Harvard University removed human skin from the binding of “Des destinées de l’âme” in Houghton Library Wednesday after a review found ethical concerns with the book’s origin and history.

French physician Dr. Ludovic Bouland “bound the book with skin he took without consent from the body of a deceased female patient in a hospital where he worked,” according to Harvard Library.

Bouland included a handwritten note inside stating “a book about the human soul deserved to have a human covering,” said associate university librarian Thomas Hyry. The note also detailed the process behind preparing the skin for binding.