Families and individuals donate about 2,800 bodies to Texas higher education institutions every year so medical, dental and physical therapy students can learn anatomy by seeing and handling actual human tissue. The universities say they handle the corpses with dignity, keeping strict track of the remains to return them to the family for burial. They strive to follow the individual wishes of donors.

“We assume that everyone who donates a body to A&M wants to be at A&M,” said John Hubbard, a physical therapy professor who directs Texas A&M University’s willed-body program. “These Aggies want to stay Aggies, and we respect that.” As a precaution, one recent donor clarified that his remains not be used under any circumstances by the University of Texas.

By law and tradition, the schools recover only the costs of handling the cadavers and use them strictly for education or research. For more than a century the state’s body-donation business has existed as a closed system, its clubby academic feel exemplified by the agency that oversees it. An unpaid panel of academics, the Anatomical Board of the State of Texas has no administrative or regulatory staff.

Now, however, the entrance of a for-profit company into the Texas dead-body business is upending the state’s legacy system of collecting and distributing donated corpses. Unlike the schools, Phoenix-based Science Care actively solicits corpses, partnering with funeral homes and hospices to sign up potential donors. Families receive free cremation services in exchange.

Instead of distributing whole corpses to medical schools, Science Care typically parts out donations to research facilities and medical device companies. “Most people imagine a cadaver in a lab with medical students and nurses,” said Barbara Kemmis, executive director of the Cremation Association of North America. “But it can be very different.”

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A torso may be shipped to one place, a knee to another, with parts often never fully reunited for cremation. According to the company’s lengthy disclosure, in addition to dissection, “Exposure of the donated tissue to destructive forces may be involved, including simulated injury, trauma, impact, crash, ballistic or blast.”

In filings and correspondence, the company says donated cadaveric material is used strictly for medical science. Even though it earns money, its executives say Science Care discloses everything to donors and operates with high medical and ethical standards.

Yet university professors and medical school administrators have strenuously objected to its Texas plans. In letters to Attorney General Ken Paxton, they have argued no one should earn money off human remains.

“Life is sacred, and an individual’s decision to altruistically donate their body to science is an important decision,” wrote Kerry Gilbert, co-director of the Institute of Anatomical Sciences at Texas Tech, which is opening a state-of-the-art anatomy lab. “The [willed-body programs] of the State of Texas understand this sacred gift … Commercializing this process for profit is, in my opinion, inherently wrong, egregious, insensitive, and immoral.”

Three months ago, however, Paxton concluded for-profit tissue companies such as Science Care violated no Texas laws. The company’s 24,000 square-foot cadaver receiving, processing and training facility in Coppell is scheduled to open next month .

Few laws for buying, selling dead people

Universities say they prefer to be passive recipients of bodies, maintaining a respectful word-of-mouth approach to donations. Science Care grew quickly thanks to its strategy of showing up at death’s door.

“When I started Science care in 2000, [I] was figuring out which funeral homes and which hospices and which social workers and which clergy member in an office down a hallway in some big hospital would be receptive to our message,” an executive told Reuters for a 2017 article.

Although the company has processing facilities in six states, it solicits willed bodies nationally. It partners with local funeral service providers, whose state licenses typically are necessary to receive and transport the cadavers. Frank Seddio, general manager of Mesquite-based aCremation, said he receives no direct compensation for promoting Science Care to customers.

But he said the alliance pays off when Science Care hires the company to handle and deliver a donation to one of its facilities. Seddio added that while some families wish to contribute “to better the future of mankind,” many others are swayed by the promise of the free cremation service — worth $700 and up.

“The ability to pay for a funeral nowadays is difficult for anyone,” he said.

As in many states, Texas’s rules for buying and selling dead people are surprisingly vague. The handling of organs for transplant — hearts, kidneys, livers — is strictly regulated; profiting from them is a crime.

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But there are few rules for simple tissue and whole bodies. Hubbard said the State Anatomical Board has maintained a “gentleman’s agreement” that schools only recoup direct costs. But he conceded nothing in the law expressly prohibits profit: “While it may be unethical or immoral, it is not illegal.”

