Yikes. Pathologist caught burying fetuses in her garden

Here’s a story of a Polish pathologist who was discovered to have been taking fetuses from the hospital to her home and doing … something …. with them, then burying the bodies in her garden.  She said she was doing research.  See:

https://people.com/pathologist-arrested-after-remains-of-more-than-30-unborn-babies-found-in-garden-11997776

There seems to be a paradoxical view of this kind of thing today, both with fetal and “regular” remains.  It has always been a vexing issue.  I’m going to assume that these fetuses are from abortions, commonly called “Products of Conception” here in the US.  They are evaluated by a surgical pathologist to make sure there’s not some problem like a molar pregnancy, and then usually disposed of as biological waste.  At least that’s what happened the last time I looked at them many years ago.  So there’s a bit of a paradox here.  These fetal parts probably would just be incinerated and disposed of had they remained at the hospital, but now it’s an outrage that they were buried.

It’s not as simple as that, of course.  There are the issues here of medical information,  privacy, etc.  Her actions if the presentation in the news article is correct, is pretty outrageous.  It’s not clear what this pathologist was doing, after all.  I presume she’s a surgical pathologist and not a forensic pathologist.  And, miscarriages are often treated differently than abortion remains.  Some parents want a full burial for a stillbirth, and God bless them for it.  But I am a bit bemused at the attitude that it’s an outrage that these products of conception were not treated with respect when they are classified as waste at he hospital and there’s no outrage about that.  Nobody outside the pro-life community seemed to be concerned with the way Planned Parenthood treats fetal tissues.

Ah well.

In Forensic Pathology, there are problems that come and go.  Back when I was in training four decades ago, we did not return organs to the body following an autopsy.  Instead, they were collectively put in large 55 gallon drums.  Once a month, a priest would come by and say words over the drum, and it would be sent out for cremation and disposal as waste.  Nobody seemed to have a problem with it.  Then, some time in the 1990s or so, people started getting upset about it and demanded that the organs be buried with the body.  That’s not a problem for an ME office in general, though it’s a technical issue for the embalmer; since the blood vessels to the organs are cut, they can’t infuse the organs with preservative as easily.

The only time it becomes an issue is when we need to retain an organ for extra studies.  This happens most commonly with brains retained for formal neuropathologic evaluation, since these brains usually have to be fixed in formalin for 1-2 months before examination in order to make them firm enough to work with. It turns out that dissecting a brain “fresh” is very inexact because of the soft and rather mushy texture of the brain.  It’s OK for big things like big hemorrhages, huge tumors, burst aneurysms, and such.  But it’s simply not sufficient if you have suspicion of a small, but significant lesion.  And, for some more esoteric diseases, it may be useful to ask a neuropathologist with special training in looking at brains to take a look. That means that the body has been long been buried or cremated by the time we are done with the organ.   Moreover, a normal pathologic evaluation of a fixed brain is pretty destructive.  The brain is sliced into small slices and then portions are further cut out for special processing.  The fixed brain slices frequently fracture into pieces upon handling.  Thus, at the end of the procedure, there’s not a brain-looking brain, but a jar of brain pieces.  The procedure I’ve seen for dealing with this varies from jurisdiction to jurisdiction.  Most of the places I know of treat these pieces a medical waste — they are incinerated and disposed of.  However, I have heard of offices that contact the family and ask if they want the jar. I’ve seen that happen a couple of times personally; both times the family said to dispose of it.

Another organ that is sometimes, but less often, retained is the heart.  The results of analysis are similarly destructive.   Many years ago, I retained a heart for external consult with an outside cardiac pathologist.  I noted that I had sent it out for consultation in my report.  The wife of the decedent called and was outraged that her husband was buried without her heart.  I talked to her for a couple of hours that day, trying to get her to understand why it was important that someone with more expertise in cardiac pathology than I look at the organ.  She was crying and profoundly agitated.  Then in passing, as I was going through my procedure, I said that I put a portion of the apex of the heart into the bag of organs which was returned to the body.  She immediately settled down.  It wasn’t important to her that the *entire* organ was returned to the body, just part of it.  So, we ended the call on amicable terms.  Go figure.

During the 2000s, this concern seemed to peak, with some state-level laws being proposed to enforce return of things to the next of kin.  Then, in the past decade or so, the issue seems to have waned.  Some places I’ve heard of, mostly outside of the US have taken this to an extreme, insisting that blood that passively drained from the body be collected and returned, and that even such things as histologic slides and paraffin blocks be returned.  I don’t see how that would be workable, since slides and blocks can be important in trial years after the death.

There’s a balance to be maintained, of course.  We as Forensic Pathologists always want to be respectful both to the dead and to the families of the dead.  There’s an old joke among physicians that pathologists become pathologists because we don’t like to deal with people.  The opposite is true for us in forensics.  We spend hours and hours talking to families, lawyers, police, etc.  Part of our training is how to deal with issues regarding our cases in a way that is frank and complete, but also respectful and compassionate.  With respect to retaining tissues, we want to be as accommodating as possible to the wishes of the next of kin, but at the same time, we must be able to do the analyses we need to do.  It is inevitable that there will be tension between these two needs on occasion.