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Cornwall J, Hildebrandt S, Billings B, Kramer B. Contemporary ethical standards and the presence of exhibitors at anatomy conferences. ANATOMICAL SCIENCES EDUCATION 2024. [PMID: 39228056 DOI: 10.1002/ase.2517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2024] [Revised: 08/22/2024] [Accepted: 08/23/2024] [Indexed: 09/05/2024]
Affiliation(s)
- Jon Cornwall
- Centre for Early Learning in Medicine, Otago Medical School, University of Otago, Dunedin, New Zealand
| | - Sabine Hildebrandt
- Division of General Pediatrics, Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Brendon Billings
- School of Anatomical Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Beverley Kramer
- School of Anatomical Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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der Heyden KAV, Gibbon VE, Mpolokeng KS. A South African case study on anatomical embalming for human body donation programmes with toxicological considerations. Ann Anat 2024; 255:152296. [PMID: 38925274 DOI: 10.1016/j.aanat.2024.152296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 06/03/2024] [Accepted: 06/13/2024] [Indexed: 06/28/2024]
Abstract
Body embalming, a practice with deep historical roots across various cultures, forms the backbone of contemporary human body donation educational programmes. In this study, we explored current embalming practices within six South African human anatomical dissection programmes, focusing on the use and volumes of key chemicals-formalin, phenol, and alcohol-and their associated health risks and potential toxicity. We measured and compared aspects of embalming practices such as the duration of body preservation and the annual intake of bodies. Variations in embalming practices and chemical ratios across different South African universities were found. However, the consistent use of formalin, phenol and alcohol were observed across all six programmes. Formaldehyde concentrations used in South African dissection programmes were within the generally acceptable international range. Regarding arterial embalming, South African dissection programmes showed widespread adherence to international embalming practices, with one programme using a substantially lower concentration of formalin. The dual nature of formaldehyde as both an effective preservative and a recognised carcinogen was underscored in relation to human health regarding chemical toxicity. Phenol, like formaldehyde, was consistently used as it is important for the inhibition of bacterial and fungal growth. Alcohol was also consistently used, but there was much greater variation in its volume across South African institutions. Our data showed a slight positive relationship between storage duration and the volumes of formalin and phenol in human embalming fluid. South African regulators enforce stricter exposure limits than those set by the World Health Organisation and various European agencies. While South African institutions operate within internationally acceptable ranges of chemical use that both maximise preservation and minimise toxicity, we acknowledge that these data are preliminary. Further investigation is encouraged to ensure embalming practices effectively protect all those involved and support the educational goals of human anatomical dissection programmes in South Africa.
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Affiliation(s)
- Kirsten Alexandria van der Heyden
- Division of Clinical Anatomy and Biological Anthropology, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Victoria Elaine Gibbon
- Division of Clinical Anatomy and Biological Anthropology, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Kentse Sana Mpolokeng
- Division of Clinical Anatomy and Biological Anthropology, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
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Taylor AM, Wessels Q. "Spine to the future"-A narrative review of anatomy engagement. ANATOMICAL SCIENCES EDUCATION 2024; 17:735-748. [PMID: 38587085 DOI: 10.1002/ase.2417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 03/13/2024] [Accepted: 03/18/2024] [Indexed: 04/09/2024]
Abstract
Anatomy has been integral to medical and health education for centuries, it has also had a significant role in wider public life, as an educational resource, a link to their health, and also as a darker deterrent. Historically, public engagement in anatomy is hallmarked by public dissections of convicted criminals across the globe. Artists, specifically non-medical men, such as Leonardo da Vinci, are reported to have participated in public dissection. Dissection would later rekindle public interest in anatomy as graverobbing led to the reform and regulation of anatomy in many countries. In recent years, there has been growing interest from the public in learning more about their bodies as health and well-being become of paramount importance, particularly following the COVID-19 pandemic. Anatomy sits in a prime position to direct and instigate conversations around health, well-being, and body image. Every human on earth possesses a perfect resource to look at and learn about. Models, art-based anatomical activities, and crafts provide active learning opportunities for the wider public around anatomy. Most recently, apps, games, and extended reality provide novel and insightful learning opportunities for the public relating to the body. Finally, training and resources must also be made available from institutions and professional bodies to anatomists to enable them to deliver engagement in an already congested and educationally heavy schedule. This resurgence of interest in anatomical public engagement sees anatomy re-enter the public spotlight, with more appropriate resources and educational settings to offer engagement with the aim of benefiting the public.
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Affiliation(s)
- Adam M Taylor
- Lancaster Medical School, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | - Quenton Wessels
- Division of Anatomy, School of Medicine, University of Namibia, Windhoek, Namibia
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Smith CF, Stone D, Munro R, Jayanth A, Hennessy CM, O'Brien D, Ingram C, Ail G, Koenig M, Arnold L, Bemment M, Johnston M. "My Dead Body": Development, production, and reception of a documentary that publicly displays the dissection of a human donor. ANATOMICAL SCIENCES EDUCATION 2024; 17:749-762. [PMID: 38556638 DOI: 10.1002/ase.2412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 03/01/2024] [Accepted: 03/08/2024] [Indexed: 04/02/2024]
Abstract
Recently, there has been an emphasis on keeping the study of anatomy using donor material confined to the domain of medical and allied healthcare professionals. Given the abundance of both accurate and inaccurate information online, coupled with a heightened focus on health following the COVID-19 pandemic, one may question whether it is time to review who can access learning anatomy using donors. In 2019, Brighton and Sussex Medical School (BSMS) obtained a Human Tissue Authority Public Display license with the aim of broadening the reach of who could be taught using donor material. In 2020, BSMS received its first full-body donor with consent for public display. Twelve workshops were delivered to student groups who do not normally have the opportunity to learn in the anatomy laboratory. Survey responses (10.9% response rate) highlighted that despite being anxious about seeing inside a deceased body, 95% felt more informed about the body. A documentary "My Dead Body" was filmed, focusing on the rare cancer of the donor Toni Crews. Viewing figures of 1.5 million, and a considerable number of social media comments highlighted the public's interest in the documentary. Thematic analysis of digital and social media content highlighted admiration and gratitude for Toni, the value of education, and that while the documentary was uncomfortable to watch, it had value in reminding viewers of life, their bodies, and their purpose. Fully consented public display can create opportunities to promote health-conscious life choices and improve understanding of the human body.