In correspondence with state officials, Science Care stressed it does not buy or sell body parts. Rather, it charges fees for their processing, care and handling. It charges a fee to researchers and medical professionals for their use — “Like renting audio-visual equipment,” said Kemmis, of the Cremation Association of North America.

Science Care did not respond to multiple interview requests. In press releases, it described itself as the biggest whole-body donation entity in the world, with tens of thousands of online cadaver commitments. It has said Texas is its fastest-growing market.

Kemmis said relatively few Texas residents donate their bodies — about 1.7 percent, half the national rate. In states where for-profit companies have operated for several years — Arizona and California — the rates are in the double digits, she said.

According to the Texas Department of State Health Services, about 3,500 Texans willed their bodies to science each year. The State Anatomical Board reports it received about 2,500 to 2,900 of those - meaning that as a rough estimate, companies such as Science Care already may be receiving as many as a third of the state’s annual corporeal bequests.

‘Guy hosing off a torso’

Members of the State Anatomical Board and body-sale critics cast the divide between academic body-collection programs and for-profit enterprises as a stark choice. It is the educational institutions’ mission to ensure sufficient cadavers to train future Texas doctors and dentists, treat them with due respect, and diligently track even detached body parts to reunite them into a single cremation for the comfort of their families.

With for-profit body brokers, “The families have no idea that these bodies are being dismembered and sold for a profit,” said Carissa Hughes, assistant vice president for government and industry relations for Service Corporation International, one of the country’s largest funeral service providers. “It’s big business, and they’re not disclosing to the families.”

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“This isn’t about service to the medical industry, and it’s not about the education of our next generation of health care professionals,” added Jason Jones, who heads Texas Tech’s willed-body program, but stressed he was commenting only as a long-time funeral director. “It’s about maintaining the status quo on a profit margin.” He pointed to the schools’ collective response following Hurricane Ike, which destroyed the anatomy lab at the University of Texas Medical Branch in Galveston. The State Anatomical Board shifted bodies between schools to ensure student cadaver work continued.

Yet in basic ways both versions are similar. While anatomical board members showcase the use of donated bodies by Texas medical students, records show state educational institutions receive many more than they use, distributing some for purposes very much like Science Care.

Last year the University of Texas Southwestern Medical Center, the state’s largest cadaver-user by far, received 1,742 bodies. About 560 went toward medical education. Another 145 were passed on to private medical device companies for research and development; 155 more were sent out of state for use at non-Texas institutions. The university refused to answer any questions about its willed-body program.

Both for-profit and nonprofit versions of the body business also have had their dark moments.

“We had a nightmare case,” recalled Jennifer Kandt, executive director of the Nevada Board of Funeral and Cemetery Services. “The one with the guy who was seen hosing off a torso outside, letting blood and fluid and little bits of hair into the gutters.”

Southern Nevada Donor Services eventually closed. Grisly cases of shady body brokers in Hawaii, Arizona Michigan, Colorado and Oregon also have alarmed local residents and on occasion drawn the attention of police.

‘Would you do it?’

University body programs haven’t been immune from scandal, however. In 2004, UCLA discovered an employee harvesting parts from willed bodies and selling them.

Two years earlier, an audit discovered the willed-body supervisor for the University of Texas Medical Branch at Galveston sold body parts received by the school, as well as co-mingled donors’ ashes before returning them to families. The program was shuttered, reopening only in 2017 when the State Anatomical Board reinstated its certification.

Hubbard said the attorney general’s green light to Science Care to open a Texas body shop has, at the very least, illuminated the state’s outdated laws. “When the current code was written, none of this was heard of or imagined,” he said.

In a recent report to the Sunset Advisory Committee, the state’s Anatomical Board warned “it would be virtually impossible for the members of the SAB to oversee the activities of a commercial entity.” Without staff, members would be unable to inspect all the facilities receiving tissue from Science Care and “not equipped to regulate the business transactions of such companies” to prevent overcharging.

Texans donating their bodies to science, too, may have to update their ideas of the afterlives of their mortal shells. “If you knew you had donated your body to me, and you knew I was going to partition and sell it, would you do it?” said Hubbard. “That’s the million-dollar question.”

eric.dexheimer@chron.com