Creating Life and Exploring Death

In Sweden, as elsewhere, people's lives and physical bodies have become part of an advanced medical care apparatus. The present article is about this technologization of everyday life and the integration of medical high technology in the biological process. The empirical foundation is the creation of life with the aid of artificial reproduction and the investigation of dead human bodies for the purposes of autopsy and transplantation. Life and death are undeniably two focal points where the encounter of medicine, biology, and culture is made visible. By looking closely at the techniques that make it possible to stretch these fundamental principles, we want to reason about changes in people's cultural identity

Life and death, when they arc problematizcd, are seen to have many fe atures in common, revealing several general associations. Both in vitro fe rtilization and the encounter with death raise a number of existential questions. Life and death are self-evident opposites, yet each presupposes the other. It is difficult to reflect about death without simultaneously wondering about the meaning of life. When questions like these are raised, we also see clearly the ambivalence that people experi ence when life and death are explored. What is right or wrong is not given once and for all but is negotiable in any particular situation. This highlights the relation between biology and culture. How far can and should one reshape biological givens to achieve culturally desira ble goals? Where is the limit to what is hu manly irreplaceable?� In this context one can ask what it means that we today not only use our physical appear ance as an instrument for communication, but that it is also possible to change and reshape our bodies as we please (Mestrovic 1993). Now women without fa llopian tubes can give birth to children, infertile men can become fathers, and seriously ill or dying people can be granted new life through organ donation. The artificial fe rti lization of eggs, and the combination of differ-ent persons' bodies through organ transplants, or even the practice of injecting the brain sub stance of aborted fo etuses into people suffering fr om Parkinson's disease -such techniques undoubtedly indicate that our bodies are re placeable. At the same time, they blur the distinction between life and death.
Empirical material concerning life and death will be used here as a basis for our contribution to an ongoing discussion in cultural theory. This has increasingly fo cused on the interaction of societal structures, identity, and body. The aim is to discern how general processes and cultural patterns can be manifested in the individual's body (cf. Foucault 1991(cf. Foucault [1963 ;Giddens 1993;Melucci 1992). The modern Swedish society of the early twentieth century is a good example of such links. People were given everything fr om rational infant care at the start of life to con cerned nursing in late old age. This revealed the plan economy not only of the state but also of the body; the citizens' bodies became important cogs in a general collective machinery (Frykman 1994b).
In today's post-modern society we see a dif fe rent linkage between individual and society. There is much to suggest that we are living in an age that is obsessed, more than ever before, with individual identity, and where it is not primari ly t:nllective but personal needs that are sig-n:tlled throug-h our bod ies.
In what lilllows we want to te::;t these per spect ives by drawing attention to ::;pet:ifit:ally Swed ish cxpcricnt:es of arti fit: in I re production , t:o mmonly known as test-tube babic::;, and the hnndling of dead bodies. l<' irst Susanne Lundin looks at the problemaiit: of' in. vitm fe rtil izati on , under the heading "Creating Life". Then, with a corpse on an auiup::;y table us a starting point, Ly nn A kcsson goes on to ranson about "Explor ing Death".

Creating Life
There arc some questi ons th at always have a capat:ity to stir up people's minds. One ofthese is undoubtedly the q ucsiion of what is naturally and genuinely human. With ioday's technology we can transgress old boundaries, namely, those surro u nding our bi ol ogi ca l bod ies. People's thoughts about biology and advanced medical methods arc therefore a rewarding approach to a cultural analysis thai seeks to arrive at a knowledge ofthe cultural principles underlying the ethical standards of modern society. We have seen a number of fr uitful attempts to reveal our norm systems (Rapp 1993;cf. Strath ern 1993acf. Strath ern , 1993b. Far fewer studies, however, fo cus on the question of how people in their everyday lives handle experiences ofliving in a high-tech biomedical society. The aim of this discussion is therefore to acquaint the reader with some people who have a close concrete relationship to high technology. They are Swed ish couples who are unable to have children and who therefore try to become parents with the aid of assisted conception.
The interviews conducted with these couples are permeated with a great ambivalence sug gesting that both the original childlessness and the technologization ofreproduction arouse com plex fe elings. The ambivalence is exacerbated by the fact that the dividing lines between natural and unnatural show such large nation al and cultural variations. In Sweden, for exam ple, there is a special linkage between the view of nature and the view of humanity which is probably of significance for both state practice and popular ethics.
My inf(,rmn n is' rcllcciions about involun tary t:hildlcssncss and artificial reprod uct ion provide an cmpirit:al gateway to the subject. The f(,w::; is on the relation of individual needs and strategies to the cultural fi:·amcwork of sot:iciy: how the biological urge to have ch ildren interacts with th e more soci ally formed dream of parenthood.