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Affiliation(s)
- Claire F Smith
- Department of Medical Education, Brighton and Sussex Medical School, University of Sussex, Brighton, UK
| | - Danya Stone
- Department of Medical Education, Brighton and Sussex Medical School, University of Sussex, Brighton, UK
| | - Ross Munro
- Department of Medical Education, Brighton and Sussex Medical School, University of Sussex, Brighton, UK
| | - Aiden Jayanth
- Department of Medical Education, Brighton and Sussex Medical School, University of Sussex, Brighton, UK
| | - Catherine M Hennessy
- Department of Medical Education, Brighton and Sussex Medical School, University of Sussex, Brighton, UK
| | - Dominic O'Brien
- Department of Medical Education, Brighton and Sussex Medical School, University of Sussex, Brighton, UK
| | - Camilla Ingram
- Department of Medical Education, Brighton and Sussex Medical School, University of Sussex, Brighton, UK
| | - Geetika Ail
- Department of Anatomy, Institute of Health Sciences Education, Barts and the London School of Medicine, Queen Mary University London, London, UK
| | - Michael Koenig
- Department of Medical Education, Brighton and Sussex Medical School, University of Sussex, Brighton, UK
| | - Laura Arnold
- Department of Medical Education, Brighton and Sussex Medical School, University of Sussex, Brighton, UK
| | - Matthew Bemment
- Department of Medical Education, Brighton and Sussex Medical School, University of Sussex, Brighton, UK
| | - Malcolm Johnston
- Department of Medical Education, Brighton and Sussex Medical School, University of Sussex, Brighton, UK
- Department of Radiology, University Hospitals Sussex, Brighton, UK
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5
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Hadie SNH, Gasmalla HEE, Wadi MM, Zainul Abidin MA, Yusoff MSB. From generosity to gratitude: Exploring Islamic views on body donation, human dissection, and honoring the gift of life. ANATOMICAL SCIENCES EDUCATION 2024. [PMID: 38332675 DOI: 10.1002/ase.2393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 01/24/2024] [Accepted: 01/26/2024] [Indexed: 02/10/2024]
Abstract
Human dissection is an ancient pedagogical method that is still relevant in modern anatomy curricula. The body procurement process for dissection purposes has undergone significant evolution from the medieval era until now, whereby body donation has become the main source for human bodies in medical education. The appreciation ceremony for body donors is an excellent way to promote a body donation program, whereby both dissection and appreciation ceremonies are effective in inculcating professional behaviors and altruism among medical students. Despite the benefits of dissection and such ceremonies, conflicting ideas about the acceptability of these methods exist among Muslim scholars and students. Hence, this article provides a theological Islamic interpretation of human dissection, body donation, and appreciation ceremonies from four sources of Islamic law-the Qur'an, Hadith, Idjmaa, and Qiyas-to justify Muslims' involvement in the aforementioned. It is important to note that the fundamentals of Islam are submission to the will of the one and only God, Allah Subhanahu wa ta'ala (SWT) and recognition of Prophet Muhamad (peace be upon him) as the last messenger of God. Therefore, the actions of a Muslim are strongly based on faith and virtue.
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Affiliation(s)
- Siti Nurma Hanim Hadie
- Department of Anatomy, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Malaysia
| | | | - Majed M Wadi
- Medical Education Department, College of Medicine, Qassim University, Buraidah, Saudi Arabia
| | - Mohd Asri Zainul Abidin
- Jabatan Mufti Negeri Perlis, Kangar, Malaysia
- School of Humanities, Universiti Sains Malaysia, Penang, Malaysia
| | - Muhamad Saiful Bahri Yusoff
- Department of Medical Education, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Malaysia
- Centre for the Development of Academic Excellence, Universiti Sains Malaysia, Penang, Malaysia
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Bhattacharjee S, Ghosh SK. The Sun Also Rises: Tracing the evolution of humanistic values in anatomy pedagogy and research, including cadaveric acquisition practices. J Anat 2023; 243:1031-1051. [PMID: 37525506 PMCID: PMC10641044 DOI: 10.1111/joa.13938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 06/04/2023] [Accepted: 07/17/2023] [Indexed: 08/02/2023] Open
Abstract
Anatomy has always been at the intersection of the socio-cultural and political landscape, where new ideas constantly replace older wisdom. From ancient Egyptians through the Greeks, and then the Romans, finally culminating into the European Renaissance-all the significant eras of human civilisation have left their insignia and distinct marks on the evolution of anatomical practices. Despite its utility as a tool for anatomy pedagogy and research that has proven its worth over millennia, cadaveric dissection has particularly been subject to political and social vicissitudes. A major debate about anatomical dissection lay with the ethical considerations, or its lack thereof, while acquiring corpses for demonstration in the dissection halls. From antiquity, anatomical dissection-often synonymous with medical studies-had typically been carried out on the dead bodies of executed criminals with certain laws, such as the Murder Act of 1752, facilitating such uses. Gradually, the uses of unclaimed bodies, resourced primarily from the impoverished sections of society, were also introduced. However, these body acquisition protocols often missed the crucial element of humanism and ethical considerations, while knowledge augmentation was taken as sufficient reasoning. Unfortunately, a gross disregard towards humanistic values promulgated heinous and illegal practices in acquiring corpses, including grave robbery and even murders like in the case of Burke and Hare murders of 1828. Follow-up legislation, such as the Anatomy Act of 1832, and comparable laws in other European nations were passed to curb the vile. What distils from such a historical discourse on humane values in anatomy dissection, or medical science in general, is that the growth and integration of humanism in anatomy have never been linear, but there were intermittent and, yet, significant disruptions in its timeline. For example, there were serious human rights violations in anatomical practices during the Third Reich in Germany that perpetrated the holocaust. The medical community has kept evolving and introducing new moral values and principles while using such egregious events as lessons, ultimately resulting in the Declaration of Helsinki in 1964. This article revisits the heterogeneous journey of integrating humanistic values in anatomy practice. Such humanistic traits that, like medical science, have also developed over centuries through the inputs of physicians, researchers, and philosophers-from Greece to modernity with an important stopgap at the Renaissance-are a fascinating lore that deserves to be re-envisioned through the lens of contemporary values and ethos. In parallel to human medicine, humanistic values continue to influence veterinary medicine, a welcome development, as our society condemns animal cruelty in any form. There are lessons to be learned from this historical journey of how humanism shaped many of the concepts that anatomists use now. Finally, and most importantly, it might prevent the medical community from repeating the same mistakes by cautioning against the traps that are there, and in a convoluted world where morality as such is eroding from our social fabric, will always be there. Such historical account acts as a righteous, ethical, and contextual compass to guide the existing and upcoming anatomists in discerning between light and dark, right and wrong, and roads-to be or not to be-taken.
