Jeremy Laurance: Think the cost of living is high? Try the cost of dying

Medical Life
Tuesday 11 May 2010 00:00 BST
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It was my aunt’s misfortune to die on Maundy Thursday, less than 24 hours before the longest bank holiday of the year. She had donated her body to medical science and for the last 30 years of her life talked of little else. But when the day came, her donation was, maddeningly, refused.

“We offer our condolences at your sad loss,” said the voice on the answer machine at the London medical schools’ anatomy office. “We regret we cannot accept any donations over the weekend.”

The reason was immediately clear. To be fit for presentation to a bunch of young medical students beginning their study of anatomy, a body must be preserved fresh. Even if kept in the hospital’s refrigerated mortuary, it starts to decay within days. Five is the maximum the anatomy department allows.

That left my uncle and me facing a dilemma. My aunt had counted on the dissection slab to deal with her mortal remains. She had made no other plans. |In recent years, her life had revolved around hospitals. On return from her frequent visits, she would describe, with relish, how she had “lent her body” to the medical students. She loved it when they failed to establish her diagnosis, systemic lupus erythematosus (SLE). It was like winning a round of cards.

She was not religious and had no interest in a funeral. She was from a generation that disliked expense and didn’t like “fuss” – funerals involved both.

My uncle and I discussed what to do. We agreed to go for the simplest option, |in accordance with what we believed would have been her wishes. I began making enquiries.

I phoned six funeral directors and asked them to quote for a cremation. |In London, a 45-minute slot at a crematorium costs around £500, but if you are prepared to accept an early morning appointment – 9am or 9.30am – the charge drops to less than £200.

In addition, you must pay the fees of two doctors to confirm the death, amounting together to £147. This iniquitous and unavoidable charge has been known as “ash cash” to generations of junior doctors, who count on it as a useful supplement |to their income. The signatures are required, and the bill must be paid, even when, as in my aunt’s case, the patient dies in hospital.

The quotes I received from the funeral directors ranged from £1,500 to £2,000. I did some arithmetic. Allowing £200 for the cremation, £150 for the doctors’ signatures and £150 for a cardboard coffin (at cost) came to £500 in all. The task for the funeral director was to collect the body from the hospital – St Mary’s, Paddington – and take it to the crematorium (Golders Green, Marylebone, Islington or – the cheapest – Mortlake).

For the living, the cost of this journey by taxi would be about £30. For the dead, it turns out, it is £1,000.

Dead unlucky, you could say. Next time, I plan to hire an estate car, buy a coffin and do the job myself.

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