Life Outside the Body
When f interviewed the fi rst coupl e I expected them to be reticent. I thought that I would have to coax them to talk about a sensitive and tricky subject. It turned out instead that they spoke both willingly and eloquently about their lives. lt is possible that thoughts about reproduction and its conditions open people's minds to a multitude of existential questions. Most of the interviewed couples, regardless of their origin an d education, showed precisely this kind of scli�reflexivity and capacity to regard society critically.
One of the couples, Eva and Lars, were for many years among the 10-15 per cent of the Swedish population who are unable to have children. I met them just after they had been through their sixth attempt at artificial insem ination, the in vitro fertilization that led, after five years of repeated treatment, to a child.3 It was in 1988 that Eva was informed that her fallopian tubes were blocked and that she could not become pregnant naturally. Not con tent with this, the couple decided to try to become parents with the aid of technology.
The aspiration to have children is, of course, not unique to our own times. Even if the reasons have varied -everything fr om children as a guarantee of the survival of the collective to today's view of the fa mily as an individual emotional project -infertility in itself has al ways given rise to elaborate programmes of action (cf. Sachs 1993). We find everything fr om religious blessings and fo lk cures such as scat tering quick-growing peas in the bed,4 to the biomedical and genetic techniques of the late twentieth century.
It is good to bear in mind the deep historical roots of this search for suitable measures to cure infertility when we discuss today's view of how we l:an deal with involu ntary l:h ild less ness. J\riilicial fertilizat ion h:.l :; been iran:; fo rmed in just a few years fr om �Sl:ienl:e fkiion into a pa ri of everyday lilc li1r many people. The first so-l:al led ie:;i-iubc baby was born in Eng land in 1978 (Brinsdcn & Ra insbury 1 992). 'rho method has quiddy spread all over the world, which moans thai ch ildlcs:; women today can choose in vitro fcriil iwiion, with the ov um and the sperm uniting in tho iesi-iube io l:reaie new life outside the body. " In our modern society, then, we do not have to content ourselves with bygone ritual praciil: es; medil:al intervention l:an l:Orred our physi cal defects (cf. Melucci 1992:120). Tod ay we have the potenti al to change , create, and recre ate what is ostensibly biologically determined (cf. Featherstone 1992;Frykman 1994). This potential is naturally a source of joy to many people; it gives a cure to those who are barren and child less. However, if' we listen io the voices that can be heard in literature, film, theatre, and art, we are also made aware of a serious threat. The overarching pr oblem atic concerns what is ethically defensible and biologically negotiable (Arditti, Klein & Minden 1984).
The Te chnologization of the "Natural" In May 1993, Eva was wheeled into the opera tion theatre of the women's clinic. She was groggy fr om the tranquillizers and needed help fr om the anaesthetist to get into the gynaecol ogist's chair. The doctor inserted the ultrasound probe in Eva's body. The screen showed the fa llopian tubes and the ovaries with the fo llicles hovering like balloons. They were the target for the doctor, who punctured the fo llicles with a thin needle which also caught the ova. A while later, the ova were put in a nutrient solution to be united soon after with the husband's sperm. It was here, in the laboratory, that the seeds of human life began to grow.
Eva and her husband Lars were already back home at the moment when the fe rtiliza tion took place. While their ova and sperm were being cultured, they waited in suspense for a message fr om the hospital that everything had gone well and that the ova were ready to be implanted in the womb.
A short time after, the signal l:ame. Eva once ag-ain got. into the gy naecologist's l:hair and t. he fertilized eggs were carefully inserted in her uierus.n While the operation was in progress, Lars sat in the waiting room. A fe w minut es later, Eva came out, pregnani. 7 Eva's p regnanc y thus beg·an with an opera tion thai was not very diflcreni fr om a normal gynaecological examination. All this may seem far removed irom what we normally associate with the conception of a child, but nevertheless a handy method for treating childlessness. Ar tificial fertilization, however, is not simple or something io be taken for granted; nor is it p ainless.
For Eva the way to a child was a long one; after several years of medical treatment, re peated attempts at insemination, mi scarriages, and mental ups and downs, she gave birth to a son. Over these years she had acquired a very diflcreni attitude io herself as a woman, io thoughts offamily and kin, as well as to her own body. Reproduction, which is regarded as the most natural thing in life by many people, became for Eva and Lars a highly mechanical and at times even artificial process. The young woman gradually came to view her own body as a machine, an object which, with the aid of advanced technology, could be a potential carri er of a fu ture child.8 There is undoubtedly a great deal to suggest that a change occurs in our perception of reality and the self when technology intervenes in the domains of the body, when we realize that sexuality can be replaced by medical skills and that biological limits can be stretched, for ex ample, by making infertile men into fa thers and women with defective fallopian tubes into moth ers (cf. Assier-Andrieu 1994; Giddens 1993).