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Bharambe VK, Prasad A, Bokan R, Kalthur S, Manvikar P, Puranam V. The anatomist’s perspective today towards human body donation for procurement of cadavers for study of human anatomy. ELECTRONIC JOURNAL OF GENERAL MEDICINE 2023. [DOI: 10.29333/ejgm/13054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2023]
Abstract
Anatomy is the study of structure of human body. Dissection of human cadavers has always been an integral part of study of anatomy as well as research in it. Till now the only source for cadavers for dissection purposes were unclaimed bodies. Today the need for bodies for medical education has increased and most medical schools are experiencing difficulties in procuring the requisite number of cadavers.<b> </b>Body donation programs may help fulfil this need of the medical schools. The present study was an attempt to analyze the attitude of the anatomists towards different aspects of body donation. 24.7% of the participants stated that they have insufficient cadavers, 12.3% claimed surplus cadavers while 62.8% claimed sufficient cadavers. 26% of the anatomists were unaware of the necessity for a death certificate and 35% were unaware of the necessity for a unique identification document for carrying out body donation.
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Affiliation(s)
| | - Arun Prasad
- Symbiosis Medical College for Women, Symbiosis International Deemed University, Pune, INDIA
| | - Raju Bokan
- Department of Anatomy, AIIMS, Guwahati, INDIA
| | - Sneha Kalthur
- Department of Anatomy, Kasturba Medical College, Manipal, INDIA
| | | | - Vatsalaswamy Puranam
- Department of Anatomy, Dr. D. Y. Patil Medical College, Hospital and Research Center, Pune, INDIA
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McMenamin PG. The Third Dimension: 3D Printed Replicas and Other Alternatives to Cadaver-Based Learning. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1421:39-61. [PMID: 37524983 DOI: 10.1007/978-3-031-30379-1_3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/02/2023]
Abstract
Capturing the 'third dimension' of complex human form or anatomy has been an objective of artists and anatomists from the renaissance in the fifteenth and sixteenth centuries onwards. Many of these drawings, paintings, and sculptures have had a profound influence on medical teaching and the learning resources we took for granted until around 40 years ago. Since then, the teaching of human anatomy has undergone significant change, especially in respect of the technologies available to augment or replace traditional cadaver-based dissection instruction. Whilst resources such as atlases, wall charts, plastic models, and images from the Internet have been around for many decades, institutions looking to reduce the reliance on dissection-based teaching in medical or health professional training programmes have in more recent times increasingly had access to a range of other options for classroom-based instruction. These include digital resources and software programmes and plastinated specimens, although the latter come with a range of ethical and cost considerations. However, the urge to recapitulate the 'third dimension' of anatomy has seen the recent advent of novel resources in the form of 3D printed replicas. These 3D printed replicas of normal human anatomy dissections are based on a combination of radiographic imaging and surface scanning that captures critical 3D anatomical information. The final 3D files can either be augmented with false colour or made to closely resemble traditional prosections prior to printing. This chapter details the journey we and others have taken in the search for the 'third dimension'. The future of a haptically identical, anatomically accurate replica of human cadaver specimens for surgical and medical training is nearly upon us. Indeed, the need for hard copy replicas may eventually be superseded by the opportunities afforded by virtual reality (VR) and augmented reality (AR).
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Affiliation(s)
- Paul G McMenamin
- Faculty of Medicine, Nursing and Health Sciences, Department of Anatomy and Developmental Biology, Monash University, Melbourne, VIC, Australia.
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Narang K, Imsirovic A, Dhanda J, Smith CF. Virtual Reality for Anatomy and Surgical Teaching. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1397:135-149. [DOI: 10.1007/978-3-031-17135-2_8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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10
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Patnaik R, Khan MTA, Oh T, Yamaguchi S, Fritze DM. Technical skills simulation in transplant surgery: a systematic review. GLOBAL SURGICAL EDUCATION : JOURNAL OF THE ASSOCIATION FOR SURGICAL EDUCATION 2022; 1:42. [PMID: 38013707 PMCID: PMC9483372 DOI: 10.1007/s44186-022-00028-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 05/02/2022] [Accepted: 06/13/2022] [Indexed: 11/29/2023]
Abstract
Purpose Transplant surgery is a demanding field in which the technical skills of the surgeon correlates with patient outcomes. As such, there is potential for simulation-based training to play an important role in technical skill acquisition. This study provides a systematic assessment of the current literature regarding the use of simulation to improve surgeon technical skills in transplantation. Methods Data were collected by performing an electronic search of the PubMed and Scopus database for articles describing simulation in transplant surgery. The abstracts were screened using the preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines. Three reviewers analyzed 172 abstracts and agreed upon articles that met the inclusion criteria for the systematic review. Results Simulators can be categorized into virtual reality simulators, cadaveric models, animal models (animate or inanimate) and synthetic physical models. No virtual reality simulators in transplant surgery are described in the literature. Three cadaveric models, seven animal models and eight synthetic physical models specific to transplant surgery are described. A total of 18 publications focusing on technical skills simulation in kidney, liver, lung, pancreas, and cardiac transplantation were found with the majority focusing on kidney transplantation. Conclusions This systematic review identifies currently reported simulation models in transplant surgery. This will serve as a reference for general surgery and transplant surgery professionals interested in using simulation to enhance their technical skills.
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Affiliation(s)
- R. Patnaik
- Department of Surgery, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229-3900 USA
| | - M. T. A. Khan
- Department of Surgery, University of Texas Health San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229-3900 USA
| | - T. Oh
- Long School of Medicine, University of Texas Health San Antonio, San Antonio, TX USA
| | - S. Yamaguchi
- Department of Transplant Surgery, University of Texas Health San Antonio, San Antonio, TX USA
| | - D. M. Fritze
- Department of Transplant Surgery, University of Texas Health San Antonio, San Antonio, TX USA
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Asman O, Kagan I, Itzhaki M. Nursing students' experiences and perceptions of an anatomy laboratory session: Mixed methods study. ANATOMICAL SCIENCES EDUCATION 2022; 15:898-909. [PMID: 34021533 DOI: 10.1002/ase.2106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 05/11/2021] [Accepted: 05/16/2021] [Indexed: 06/12/2023]
Abstract
Many nursing curricula do not offer anatomy laboratories and exposure to cadaveric material. In this mixed methods study, nursing students' perceptions and experiences from an anatomy laboratory session were examined. Students from two academic nursing programs (a four-year general baccalaureate nursing program and a two-year accelerated nursing program for non-nursing baccalaureate graduates) took part in an anatomy laboratory session (N = 223). Participants' learning experiences, emotional experiences, and satisfaction with the anatomy laboratory session were assessed by their responses to closed-ended questionnaires. Participants' reasons for participation and suggestions for improvement were examined by open-ended questions. A mixed methods analysis of the data revealed a high level of satisfaction with the anatomy laboratory experience. Positive attitudes and learning experiences correlated with a sense of identification with the nursing profession. Satisfaction was positively associated with a perceived quality of learning and negatively associated with a negative emotional experience. Curiosity and self-challenge, as well as the quest for tangible, in-depth learning, were major motivators involved in the students' desire to participate in the session. Both qualitative and quantitative analyses indicated that the educational experience was significant. Therefore, it is recommended to integrate anatomy laboratory sessions into anatomy courses for nursing students. This will help to illustrate and assimilate classroom material and strengthen nursing students' sense of identification with their profession.
