The Unexpected Link Between Cadavers and Careers

If you happen to be in need of human cadavers, you'll have more success targeting married nursery school teachers than, say, married cowboys or firefighters.

That's essentially the implication of a new study that explores a previously unstudied subset of the American population: married couples who jointly decide to donate their bodies to science after they die. In Individuals' Decision to Co-Donate or Donate Alone: An Archival Study of Married Whole Body Donors in Hawaii, published online by the Public Library of Science, the authors report that married people who work in female-dominated occupations are more likely to bequeath their corpses to medical research than those in male-dominated occupations.

“There's a lot of discussion in the field of donation on how to morally increase the supply.”

The finding is important because the medical community suffers from a shortage of cadavers, explains Michel Anteby, an associate professor in the Organizational Behavior Unit at Harvard Business School who cowrote the paper with Filiz Garip of Harvard University, Paul V. Martorana of Wagner College, and Scott Lozanoff of the University of Hawaii.

It's a matter of death-and-life. Medical schools require future doctors to study cadavers for the purpose of gaining experience with actual human anatomy. This helps ensure they will know what they're doing when it comes time to treat and save the lives of real patients. Unfortunately, the number of donations pales in comparison to the number of future doctors.

Many medical schools and teaching hospitals have proactive programs dedicated to recruiting would-be cadaver donors, encouraging people to explore the idea of bequeathing their bodies for medical research in lieu of immediate burial or cremation. In addition, new for-profit and nonprofit entrepreneurial ventures have begun to address the need for cadavers. Generally, recruiters for these ventures target those for whom death is likely to be top of mind.

"They'll set up a stand at a retirees' convention, go to nursing homes to do presentations, or go to hospitals and talk to the families of patients who are soon-to-be deceased," says Anteby, who for several years has studied the morality of markets by focusing on legal cadaver commerce in the United States. "There's a lot of discussion in the field of donation on how to morally increase the supply."

Two cadavers are better than one in this regard, so Anteby was encouraged when several donation program directors mentioned the co-donation phenomenon among married couples. "They said that sometimes they had spouses who would donate together," he says. "Oftentimes one person would initiate the contact with the program by asking for an enrollment sheet, but then would go on to request an additional sheet for the other spouse to enroll."

Seeking to help donation programs improve and target their outreach campaigns, Anteby and his research team decided to study the individual factors that might influence co-donation by married couples.

Focus On Hawaii

The team set out to analyze and classify 1,746 archived records of registered donors to the University of Hawaii's Willed Body Program from 1967 to 2006. The researchers focused on Hawaii for two reasons of simplicity. One, the university was the only procurer of whole body donations in the state, which negated the risk that the researchers might miss registrants in the selected geography and time frame. Two, Hawaii's remote location helped deter the likelihood that a Hawaiian resident would register with an out-of-state program; the cost of transferring a body out of state is especially prohibitive.

"Because of the length of flight…anything that happens in Hawaii stays in Hawaii," Anteby says.

“Occupations are powerful groups.”

In order to register for Hawaii's donation program, potential donors were required to fill out a form that included date of registration, gender, ethnicity, religious affiliation, marital status, and primary occupation (either current or prior to retirement), among other information. Married registrants were asked to provide their spouses' names, which enabled the team to determine whether couples registered at the same time; this indicated a joint decision to donate. Of 806 married registrants in the sample, co-registrants accounted for 308, or 38.2 percent.

The team found that married registrants in female-dominated occupations were significantly more likely to co-register for donation than those in other occupations. (An occupation was deemed "female dominated" if women composed more than 55 percent of the workforce in that field, in the United States, during the 1980s, which was midpoint of the study period.) In other words, a married male dental assistant would be more likely to sign up for cadaver donation with his spouse than a married female firefighter would with hers.

The findings indicate that donation program directors may want to target possible donors by sending educational information to employees in female-dominated occupations—or those who have retired from those occupations.

Broader Implications

Anteby acknowledges that the team has yet to determine why cadaver co-donation correlates with occupational gender segregation.

"On one hand, we can assume that there's something about selecting into female occupations that might explain these co-altruistic behaviors," he says. "On the other hand, maybe it's that once in an occupation, one gets socialized into certain group behaviors that are typical of that group. We can't tease out whether it's an input selection or an internal socialization process."

That said, the study's implications extend beyond cadaver donations. To Anteby, who teaches the MBA elective Managing Human Capital, the findings offer proof that our career choices directly affect other major life decisions.

"There's something about being a member of a particular group that actually might drive behaviors like we're seeing here," Anteby says. "Occupations are powerful groups. And to me that's the most interesting implication of [this study]. Here's a weird instance—whole body donations-—where we would never expect occupations to be a relevant factor, and yet we find that they are. So if it's relevant even in this somewhat unusual instance, then occupations must be fairly potent as socializing entities."

It's a lesson for Anteby's MBA students to keep in mind as they work toward becoming general managers.

"Most students have a managerial identity but aren't trained toward any given profession," he says. "It's really important for them to understand variations in occupational dynamics and their implications on decision-making—including decisions surrounding death."