But it was not just this changed self-under standing, a sort of physical and mental integra tion with technology, that Eva went through. Her view ofthe boundary between natural and unnatural was also affected. Above all during many of the unsuccessful attempts at fe rtiliza tion, she was burdened by thoughts about how far man can intervene in what appears to be given by nature. The fa ilure to become preg nant became for her a sign that someone, a divine fo rce or the power of nature, wanted to punish her. But she wa:; also haunted by anxi ety a bout what the result or artificial fertiliza tion could be. She often wondered what would come out or her body. What if Homeone had man ipulated the ova? Thou ghts like these con tinued to disturb her even afte r the ch ild was born . 1 ler dread of"reprisals" was expressed in fe ars that the child m ight not be her ow n: perhaps other ova and sperm had been substi tuted by m istake .
Eva's fe ars abo ut what. happen s when tech nology intervenes in the h u man body resemble the message of books and fi lms fro m Frn nl wn stein to Te rm inator and Ju rn s.�ic: Pa.rk . They also remind us of today':; headl ines in tho me dia, where there arc debates about whether it is ethically defi:msiblc to transplant the ovaries of dead girl fo etuses into infertile women, or to use technology to bl ur the boun dary between life and death (cf. Lundin & A kesson 1994). We also hear stories about Swed ish women in thei r sixties who go to clinics in Italy to become first time mothers through ovum donation , or about infertile women who become pregnant with the aid of ova fr om their own mothers.
Such reports can shake our view of the fam ily and raise the spectre of incest, especially if insemination is done, ior example, with sperm donated by the woman's own father. Is it possi ble, in other words, for genes to commit incest (cf. Edwards 1993)? In Sweden there are far more restrictions on in vitro fertilization than in many other countries (SOU 1985(SOU , 1989. The Swedish laws thus make the culturally fo rmed question about incest via genes into a hypothet ical question, but such questions are posed in both the international and the Swedish debate and are transformed in Sweden, with the help of the media, into a real threat. Parallel to the ardent desire to have chil dren, then, many people wonder whether bio medical solutions are morally acceptable. In Sweden it is considered unethical, for example, to be able to choose the sex of the child, as people can do in some private clinics in England.B Equally unacceptable are the solutions prac tised in India, where there are commercially operated clinics offering abortions to women if antenatal diagnostics show that the child is a gir I. Some of my informants even wonder wheth-40 or Sweden might soc the growth or a black medical market f() r sorting o ut unwanted he reditary characteristics.

An Authentic Family
Despite such fears, many couples go abroad to have children in a way th at is considered un ethical in Sweden. The issue bears thinking about: what is it that creates such ambivalence about how to handl e the possibi lities oile rcd by medicine? Perhaps it is the case that coping with childlessness actually takes place at the intersection between optim ism about the fu ture and a kind of cultural insecurity (cf. Ziehe 1 989). As Alberto M elucci argues, people have a sense of bewilderment when offered ultramod ern technologies to restore what is "natural" and give birth to children; a situation like this highlights many of our fu ndamental values about what is genuinely and irreplaceably hu man (cf. Melucci 1992;Kemp 1991).
Th e actions of my informants, however, should not just be seen as an encounter with the culturally unknown, but also as a confrontation with what is established and normal. In most societies, being a parent is regarded as self evident, while childlessness is a departure from this normality. In Sweden, moreover, perhaps more so than in other western cultures, the view of a well-functioning society has long been associated with ideas of a limited fa mily: moth er, father, child. 10 Although this pattern is chang ing today as a result of divorce and remarriage, leading to new siblings and new parents, and also as a result of the adoption of children fr om other countries, the idea of the "natural" biolog ical nuclear family still survives.11 These ideas are reflected, for example, in Swedish legisla tion.12 Ovum donation is prohibited in Sweden, which means that only the biological mother is permitted to give birth. The same view of genet ic closeness and the demand to be able to trace one's own genetic origin can be seen in the Swedish laws on sperm donation. The anonym ity of donors is not protected, as it is in most other countries; a child resulting fr om artificial insemination by a donor is entitled to be in fo rmed of the identity of his "real" fa ther. 13 In modem Swedish society, then, ideas about re-production and parenthood seem to be associat ed with the idea of what I would call clo.�e genetic bonds oj' hinsh ip.
Among the nearly nine million peop l e who live in Sweden, th ere arc at least 250,000 cou ples who can not become parents, who cannot fit the picture of a society where the biological family is taken for granted as the nuclcus.1 '1 Many ofihcm struggle with delicate questions about authenticity, about gender identity and parental identity. Not on ly do they have to renounce a biologi cal yea rn ing, they also fe el a sense of social alienation. Longing for children is certainly a matter of needs and drives, but it is also a desire for social community.