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Affiliation(s)
- Oren Asman
- Department of Nursing, School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ilya Kagan
- Department of Nursing, School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Michal Itzhaki
- Department of Nursing, School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Ghosh SK, Walocha JA. The place of ethics in practice of anatomical sciences: have we left our dark past behind and looking towards a bright future? SURGICAL AND RADIOLOGIC ANATOMY : SRA 2022; 44:1185-1192. [PMID: 35895100 DOI: 10.1007/s00276-022-02994-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 07/18/2022] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Anatomical sciences involve handling of human tissues and, therefore, application of principles of bioethics is central to anatomical practice. For a considerable period of time, anatomy was practiced without ethical norms as concept of ethics developed during second half of twentieth century. Hence, possible glimpse into contrast in ethical standards between anatomy in the past and present was deemed as an intriguing research theme. METHODS A literature search was undertaken from indexed databases (Medline and Pubmed, Scopus, Embase, CINAHL Plus, Web of Science and Google Scholar). Relevant data were extracted from 37 articles that were selected from an initial pool of 752 articles based on search criteria set for the study. RESULTS Prevalent anatomical practices in the past such as dissection of executed criminals, acts of vivisection, illegal procurement of human remains, use of human tissues obtained as part of war crimes and dissection of human fetuses as well as their archival were analyzed through prism of established ethical norms in present day. The observations from past were presented vis-à-vis ethical practices undertaken in present times such as use of donated bodies and/or body parts procured through legal means for dissection, adherence to ethical norms during dissection, archival of human tissues mandating stringent regulation and dignified disposal of human remains. Existing loop holes were identified and future prospects regarding ethical standards in anatomy were highlighted based on rational judgment of existing trends. CONCLUSION The article concludes with defense on future prospects of ethics in anatomy based on documented arguments.
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Affiliation(s)
- Sanjib Kumar Ghosh
- Department of Anatomy, All India Institute of Medical Sciences, Academic Building, 3rd Floor, Phulwarisharif, Patna, 801507, Bihar, India.
| | - Jerzy A Walocha
- Department of Anatomy, Jagiellonian University, Kopernica 12, 31-034, Krakow, Poland
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Patnaik R, Khan MT, Yamaguchi S, Fritze DM. Building a Low-Cost and Low-Fidelity Kidney Transplant Model: A Technical Report on the San Antonio Kidney Transplant Model. Cureus 2022; 14:e23883. [PMID: 35530913 PMCID: PMC9075688 DOI: 10.7759/cureus.23883] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/04/2022] [Indexed: 12/22/2022] Open
Abstract
One of the most challenging aspects of the kidney transplant operation is performing vascular anastomoses in the confines and depths of the iliac fossa. General surgery residents need to be adequately trained in this skill to maximize their intraoperative experience during their transplant surgery rotation. While several kidney transplant models have been developed, they are limited in their ability to simulate the challenges of performing anastomoses at varying depths and in confined spaces. Furthermore, they may be expensive or require specialized equipment, such as three-dimensional printers, to build. In this technical report, we describe how to build a low-fidelity, low-cost, and portable kidney transplant model capable of simulating vascular anastomoses at varying depths. Our model can be easily replicated for less than 30 USD using materials available in local stores. It uses inexpensive and reusable parts, allowing trainees a high volume of repetitions.
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Affiliation(s)
- Ronit Patnaik
- General Surgery, University of Texas Health Science Center at San Antonio, San Antonio, USA
| | - Mustafa T Khan
- General Surgery, University of Texas Health Science Center at San Antonio, San Antonio, USA
| | - Seiji Yamaguchi
- Transplant Surgery, University of Texas Health Science Center at San Antonio, San Antonio, USA
| | - Danielle M Fritze
- Transplant Surgery, University of Texas Health Science Center at San Antonio, San Antonio, USA
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Comer AR. The evolving ethics of anatomy: Dissecting an unethical past in order to prepare for a future of ethical anatomical practice. Anat Rec (Hoboken) 2022; 305:818-826. [PMID: 35244981 DOI: 10.1002/ar.24868] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 12/02/2021] [Accepted: 12/17/2021] [Indexed: 11/09/2022]
Abstract
Anatomical practice has arguably one of the most ethically challenging histories in the medical sciences. Among the oldest scientific disciplines in medicine, dissection of the human body for scientific purposes occurred as early as the third century Before the Common Era. Throughout the history of anatomical practice, human dissection has occurred in ways that cross the line from progressing medical science to violating the sanctity of the human body. The dissection of the human body creates ethical dilemmas which stem from the need for anatomical science to gain medical knowledge in juxtaposition with prevailing religious and moral views surrounding anatomy as a threat to the sanctity of the human body. This article examines the unethical history of human dissection throughout the ages and explores the rationale behind the unethical practices. In addition, this article explores imperative modern day ethical standards in anatomy including, the ethical handling of human bodies, respecting human life, and ensuring informed consent for dissection of bodies that are donated. Finally, this article explores the question of which ethical prism we should use when dealing with anatomy collections or works of the past. Learning both the history of unethical practices in anatomy and the rationale behind them is imperative so that the discipline can prepare for an ethical, diverse, and inclusive future. This article provides a foundation for understanding the evolution of ethics in anatomical practice and is a valuable resource for students and anatomists alike.
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Affiliation(s)
- Amber R Comer
- Department of Health Sciences, Indiana University, Indianapolis, Indiana, USA
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15
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El‐Haddad J, Štrkalj G, Pather N. A global perspective on embryological and fetal collections: Where to from here? Anat Rec (Hoboken) 2022; 305:869-885. [DOI: 10.1002/ar.24863] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 11/24/2021] [Accepted: 12/14/2021] [Indexed: 12/18/2022]
Affiliation(s)
- Joyce El‐Haddad
- Department of Anatomy, School and Medical Sciences, Faculty of Medicine and Health University of New South Wales Sydney Australia
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16
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Keet K, Kramer B. Advances in Digital Technology in Teaching Human Anatomy: Ethical Predicaments. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2022; 1388:173-191. [DOI: 10.1007/978-3-031-10889-1_8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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17
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The "economy of truth" - new historical sources allow new insights into Hermann Stieve's use of bodies of execution victims for research. Ann Anat 2022; 241:151893. [DOI: 10.1016/j.aanat.2022.151893] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 11/23/2021] [Accepted: 01/10/2022] [Indexed: 11/23/2022]
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18
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Abstract
While cadaveric dissection has stood the test of time because of its widely accepted educational value by experienced surgeons, the introduction advances in 3D printing and biomaterial technologies could potentially provide alternative tools for surgical training. This novel concept in simulation (physical reality) would encompass all the benefits of cadavers in terms of realism and clinical relevance without any of its ethical, infection, safety, and financial concerns.
