughts in their heads of long-forgotten Amazonian tribes; the Eskimos more than a thousand words for snow; buried treasure and ancient skeletal remains. If pressed further from my well-meaning sporting colleagues, I admit that I do not engage with tribal groups or buried treasure, but that I focus on understanding skeletal variation among modern human populations, particularly South Africans, for the purposes of establishing a presumptive identification of an unknown person. Immediately my colleague understands, “oh, like the TV show Bones.” “Yes”, I reply grimacing, “just like Bones.”
South Africa isn’t like the TV show Bones, or anything near it. Our country is currently facing a humanitarian crisis with approximately 1300 unknown persons incinerated each year in Gauteng, alone (Wild 2017). The situation needs leadership and management from all areas of the forensic sciences, including anthropology, but so far, neither academic disciplines nor police services have been able to navigate this uncharted territory of missing persons and unidentified skeletal remains. To date, our institution (University of Pretoria) has an archival collection of skeletal remains from at least 600 unidentified persons, with a growth of approximately 20 to 30 people a year.
In order to address capacity building for research in South Africa with the intent of improving circumstances surrounding unidentified persons, my colleague and I decided to apply for an EU grant (Erasmus+) with various other HEI’s and the Nuclear Energy Corporation of South Africa (Necsa). The aim of our project was to develop and create a digital repository of human skeletal remains for the purposes of internationalizing research and teaching in South Africa. If we can advance our research, we may be able to improve on our methods for establishing biological profiles and facial approximations which will eventually contribute to improvements in the identification of the deceased. In 2018, we learned that we were awarded almost a million euros for our proposed project. As project-coordinator of this grant, I now find myself within a new discipline - management - which has its own set of rules and guidelines. I am no longer just an anthropologist addressing morphological features from skeletal remains to improve identification. I am an anthropologist who manages a large consortium of people both nationally and internationally and has to successfully account for a million euros. No stress.
Prior to receiving this grant, the only experience with management that I had was with monthly staff section meetings, development of performance guidelines for staff, and in establishing MOU’s with postgraduate students. Now, I have to manage projects, deadlines and of all things, the mine fields of opinions and legislation surrounding the ethical use of human remains in research and teaching, and even more importantly the use of 3D imaging of human remains within a discipline.
South Africa has a history of bioethics violations under the Apartheid government, with the death of Steve Biko in 1977 being most often cited as both an issue of medical malpractice and a human rights abuse (Behren 2013). In the early 20th century, trade in human skeletal remains to Europe, particularly those of Khoesan people, is a well-known fact, with local historians demanding repatriation of all Khoesan skeletal remains in South African museums and from overseas (Legassick & Rassol 2000). On the opposite end of this spectrum are scientists who claim the need to study human skeletal remains, as bones provide us with the means to understand population history, diet, and above all, human variation, and its changes over time (Sealy 2003). Human variation, for example, can contribute to understanding difference among population groups for a multitude of purposes from assisting in the identification of unknown remains to the development correctly fitted prosthetics for South Africans.
From the literature, we can find an ethical compromise with historic skeletal remains in the United States, but which can also be associated with modern persons, in the World Archaeology Congress of 1989 in Vermillion, South Dakota, known as the Vermillion Accord (Turnbull 2014; Sealy 2003). In this document, six ethical principles were decided upon and include the need to respect: mortal remains; wishes of the dead concerning their disposal; local community and relatives/guardians of the dead; and the scientific value of research of these remains. The final resting place of these remains, whether burial or collections, shall be negotiated among communities, science and education, with an equal validity for all concerns (Turnbull 2014; Sealy 2003).
The Vermillion Accord addresses tangible skeletal remains, but says nothing about the transformation of these remains into 3D digital images, as images can reflect the size and morphology of skeletal elements, but they are only a copy of physical bony elements. Modern literature provides a milieu of problems with digital data of archaeological remains, particularly with regard to ownership and distribution, as well as ethical issues of 3D printing of skeletal elements (e.g., Cornwall 2016; Hassett 2018). While much of the early research points out pitfalls and problems with distributing digital images of skeletal remains, no clear guidelines have been created for going forward with such digital repositories in Europe, Australia or North America. Our research grant is the first of its kind to address these issues in South Africa, and within the current popularity of bioprinting body parts for use in medicine (Vijayavenkataraman et al. 2016).
In South Africa, the National Health Act 61 of 2003 (Ch 8 (62-63)) is fairly clear on the use of whole body donations, including skeletal remains, to designated authorities such as hospitals, medical schools and medical practitioners. Designated institutions can receive whole body donations for the purposes of education and research (section 63). Additionally, the Director-General may also donate an unclaimed person after sufficient time has been spent to locate next of kin to a designated authority (section 62.3a). However, no ethical guidelines are set out for the use of images (2D or 3D) of human remains in either education or research. For example, while it may seem distasteful, University students can take a “selfie” with their favourite skeleton or cadaver during class and post it on social media, as it is both ethical, under our current rules, and legal, but clearly not professional. In the classroom, the facilitator has to decide for their subject what the best course of action is as images, particularly 3D images, can be useful in learning. However, the facilitator has to guide the student as to the correct use of these images for that purpose, and currently no clear guidelines exist to assist them with making these decisions. Most facilitators collectively and instinctively say no to taking images of skeletal remains for any purpose, which may, in the long run, affect the student’s learning potential.
The same applies for research, the 3D image of a cranium is not the mortal remains of a cranium, which is housed within a skeletal collection at a medical school in South Africa. As biological anthropology and other disciplines begin to expand into 3D research on skeletal remains, both living and dead, we need to collectively discuss and decide on a suite of ethical foundations for how to handle images of death, the dead, and their mortal remains. With advice from bioethics professionals and legal representations, the development of an ethics constitution in 3D image in South Africa is a central theme of our Bakeng se Afrika project. We encourage any and all opinions, experiences and current approaches in ethics as we dive into the rabbit hole of human rights and ethics in South Africa.
References
Behren, K.G. 2013. Towards an indigenous African bioethics. South African Journal of Bioethics and Law 6(1): 32-35. [link]
Cornwall, J. 2016. The ethics of 3D printing copies of bodies donated for medical education and research: What is there to worry about? Australian Medical Journal 9(1): 8-11. [link]
Hassett, B.R. 2018. The ethical challenge of digital bioarchaeology data. Archaeologies: Journal of the World Archaeological Congress. 14(2):185-188. [link]
Legassick, M., Rassool, C. 2000. Skeletons in the Cupboards: South African Museums and the Trade in Human Remains, 1907-1917. Cape Town: South African Museum and Kimberly: McGregor Museum. [link]
Sealy, J. 2003. Managing collections of human remains in South African Museums and Universities: ethical policy-making and scientific value. South African Journal of Science 99:238-239. [link]
Turnbull, P. 2014. “Vermillion Accord on Human Remains (1989) (Legislation)” in Smith, C. Encyclopedia of Global Archaeology. New York: Springer. [link]
Vijayavenkataraman S., Lu W.F., Fuh, J.Y.H. 2016. 3D bioprinting – an ethical, legal and social aspects (ELSA) framework. Bioprinting 1-2: 11-21. [link]
Wild, S. 2017. Long quest to understand these bodies without identities. [Online] Bones specialists try to prise secrets from the veld bodies. [Online]
Prof Ericka L'Abbé
Director of the Forensic Anthropology Research Centre (FARC)
Head: Physical Anthropology Section
Department of Anatomy
University of Pretoria
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