That is why the encounter with "ordinary fa milies" provokes strong feelings in many child less fa milies and also raises a number of ques tions about the construction of the self in rela tion to other people. Or, as one informant said, "One wants to be normal, to have children the way other people do." Eva tells how, when she was childless, she increasingly avoided contact with fr iends and acquaintances who had chil dren. When she met a pregnant woman or a pram on the street, she fe lt that her own stom ach was unbearably flat and that her breasts had dried up; it was as if her body had come to symbolize and even proclaim her infertility and estrangement (cf. Wirtberg 1992).
Many of the interviewed women refused to accept the life offered them by their bodies. Several of them claimed that their real self was a fe rtile mother figure while their physical body was a sort of enemy: a stranger who had to be overcome in order to create a whole individual. By being pregnant and having a new-born baby, they longed to manifest the identity concealed in their body.15 It almost appears as if the cultural reality for these women was fe lt to be stronger than the biological reality, and that these ideas about authenticity required an ad justment of the biology.

Biology and Culture
The birth of children is a biological fa ct. Through reproduction people become visible as biologi cal creatures with drives, instincts, and fe el ings (cf. Haraway 1992; Mestrovic 1993). But these basic physical phenomena contain more th a n just data on m enstrual cycles and hormo nal changes; these processes are also fo rm ulat ed in cultural terms so that we can handle them. Fertilization and childbirth arc revealed and confirmed in social patterns such as parent hood and fa mily structure.
It is within this fr amework, which we may call the biocultural context, that my informants express their anxiety about the consequences of' artificial reproduction while simultaneously refusing to accept their childlessness. Their reflections are based on a clear biological dispo sition but are shaped by a specific conceptual model. Their thoughts express the cultural con tradiction that permeates western society. The idea of eternal naturalness -inviolable nature and human matter protected against interven tion -is closely interwoven with our contempo rary desire to reshape the world to suit our own needs.tn It is in the intersection between these difler ent conceptual models that many people try to conquer parenthood; modern techniques make it possible to maintain traditional ideas about gender identity, family, and kinship. In this way the new technology allows not only biological but also social and cultural reproduction. This will to influence -even to correct -what ap pears to be determined by fate reflects a modern attitude. In this context, in vitro fe rtilization appears like a melting pot, where the rational ity of the technological age meets our deep seated ideas about what is biologically deter mined and universally human.

Exploring Death
The body of the dead woman on the autopsy table is still whole and almost unreal in its reality. It is difficult for an unaccustomed ob server to separate the person who once lived fr om the matter that now constitutes nothing more nor less than a dead body. The fa ce is covered, but the hands are expressive, fine boned, beautiful, fr ozen in position, with a light coloured band on the ring finger ofthe left hand, where the wedding ring was once worn. One arm is raised slightly in a gesture that invites many possible interpretations. A strange si-fence prevail::; in the brightly i l l u m inated au top::;y room of the inst itute or fi>rensic medicine in Lund. There is a striking contrast between the dead body fill· whom t ime ha::; stood still, and the cycling student::; out::;icle the window on this warm April cl ay when nature is turning green. It i::; the contrast bet ween l ife and deat h, be tween movement and tota l still nes::; .
But the d ead body has a story to te ll. lL will soon be opened . The organs will be removed and penetrated in a set order. This is done objective ly, efficien tly, and p ro fession all y. The ca use of death will be established to give cornfiHt to the bereaved relatives, to aid the growth of medical know ledge, and to satisfy soci ety's need to guar antee the rule of law.
The woman who once was, who left her fa mily in the prime of life, aged 55, caused imbalance and confusion by her d eath, leaving many questions unanswered. Some ofthem will be answered by the autopsy. Some of the imbal ance that arises when a living body is trans fo rmed into dead matter will be redressed. Through order and strict medical classification, the balance will be restored: this and only this has happened to the body. lt can give a sense of security to know the true cause of death.
The confrontation with a dead person arous es many existential questions, as it has done all through history. The questions can concern the potential danger of the deceased, the insight into the fr agility of one's own life, or the close link between life and death. Almost inevitably there is the question of what happens to the self, the identity, the soul, when the body dies.
These are the themes that interweave and overlap in the following reflections. My interest is fo cused on the dead body. 17

The Ambivalent Corpse
The danger of a dead body is evident fr om records in the Swedish folklife archives fr om the late nineteenth and early twentieth centu ries. Both historical and contemporary exam ples in ethnological and anthropological litera ture testify to the same danger (e.g. Hagberg 1937;Bloch & Parry 1982). Countless precau tions have been taken to protect the living fr om the destructive powers of the dead. It is only 42 after a scrupulously observed :mel correctly performed burial ritual that the ::;tutu::; or the dead person as rea l ly dead is confi r med. A dead but unbu ried person is in a transitional stat e or a cultural n o man's l:.t nd, and situation::; l ike this arc, as we know, alw ay s charged with danger and ambivalence (cf. Douglas 1979; Tu rner 1.98!'i).