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Affiliation(s)
- Ahmed Ghazi
- Urology department, University of Rochester, 158 Sawgrass Drive, Rochester, NY 14642, USA.
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19
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Philp J. Bodies and bureaucracy: The demise of the body snatchers in 19th century Britain. Anat Rec (Hoboken) 2021; 305:827-837. [PMID: 34636494 DOI: 10.1002/ar.24794] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 08/25/2021] [Accepted: 09/08/2021] [Indexed: 02/02/2023]
Abstract
As European anatomical teaching developed in the middle ages, anatomists found themselves balanced between the educational and judicial systems. Dissection was associated with the final stages of legal prosecutions and the supply of bodies was severely limited. Driven by increasing student demand for dissection, anatomists found themselves pushed to explore alternative routes for body supply. This led to association with the developing profession of grave robber, body snatchers, and even murderers. Keen to protect themselves from increasing vulnerability to legal prosecution, the eminent anatomists of the United Kingdom pushed for government legislation to provide a supply of cadaveric material for education. This article looks at the development of the Anatomy legislation in the United Kingdom in 1832. By highlighting three events in the early 1800s, it demonstrates that the development of the legislation was for addressing the concerns of the anatomists rather than any ethical concerns about the cadaveric supply. The poorest in society were used to develop the medical understanding of the more wealthy before, during, and after the introduction of the legislation. The first event made the anatomists criminal liable for body supply while the latter two events linked anatomists with murderers. The increasing demand for legislation to provide a supply of cadaveric material released the anatomists from the financial burden of dealing with grave robbers while still allowing dissection tables to be supplied with the poorest in society.
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Affiliation(s)
- Janet Philp
- University of Edinburgh, Old College, Edinburgh, UK
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20
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Yee A, Li J, Lilly J, Hildebrandt S, Seidelman WE, Brown D, Kopar P, Coert JH, Mackinnon SE, Israel HA. Oral and maxillofacial surgeons' assessment of the role of Pernkopf's atlas in surgical practice. Ann Anat 2020; 234:151614. [PMID: 33171220 DOI: 10.1016/j.aanat.2020.151614] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 09/15/2020] [Accepted: 09/23/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND The use of the Pernkopf atlas of human anatomy in surgery presents ethical challenges due to the author's association with the Nazi regime and the potential depiction of victims of this regime. The atlas was of particular utility to two surgical specialties: nerve surgeons and oral and maxillofacial surgeons. The representation of peripheral nerves and complex head and neck anatomy is probably unequaled in any other atlas of anatomy. While the ethical implications of the use of Pernkopf's atlas among nerve surgeons have been previously assessed, this study focuses on the volume dedicated to detailed images of head and neck dissections, and the ethical implications of using this atlas by oral and maxillofacial surgeons. OBJECTIVE To (1) assess the role of the Pernkopf atlas in oral and maxillofacial surgeons' current practice and (2) determine whether a proposal of four conditions would provide ethical guidance for use in surgery and education. METHODS Members of three American oral and maxillofacial surgical societies (ACOMS, ASTMJS, AAOMS) were surveyed and 181 responses collected. The survey introduced the historical origin of the Pernkopf atlas, and respondents were asked whether they would use the atlas under specific conditions that could be a recommendation for its ethical handling. An anatomical plate comparison between Netter's and Pernkopf's atlases was performed to compare accuracy and surgical utility. RESULTS Forty-nine percent of respondents were aware of the Pernkopf atlas, and 9% of respondents were currently using it. Amongst those aware of the historical facts, 42% were comfortable using the atlas, 33% uncomfortable, and 25% undecided. The four conditions involving disclosure, bioethical and religious considerations, and remembrance led to 75% of those "uncomfortable" and "undecided" becoming "comfortable" with use. CONCLUSIONS Amid recent developments and controversy regarding the Pernkopf atlas, a proposal detailing conditions for an ethical approach may provide guidance in surgical planning and education. Furthermore, this approach has implications for the future preparation and publication of anatomical atlases and their use.
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Affiliation(s)
- Andrew Yee
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, USA.
| | - Jessica Li
- Oral and Maxillofacial Surgery, Touro College of Dental Medicine, New York Medical College, Hawthorne, NY, USA
| | - Joshua Lilly
- Oral and Maxillofacial Surgery, Touro College of Dental Medicine, New York Medical College, Hawthorne, NY, USA
| | - Sabine Hildebrandt
- Division of General Pediatrics, Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - William E Seidelman
- Department of Family and Community Medicine, University of Toronto, Toronto, Canada
| | - Doug Brown
- Center for Humanism and Ethics in Surgical Specialties, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Piroska Kopar
- Center for Humanism and Ethics in Surgical Specialties, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | - J Henk Coert
- Department of Plastic-, Reconstructive- and Hand Surgery, Utrecht University Medical Center, Utrecht, Netherlands
| | - Susan E Mackinnon
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Howard A Israel
- Oral and Maxillofacial Surgery, Touro College of Dental Medicine, New York Medical College, Hawthorne, NY, USA
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21
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Wu P, Rieger R, McBride MM, Gray K, Mankin J. Moving From Organ Donation to Knowledge Donation: A Novel Opportunity for Surgical Education Following Organ Donation. Cureus 2020; 12:e10473. [PMID: 33083175 PMCID: PMC7567310 DOI: 10.7759/cureus.10473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
The objective of this article is to share how our institution implemented the use of organ donors for surgical education following organ recovery. Despite technological advances, realistic surgical simulation models are lacking, leaving little opportunity to practice a procedure prior to performance on a living patient. Utilization of organ donors following organ donation offers an opportunity for life-like surgical simulation. We developed a pathway to use organ donor tissue in the post-recovery period for robotic simulation. We obtained support from our local Institutional Review Board, Ethics Committee, and organ procurement organization to create a "knowledge donor" program. Our knowledge donation program provided learners hands-on experience with a novel procedure and also provided organ donors another opportunity to express their altruism. We found that the process was well accepted by donor families and learners. We implemented a knowledge donation program at our hospital that provides valuable surgical experience. We discuss future directions for knowledge donation at our institution.