The power of the dead person is not only destructive. lt can al so be uti lized to cure dis case or to aid reprod uction. Bones fro m dead peop l e or soil from a cemetery could gi ve good grow th in the fields, s uccessfu l fi sh i n g, p l enty of m i lk, or good beer (Hagberg 1937:6:J6ff. ). i deas that the fe rtile or reprod uctive powers of the dead can be transferred in sym bolic form not j ust to fields and livestock but directly to human reproduction are described in an an thro po logi cal anthology s h owing how the theme offertility is part of the actual burial ritual and the h andl i n g of the dead body (Bloch & Parry 1982).
This theme is not as evident in Sw eden , but we can nevertheless detect a similar associa tion between death and reproduction, such as the custom of dressing the corpse in a bridal shirt or shift, or dressing the corpses of young girls in fu ll bridal attire; or the fact that the woman who washed the body was sometimes the same person as the midwife (Hagberg 1937:127, 177, 181, 194). Another fa scinating theme is that women in their capacity as life giving mothers are also thought to be closest to death. Bloch and Parry (1982:21) present a variety of anthropological examples to illus trate the links between fe mininity, sexuality, corruption, death, the body, and flesh, in con trast to the association of masculinity with fe rtility, the grave, and bones. The Aztec myth about Coatlicue, the life-giving and death-bring ing goddess who is "tomb and womb at the same time" is another example (Gonzales-Crussi 1993:58). The topicality of the theme in the modern western world can be illustrated by the fascination with the mixture of(female) sexual ity and death in popular fiction. Robert Tracy, for example, sheds light on this with the aid of the vampire genre in his essay "Loving Yo u All Ways: Vamps, Va mpires, N ecrophiles and Necro filles in Nineteenth-Century Fiction" (1990). Th i::; ambivalent at t itude to dead peopl e , like the notions of' links between female sexu ality and death, is a good illustration of the inter weaving of' biology and culture (cf'. Ro::;enbeck 1989:44). Being born and dy ing can appear to be purely biological fa ct;;. Ideas that a corpse can threaten or cure, or that women arc closer to death, can appear to be nothing more than cultural con;;trudion;;. Ye t cul tural construc tions arc, in the firsi place, ju::;t as real and concrete as biol ogy. Secondly, there arc no objec tive bi ological criteria for when life either be gins or end::;. Opponents of' abortion, for exam ple, differ fr om pro-abortionists in their view of when life begins. In the same way th e criteria for deaih vary according io whether death is related io ihe activity ofihe brain, the heart, or the lungs.

Life through Death
Conceptions about the association of reproduc tion and death perhaps express a fundamental human idea that people must die so that oth ers may live. We all have to make way fo r our descendants in an eternal cycle.
This general idea about the dead making way for or giving strength and life to the living and the as yet unborn, however, has acquired a new meaning through modern transplant tech nology. As we saw above in the section "The Te chnologization of the 'Natural"', it is medical ly possible that an ovary fr om a dead woman can once again be fe rtile in a living body through transplantation. While the old body is decom posing and disappearing, its reproductive ca pacity could live on in a new body. This is still not permitted, but other parts of the body are considered to be replaceable, and a dead per son's organs can allow someone else to go on living.
But how far should we go? When does a person cease to be the same person? How many spare parts fr om other people or fr om dead people can we receive without losing our au thenticity? These problematic and controver sial issues raise the question of the boundary between life and death in a new fo rm .
The problem is brought to a head in the case of pregnant women who are brain-dead. The record fi>r a woman in ih i::; ;;tate fu nctioning as a living incubator is 108 day::;. "Who i s io decide in such cases?" wondered a doctor who cited the example with concern; the hu;;band, the wom an's parents, the doctor? Who is io say when the respirator shou ld be switched off?
Transplants presuppose brain dcaih, a death criteria introduced in Sweden in 1988 CSOU 1989:99, p. 10). There is a great demand fo r organs and a shortage of donors. This state of ail'air;; nourishes the modern legend tradition which Bengt af Kl inibe rg sums up in the com plex of motifs entitled "The Stolen Kidney" . These legends are about how unsuspecting peo ple become the victims ofveritabl e organ gangs (af Klintberg 1 994; Moravec 1993). The theme is naturally used in films and novels too. The issues of "spare-part man", genetic manipula tion, and life created outside the body arc like wise gratefully exploited for films and popular iiciion. As so often, art and the legend tradition seize on and give fo rm to our existential fe ars. It is surely no chance that every self-respecting detective film nowadays contains detailed scenes of post mortems, or that the role of the fo rensic pathologist is given more and more space (cf. Saynor in The Observer 19/12 1993). Another example is the American photographer Andres Serrano's suites of pictures fr om the morgue, where the observer is confronted with embod ied death in an eerie, fr ozen, timeless moment (Serrano 1993). Just like the body of the dead woman on the autopsy table, they lead our thoughts to life, to the incomprehensible simi larity of the dead to those who are still alive.

The Authentic Body
It can naturally be argued that we have now distanced ourselves so far fr om death and the everyday handling of dead bodies that we are fa scinated by it/8 the repression of death is supposed to create a seed-bed for fa scination with it. There may be some truth in this claim, but a changed perception of the body, that is, conceptions of what the body represents, is at least as important an angle for understanding modern man's horrified fa scination with dead bodies. This modern ambivalence is not of the same kind as that expressed in the historical and unthropologicul examples. It is sca rcely th e dang-er or wholesome powers of' the corpse that people arc now revolted or attracted by. lt is rather the dead body in its idcnti ty-bcu ring· capacity th at we relate to.
The link between body and identity offers an interesting way of'interpretingthe increasingly elaborate autopsy scenes in detective dramas. The observer ::;ccs or come::; staggerin gly close to th e total destruction of th e self. At the same time, reconstructi on brings orde r, clarif ying th e cou rse of even ts thai p receded death. In this way, the post mortem represent::; both a terrify ing dissection and a fa scinating restoration of personal identity.
If' the body has become an i ncreasingly sig nificant bearer and expression of personal iden tity (as maintained by scholars such as Fea therstone 1992; Giddens 1993;Melucci 1992), the death of the body becomes the death of identity. To put it another way: if one n o longer makes a distinction between body and soul, the flesh that was once regarded as merely the earthly shackles ofthe immortal soul now actu ally becomes one with the soul. When viewed in this light, the hesitancy of relatives to allow organ donations becomes comprehensible. It expresses a desire to preserve as a whole what once constituted the self. A dead body is unable to restore its authenticity and genuineness. It is up to the living person to constantly recreate himself.
Receiving organs does not upset this process of recreation. Nor does organ donation, as long as the donor himself has made the decision. Self-determination and hence responsibility with respect to one's own body is a characteris tic of modern man. Authorizing interventions in another person's body, on the other hand, is problematic, since it can be seen as a violation ofthe other person's integrity and right to self determination. The body as a sphere of personal responsibility applies to the dead as well.
The belief in the integrity and inviolability of the dead body also permeates the view that has been launched in recent government commis sions of inquiry in this field, especially in the report on "The Body after Death" (SOU 1992: 16). There is constant stress on the importance of handling dead bodies in an ethically correct manner, show ing the same respect unci consid eration as we do to a living body. No o perations apart fr om very minor ones muy be undertaken without the con::;cniufih e rcluiive::;. The view of the commission ofinquiry can be briefly sum med up as follows: the dignity ufthe intact body and th e influence of' ihe relatives takes precedence over the need for medical kn owledge. The fre quency uf auiopsic::;, which was once very high in Sw eden by international standards, has fa ll en by 30 per cent, and it i::; ::;ugge::; tccl thai it should be fu rther red uced .'!' The justi fication cited is not primarily economic (changed prior ities in medical care) but ethical.
The stress on the intrinsic value ofthe dead body and its equality to living bod ies is not a matter of course. Behind the commission's way of reasoning we detect a changed view of the body. Interestingly, it is closer to the layman's view of the body than to the view held by medical experts.
In medicine in general and forensic medicine in particular, staffhave an everyday fam iliarity with the fr agility ofthe human body. The whole ness and permanence that we fo ndly ascribe to it are in fa ct of short duration. People whose routine work involves handling dead bodies naturally make a sharp distinction between living and dead, associating the soul or the self with living persons only. For the rest of us, it can be difficult to dissociate the person fr om the body. Psychologists speak of a "lingering illu sion", that is, that we attribute properties to the dead body which only a living person can have (Sanner, SOU 1989:99, pp. 81 ff. ).
Forensic doctors are fu lly aware ofthis. They know what the appearance of the dead body means to the relatives, which means that they abstain as much as possible fr om any interven tions which can disfigure the body once the autopsy is complete. In other words, theirs is a very correct and real construction ofthe human body. And it does occur that relatives actually check that the body has been neatly sewn up under the shroud. The relative wants to be sure for one last time that the integrity of the de fe nceless body has been restored. With the organs put back in the skilfully sewn up corpse, the person is preserved as he or she once was, as whole, genuine, and authentic as ever.
Laymen throughout histo ry have also been eager to ensure that the dead body is kept intact. Otherwise the ghost could return to the living, demand ing the missing part of the body, or even a lock of hair th at someone cut off as a keepsake.�" The dangerous powers ofthe dead person must also have been an active obstacle to all ki nds of disfigurement of the dead body.