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Affiliation(s)
- Peter Wu
- Surgery, St. Joseph's Hospital and Medical Center, Phoenix, USA
| | - Rebecca Rieger
- Surgery, St. Joseph's Hospital and Medical Center, Phoenix, USA
| | - Margaret M McBride
- Mission Integration, St. Joseph's Hospital and Medical Center, Phoenix, USA
| | - Kayla Gray
- Research Projects Coordinator, Donor Network of Arizona, Phoenix, USA
| | - James Mankin
- Surgery, St. Joseph's Hospital and Medical Center, Phoenix, USA
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22
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The practice of ethics in the context of human dissection: Setting standards for future physicians. Ann Anat 2020; 232:151577. [PMID: 32688021 PMCID: PMC7366954 DOI: 10.1016/j.aanat.2020.151577] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 06/18/2020] [Accepted: 06/24/2020] [Indexed: 02/07/2023]
Abstract
It is a much desirable skill among physicians that clinical practice should be guided by ethical norms. The dissection room experience provides an opportunity for nurturing the principles of ethical practice among medical students early in the curriculum. When the exercise of human dissection is followed within the boundaries of ethics it effectively props an ideal example for the young minds to emulate in the future. Hence in every stage of dissection room activity precious human body needs to be handled in an ethical manner so as to set a standard for the students. The present review is an attempt to collate the recommendations documented by researchers as per ethical guidelines in the context of human dissection. The review highlights on the ethical norms which needs to be adhered to while receiving the human body of a donor and during preservation of the same. It reflects on ideal ethical behaviour in the dissection room during the act of dissection and finally emphasize on the respectful disposal of the human remains in an ethical manner. The intended purpose of this article is to support uniform adoption of the recommendations for ethical handling of human bodies used in anatomical dissection.
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23
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James H. Use of cadavers to train surgeons: what are the ethical issues? JOURNAL OF MEDICAL ETHICS 2020; 46:470-471. [PMID: 31852744 DOI: 10.1136/medethics-2019-105873] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 11/26/2019] [Indexed: 06/10/2023]
Abstract
This is an invited submission from the Editor-in-Chief as the introductory piece for an 'Ethics Roundtable'. This piece will include invited commentaries from experts in surgical education, medical ethics, law and the prospective body donor perspective.
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Affiliation(s)
- Hannah James
- Clinical Trials Unit, University of Warwick, Coventry, UK
- Trauma & Orthopaedic Surgery, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK
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24
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Czech H, Brenner E. Nazi victims on the dissection table — The Anatomical Institute in Innsbruck. Ann Anat 2019; 226:84-95. [DOI: 10.1016/j.aanat.2019.03.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 02/22/2019] [Accepted: 03/20/2019] [Indexed: 10/27/2022]
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25
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Tatar İ, Huri E, Selçuk İ, Moon YL, Paoluzzi A, Skolarikos A. Review of the effect of 3D medical printing and virtual reality on urology training with ‘MedTRain3DModsim’ Erasmus + European Union Project. Turk J Med Sci 2019; 49:1257-1270. [PMID: 31648427 PMCID: PMC7018298 DOI: 10.3906/sag-1905-73] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 08/07/2019] [Indexed: 12/28/2022] Open
Abstract
Background/aim It is necessary to incorporate novel training modalities in medical education, especially in surgical fields, because of the limitations of cadaveric training. Traditional medical education has many drawbacks, such as residency working hour restrictions, patient safety conflicts with the learning needs, and the lack of hands-on workshops. The MedTRain3DModsim Project aimed to produce 3-dimensional (3D) medical printed models, simulations, and innovative applications for every level of medical training using novel worldwide technologies. It was aimed herein to improve the interdisciplinary and transnational approaches, and accumulate existing experience for medical education, postgraduate studies, and specialty training. Materials and methods This project focused on models of solid organs and the urinary system, including the kidney, prostate, ureter, and liver. With 3D medical printing, it is possible to produce a body part from inert materials in just a few hours with the standardization of medical 3D modeling. Results The target groups of this project included medical students and residents, graduate students from engineering departments who needed medical education and surgical training, and medical researchers interested in health technology or clinical and surgical an atomy. Conclusion It was also intended to develop a novel imaging platform for education and training by reevaluating the existing data using new software and 3D modalities. Therefore, it was believed that our methodology could be implemented in all related medical fields.
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Affiliation(s)
- İlkan Tatar
- Department of Anatomy, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Emre Huri
- Department of Urology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - İlker Selçuk
- Department of Gynecologic-Oncology, Zekai Tahir Burak Research and Educational Hospital, Ankara, Turkey
| | - Young Lee Moon
- Department of Orthopedics, Chosun University, Chosun, South Korea
| | - Alberto Paoluzzi
- Department of Mathematics and Physics, Rome Tre University, Rome, Italy
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26
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Stephens GC, Rees CE, Lazarus MD. How does Donor Dissection Influence Medical Students' Perceptions of Ethics? A Cross-Sectional and Longitudinal Qualitative Study. ANATOMICAL SCIENCES EDUCATION 2019; 12:332-348. [PMID: 30903742 DOI: 10.1002/ase.1877] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Revised: 03/07/2019] [Accepted: 03/18/2019] [Indexed: 06/09/2023]
Abstract
The contribution of donor dissection to modern anatomy pedagogy remains debated. While short-term anatomy knowledge gains from dissection are questionable, studies suggest that donor dissection may have other impacts on students including influencing medical students' professional development, though evidence for such is limited. To improve the understanding of how anatomy education influences medical student professional development, the cross-sectional and longitudinal impacts of donor dissection on medical students' perceptions of ethics were explored. A cross-sectional and longitudinal qualitative study was undertaken at an Australian university where student responses to online discussion forums and in-person interviews were analyzed. Data were collected across the 1.5 years that undergraduate medical students received anatomy instruction (three semesters during first and second years). A total of 207 students participated in the online discussion forums, yielding 51,024 words; 24 students participated in at least 1 of 11 interviews, yielding over 11 hours of interview data. Framework analysis identified five themes related to ethics in an anatomical education context: (1) Dignity, (2) Beneficence, (3) Consent, (4) Justification for versus the necessity of dissection, and (5) Dichotomy of objectification and personification. The dominant themes of students' ethical perceptions changed with time, with a shift from focusing on donors as people, toward the utility of donors in anatomy education. Additionally, themes varied by student demographics including gender, ancestry, and religiosity. Together this study suggests a strong impact of donor dissection on priming students' focus on medical ethics and provides further advocacy for formal and purposeful integration of medical ethics with anatomy education.