Theologians dismissed these notions as p rimi tive superstition , but the Christian bel ief in resurrection undoubtedl y encouraged them. The idea that the soul would be reunited with a new bodily form, n ot of flesh and blood, in the life beyond the grave wasand is -on a relatively high level of abstraction. 'J'he theological view of the unimportance of the physical body was presumably not shared by people in general. But the reasons were difl"erent fr om what they are today.
The report on "The Body after Death" con tains a brief survey of the attitude of different religions to interventions in the dead body. It declares that opposition to autopsies and the like rarely receives theological support, at least not in the Christian tradition (SOU 1992:16, pp. 71f. , 353f[).�1 And even though ideas of Christian origin have remained a part of our conceptual patterns in a secularized world (cf. A kesson 1991:160), the most important divid ing line between experts and laymen today is scarcely that between the priest and his congre gation. It is more likely the dividing line be tween doctor and patient (cf. Frykman 1981;Lasch 1977).22 But the medical hegemony over our bodies has also been questioned. One expression of this is in the flourishing alternative therapies and health movements ( cf. Frykman 1994;Lun din 1987;Salomonsson 1987). Heightened de mands for the personal right to the body are also seen in the case of the dead. Untiljust a few years ago this was a medical or a state concern, but now relatives are entitled to see dead bodies at the institute of fo rensic medicine. We can draw parallels to the stillborn children that mothers were never allowed to see a few years ago. Now it is instead considered important for the parents to be together with the dead child. At the University Hospital in Lund these small creatures are photographed, nicely dressed and arranged, liJr the benefit ofthe parents. After an interlude of some fi fty years, we are now seeing a return to the custom of wanting to see the corpse, at least among the immediate famil y. From the decades around the turn ofthe centu ry there are plenty of pictures of dead children (but not of stillborn babies) in the Scandinavian archives (Kildegaard 1985).
This new-fi:1ngled retu rn to someth ing that fe els historically fa miliar is due the realization by health service personnel that social death is necessary for the mourn ing process. To be able to mourn for someone, to understand death, an authentic body is needed. The fa ct that a gov ernment commission presenting a report like "The Body after Death" has come close to the layman's perspective, sometimes in opposition to the wishes of medical science, is probably an expression of this insight. 2 ' 1

Body and Identity
Artificial reproduction and the handling of dead bodies give us important information about the interaction between societal structures, identi ty, and the body. They also tell us something about the extent to which it is collective or personal needs that are signalled via the body. On the basis ofthe two empirical fields studied here, we think that we can say that the experi ence of living in a high-tech society, where questions oflife and death have become negoti able, means a changed identity perception, a different view ofthe self. There appears to have been a shift of periphery and centre; the centre of people's consciousness is no longer society as much as the self.
This does not mean, however, that people's bodies have ceased to be an expression of collec tive needs. There is rather an interaction be tween social structure and the satisfaction of personal needs.
As regards the dead body, the interest in preserving the body intact and authentic testi fies to the strong bond between identity and the body. This individual need for wholeness can be stretched, however, as the positive Swedish attitude to autopsies shows. Swedes are willing to place corpses at the disposal of science for the collective good. After the autopsy the wholeness of' Lhe body ca n be restored, which means thai indiviclual and collective need::; do noi need io conll ict.
In this respect, artificial re p rod uct ion i::; more problematic. Having a ch ild by in vitro fe rtiliza tion satisfies personal needs ofboih a biological and a collective kind. Bui these personal needs have an age limit in Sweden. Collective needs dcli nc a "natural" fiJmily. ln this f�tmily there is no room for, say, women who become pregnant aft er ihe menopause. There is no mistaking ihe signifi cance of th e fe rtile or inferti le body f()r identity. Here people arc prepared io adjust biological conditions which run counter to their view of the right cultural identity.
l 10. The will to define a person's exact genetic origin and hence his or her place in the fa mily structure is revealed, lor example, in linguistic usage.
Wh ere English has the general term grandmoth er and German Gro[Jmutter, Swedish has to spec ify whether it is mormor (mother's mother) or {a rmor (father's mother).
11. Ideas about parenthood, that is, the cultural construction of the fa mily, have varied through time and place. Blood tics arc not always a precondition for kinship. Anthropological stud ies have shown how fictive practices can main tain ties of parenthood and kinship in a similar way to genetic bonds (cf. Strathern & Franklin 1993). 12. Insemination Act (1984:1140, External Fertili zation Act (1988:71). 13. Sperm donation is permitted in Sweden; if the male in a couple is sterile, sperm can be donated by an outsider. Ovum donation, however, is pro hibited by law. The report of the government inquiry into artificial fe rtilization describes it as "far too unnatural" to allow, for example, a wom an with defective fa llopian tubes to give birth (Nordborg 1991;SOU 1985:5). There is however a heated debate since some people want to change this law. 14. In Sweden some 250,000 couples, or 500,000 people, are registered as involuntarily childless. The figure comprises people of fe rtile age. Over and above thiH iH a larl-(e dark fil-(ure, which indudeH people who have choHen not.  Marine (1981) and is the th eme of an ongoi ng research project entitled "Death as a Cultural Construction" under the leadership of Finnur Magnusson, Lund University. Death and burial in historical perspective is a classic research field in ethnology, which has been studied in detail by Nils-Arvid Bringcus (e.g. 1987. See also Hagberg 1937. Research into death and dying is an expand ing field at present. For international references see, e.g., Huntingdon & Metcalf 1979;Ceder roth, Corlin & Lindstrom 1988;Clark 1993;and the journal Te rraine for 1992, 1993. 18. The view ofthe taboo on death in modern society is expressed, for example, by Aries (197 4), but his perspective has been criticized on historical grounds, partly for his romantic attitude to dy ing in the past. For a survey see Hagen 1984. 19. The fr equency of autopsies in recent decades has been between 30 and 40 per cent of the total number of deaths in Sweden. From a peak of 48 per cent in 1975, the fr equency has decreased. In 1988 the figure was 33 per cent. A constant fe ature in autopsy statistics is that more men than women undergo post mortems, the differ ence being about 10 per cent. There are also large regional differences in Sweden. In 1985 the fr e quency was highest in Malmo municipality, at 77 per cent, while in the counties of Skaraborg and Gotland it was no more than 19 per cent (statis tics fr om SOU 1992:16, p. 114). Sweden has long been known for its high autopsy fr equency. The figures above can be compared with the 8 per cent for New Yo rk. In Sweden anatomical disscdionH and allcnd:lllce at. aulopHieH arc oblil-(alory clements in medical education. An American l;iudy l;howcd that !i8 per cent of' 1 :�6 educati onal institutions did not. demand lhiH (SOU 1992:17, p. 102). Thil; natu rally al'li!clH the frequ e ncy of autopsies, a� well aH the great variations in practice between dif'fcr cnl hoHpit.ak Even in Sweden the fr equency of' autopsies varies not j ust between region:; but aiHo between diflcrcni departments ol' ihe sanw hoHpiial (SOU 1992: 16, p. 114). Besides ihc role of' dociorl;, there arc interesting diff' crcnccl; be tween Swcclcn and the USA as regard s ihc a ii i tude of relatives to autopsy. A compariso n be tween a Swedil;h (1973) and an American ( l!:l8!:l) l;iudy l;howcd thai 80 per cent of Swedish rcla iivel; granted consent for autopsy, compared with 44 per cent in the USA (SOU 1992:17, pp. 671'1'. ).
Sanner's concluding discussion shows th at there is not the same positive view of organ donation : "few people question ihe value of autopsy. 'l'hil; work is noi regarded as controversial in the same way as, say, transplantation. The long tradition and ihc sometimes com pulsory nature of autop sies has had ihe effect of creating a norm which makes them accepted in a way that transplant.H are not" (Sanner, SOU 1992:17, p. 137).
From 1 July 1996 a new transplantation law has been in fo rce, in which the principle of "pre sumed consent" applies. Before the law was introduced, the National Board of Health and Welfare sent fo rms to everyone in Sweden, ask ing them to state their attitude to organ dona tion. An unexpectedly large number of responses were received, many of them positive. Some people, however, made the reservation that their organs should not be given to, for example, for eigners , people outside the family, and the like, even though the law does not admit any such exceptions. The new law has been discussed and criticized fr om many quarters. One serious ob jection is that silence in the shape of a fa ilure to respond is interpreted as a positive attitude. The board has nevertheless ensured that the right of relatives to veto organ donation will still obtain in fu ture. 20. Records in the Lund University FolklifeArchive, M3145:1, M3989:184, M3620:9. 21. There are exceptions here: the Greek and Syrian Orthodox churches and the Assyrian church (SOU 1992:16, p. 358). 22. The art historian To rsten Weimarck has devoted several works to the analysis of the way anatomy -and ultimately medicine -became a modern model science. It represents a world-view gov erned by reason, which denies an animistic or magical view of the wholeness of the worldly body. Public anatomical dissections, which were conducted for the first time in Sweden in 1677, prc::;uppo::;cd that the body on the autopsy table "was not a person but a sou l less co rpsc" (l988:299) and lwncc made a sharp dist inction between body and ::;ou l. Jn the dead body one could "read, no long-er about. destiny nnd cosmic pro::;pccls, hut nbout somet hing' very sccu lnr and seeming-ly concret e, na mcly, the :;tate of' henlth" ( 1 988:29fi ). According-to Wc imarck, the iden of' health rc plncccl the hope of' salvntion. Thc::;e ideas arc developed fu rt her in Wc imarck's recently !J ub lishcd major work, 1\lwdr·llli ol'h ana/o111.i (1996).