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Affiliation(s)
- Georgina C Stephens
- Centre for Human Anatomy Education, Department of Anatomy and Developmental Biology, Monash University, Clayton, Victoria, Australia
| | - Charlotte E Rees
- Monash Centre for Scholarship in Health Education (MCSHE), Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
| | - Michelle D Lazarus
- Centre for Human Anatomy Education, Department of Anatomy and Developmental Biology, Monash University, Clayton, Victoria, Australia
- Monash Centre for Scholarship in Health Education (MCSHE), Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
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27
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Wainman BC, Cornwall J. Body Donation after Medically Assisted Death: An Emerging Consideration for Donor Programs. ANATOMICAL SCIENCES EDUCATION 2019; 12:417-424. [PMID: 30848063 DOI: 10.1002/ase.1874] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 03/04/2019] [Accepted: 03/05/2019] [Indexed: 06/09/2023]
Abstract
Around the world, the recent introduction of assisted death laws has meant that undertaking medical assistance in dying (MAID) is now an option for some persons wishing to end their life. Some of these people donate their bodies to medical science, and by doing so have created a new route from which donor programs can now receive bodies. Such donations have also illuminated a myriad of novel ethical questions. This article considers the emotive and controversial topic of MAID in relation to body donation, describing the experiences of McMaster University, Canada, where several MAID body donors have been received by the anatomical donor program. It provides background on the development and implementation of MAID in Canada, and describes the experience of staff and students at McMaster to MAID donations. It also explores the relevance of MAID to body donation programs, and discusses several of the ethical challenges facing body donation programs who may encounter MAID body donors. These include the appropriateness of accepting MAID donors, issues with informed consent, the effect of personal engagement with MAID donors, information sharing around MAID donations, governance issues, and negative historical parallels between MAID and euthanasia. Suggestions on how to manage MAID body donation focus on how issues affecting institutions, faculty, and students may be approached utilizing appropriate transparency and communication, some of which may facilitate student professional development around the topic of MAID. It is also suggested that the development of ethically appropriate guidelines on MAID body donations may positively guide the anatomical community.
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Affiliation(s)
- Bruce C Wainman
- Pathology and Molecular Medicine and Education Program in Anatomy, McMaster University, Hamilton, Ontario, Canada
| | - Jon Cornwall
- Centre for Early Learning in Medicine, Otago Medical School, University of Otago, Dunedin, New Zealand
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28
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Hildebrandt S. The Role of History and Ethics of Anatomy in Medical Education. ANATOMICAL SCIENCES EDUCATION 2019; 12:425-431. [PMID: 30580499 DOI: 10.1002/ase.1852] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 12/13/2018] [Accepted: 12/17/2018] [Indexed: 06/09/2023]
Abstract
While time spent on anatomical education in medical school curricula has been diminishing over the last decades, the recognized role of anatomical dissection has expanded. It is perceived by many students and faculty not only as the means of learning the structure and function of the human body, but also as an opportunity for the acquisition of professional competencies such as team work, patient-doctor interaction, medical epistemology, self-awareness, and an understanding of medical ethics. This viewpoint article proposes that this learning process can be supported effectively through studying examples from the history of anatomy, as insights from this history can help illuminate contemporary ethical issues in anatomy and medicine. Anatomical education can thus provide not only the opportunity of gaining awareness of ethical questions, but also a chance to practice these new insights within the protected environment of the laboratories, in interaction with the dead and the living. Consequently, a new role has developed for anatomists, which includes the interweaving of the scholarly exploration of the history and ethics of anatomy with the practical application of research results into a reframed concept of anatomical education. Anatomy, as a foundational discipline in the medical curriculum, can thus provide a first step on the educational path of empathetic and humane medical caregivers.
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MESH Headings
- Anatomists/organization & administration
- Anatomists/psychology
- Anatomy/education
- Anatomy/ethics
- Anatomy/history
- Cadaver
- Clinical Competence
- Curriculum/trends
- Dissection
- Education, Medical, Undergraduate/ethics
- Education, Medical, Undergraduate/methods
- Education, Medical, Undergraduate/trends
- Ethics, Medical/education
- Ethics, Medical/history
- History, 18th Century
- History, 19th Century
- History, 20th Century
- History, 21st Century
- Humans
- Professional Role
- Schools, Medical/ethics
- Schools, Medical/organization & administration
- Schools, Medical/trends
- Students, Medical/psychology
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Affiliation(s)
- Sabine Hildebrandt
- Division of General Pediatrics, Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
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29
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Kramer B, Hutchinson EF, Brits DM, Billings BK. Making the Ethical Transition in South Africa: Acquiring Human Bodies for Training in Anatomy. ANATOMICAL SCIENCES EDUCATION 2019; 12:264-271. [PMID: 30179313 DOI: 10.1002/ase.1814] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 05/13/2018] [Accepted: 06/09/2018] [Indexed: 06/08/2023]
Abstract
While dissection remains the method of choice for teaching human anatomy, ethical requirements for obtaining cadavers has made the process of acquiring human bodies more strenuous for institutions. In Africa and at the School of Anatomical Sciences in South Africa, dependence on unclaimed bodies has been prevalent. The aim of the present study was to determine whether more rigorous application of ethical consent has altered the provenance of the cadavers in the School of Anatomical Sciences, University of the Witwatersrand. The numbers of bequeathed/donated/unclaimed cadavers received over the period 2013-2017, as well as their sex and population affinity were analyzed. The majority (96.8%) of the cadavers dissected over the period were from bequests/donations. Marginally more females than males were available. In addition, the population affinity of the cadavers had changed from a majority of South African African (unclaimed) bodies to a majority of South African White (bequest/donated) bodies. The study shows that even with ethical constraints it is possible to transition from the use of mainly unclaimed bodies to the acquisition of bequeathed/donor bodies. However, there may be challenges in relation to anatomical collections in the School as few of the bequest/donated cadavers remain in the School to be added to the collections. These changes also affect the demographics of the Schools' collections.
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Affiliation(s)
- Beverley Kramer
- School of Anatomical Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Erin F Hutchinson
- School of Anatomical Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Desiré M Brits
- School of Anatomical Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Brendon K Billings
- School of Anatomical Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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30
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Habicht JL, Kiessling C, Winkelmann A. Bodies for Anatomy Education in Medical Schools: An Overview of the Sources of Cadavers Worldwide. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2018; 93:1293-1300. [PMID: 29561275 PMCID: PMC6112846 DOI: 10.1097/acm.0000000000002227] [Citation(s) in RCA: 126] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
The International Federation of Associations of Anatomists (IFAA) recommended in 2012 that only donated bodies be used for anatomy teaching and research. However, in many countries around the world, anatomists still depend on bodies that do not stem from voluntary donations by the deceased but, rather, are "unclaimed." A broad search of the literature was conducted to produce a baseline overview of the sources of cadavers used for anatomy teaching in undergraduate medical curricula on a global scale. Information from the literature search was supplemented with data from a 2016-2017 survey of selected senior local anatomists. Of 165 countries with medical schools, information was gathered for 71. In 22 (32%) of the 68 countries that use cadavers for anatomy teaching, body donation is the exclusive source of bodies. However, in most other countries, unclaimed bodies remain the main (n = 18; 26%) or exclusive (n = 21; 31%) source. Some countries import cadavers from abroad, mainly from the United States or India. In one country, bodies of executed persons are given to anatomy departments. The heterogeneous geographical distribution of body sources cannot easily be accounted for, but religion, culture, and folk beliefs about what should happen to bodies after death seem to play a role. Implementation of the IFAA recommendations still has a long way to go, but it is encouraging that functioning body donation programs exist on all continents and that there are examples of recent rises in donations and of anatomists initiating new donation programs.
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Affiliation(s)
- Juri L. Habicht
- J.L. Habicht is a third-year medical student, Medical School Brandenburg, Brandenburg Campus, Brandenburg an der Havel, Germany
| | - Claudia Kiessling
- C. Kiessling is head of the assessment department, Medical School Brandenburg, Neuruppin Campus, Neuruppin, Germany; ORCID: http://orcid.org/0000-0003-4104-4854
| | - Andreas Winkelmann
- A. Winkelmann is full professor, Institute of Anatomy, Medical School Brandenburg, Neuruppin Campus, Neuruppin, Germany, and chair, Federative International Committee for Ethics and Medical Humanities, International Federation of Associations of Anatomists (IFAA); ORCID: http://orcid.org/0000-0003-1047-2477
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31
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Diallo-Danebrock R, Abbas M, Groß D, Kellner U. [History of the anatomical and clinical autopsy]. DER PATHOLOGE 2018; 40:93-100. [PMID: 30062578 DOI: 10.1007/s00292-018-0461-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The history of the autopsy is naturally also a part of the history of anatomy and pathology and spans over about 2300 years. The first documented autopsies were conducted in about 300 B.C. Thereafter, due to the prohibition of dissections due to religious, social, or hygienic reasons, a long period of stagnation took place. With the onset of the Renaissance in the 15th and 16th century, interest in the ancient sciences such as anatomy began to rise and consequently an increasing number of dissections for anatomical studies were conducted. Nevertheless, it took nearly 200 years until clinical symptoms and/or causes of disease and death were correlated with anatomical findings. In the second half of the 19th century, the clinical autopsy based on the combination of macroscopic and microscopic findings became more and more important as a precondition for the systematic description of diseases. Based on autopsy findings and together with several new techniques, modern pathology could be established at the beginning of the 20th century as a source of scientific knowledge for the clinical medicine and as a theoretical discipline of its own.
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Affiliation(s)
- R Diallo-Danebrock
- Institut für Pathologie, Johannes Wesling Klinikum Minden, Paul-Ehrlich-Str. 9, 32429, Minden, Deutschland.
| | - M Abbas
- Institut für Pathologie, Johannes Wesling Klinikum Minden, Paul-Ehrlich-Str. 9, 32429, Minden, Deutschland
| | - D Groß
- Institut für Geschichte, Theorie und Ethik der Medizin, Uniklinik RWTH Aachen, Aachen, Deutschland
| | - U Kellner
- Institut für Pathologie, Johannes Wesling Klinikum Minden, Paul-Ehrlich-Str. 9, 32429, Minden, Deutschland
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32
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Czech H, Druml C, Weindling P. Medical Ethics in the 70 Years after the Nuremberg Code, 1947 to the Present. Wien Klin Wochenschr 2018; 130:159-253. [DOI: 10.1007/s00508-018-1343-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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33
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Henry BM, Vikse J, Pekala P, Loukas M, Tubbs RS, Walocha JA, Jones DG, Tomaszewski KA. Consensus guidelines for the uniform reporting of study ethics in anatomical research within the framework of the anatomical quality assurance (AQUA) checklist. Clin Anat 2018. [PMID: 29532521 DOI: 10.1002/ca.23069] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Unambiguous reporting of a study's compliance with ethical guidelines in anatomical research is imperative. As such, clear, universal, and uniform reporting guidelines for study ethics are essential. In 2016, the International Evidence-Based Anatomy Working group in collaboration with international partners established reporting guidelines for anatomical studies, the Anatomical Quality Assurance (AQUA) Checklist. In this elaboration of the AQUA Checklist, consensus guidelines for reporting study ethics in anatomical studies are provided with in the framework of the AQUA Checklist. The new guidelines are aimed to be applicable to research across the spectrum of the anatomical sciences, including studies on both living and deceased donors. The authors hope the established guidelines will improve ethical compliance and reporting in anatomical research. Clin. Anat. 31:521-524, 2018. © 2018 Wiley Periodicals, Inc.
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Affiliation(s)
- Brandon Michael Henry
- Intentional Evidence Based-Anatomy Working Group, Krakow, Poland.,Department of Anatomy, Jagiellonian University Medical College, Krakow, Poland
| | - Jens Vikse
- Intentional Evidence Based-Anatomy Working Group, Krakow, Poland.,Department of Anatomy, Jagiellonian University Medical College, Krakow, Poland
| | - Przemyslaw Pekala
- Intentional Evidence Based-Anatomy Working Group, Krakow, Poland.,Department of Anatomy, Jagiellonian University Medical College, Krakow, Poland
| | - Marios Loukas
- Department of Anatomical Sciences, St. George's University School of Medicine, Grenada, West Indies
| | | | - Jerzy A Walocha
- Intentional Evidence Based-Anatomy Working Group, Krakow, Poland.,Department of Anatomy, Jagiellonian University Medical College, Krakow, Poland
| | - D Gareth Jones
- Department of Anatomy, University of Otago, Dunedin, New Zealand
| | - Krzysztof A Tomaszewski
- Intentional Evidence Based-Anatomy Working Group, Krakow, Poland.,Department of Anatomy, Jagiellonian University Medical College, Krakow, Poland
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Gürses İA, Coşkun O, Öztürk A. Current status of cadaver sources in Turkey and a wake-up call for Turkish anatomists. ANATOMICAL SCIENCES EDUCATION 2018; 11:155-165. [PMID: 28657659 DOI: 10.1002/ase.1713] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Revised: 04/21/2017] [Accepted: 06/06/2017] [Indexed: 06/07/2023]
Abstract
Persisting difficulties in body procurement in Turkey led to the acquisition of donated, unclaimed, autopsied, and imported bodies regulated under current legislature. Yet, no study had investigated the extent of the on-going cadaver problem. This study was aimed to outline cadaver sources in anatomy departments and their effectiveness by means of an online survey. Additionally, official websites of each department were investigated regarding any information on body donation. Unclaimed cadavers (84.8%) were the major source for anatomy departments, followed by donated (50%) and imported cadavers (39.1%). Foundation-based medical faculties were more likely to import cadavers (P = 0.008). There was a moderate increase (rs = 0.567; P = 0.018) in donation registrations to our department after 2000. The departments in cities with significantly higher City-Based Gross Domestic Product measures (US$9,900 vs. US$16,772, P = 0.041), frequencies for mid- or high-school graduates (30.4% vs. 31.3%, P = 0.041), and frequencies for under- or post-graduates (13.1% vs. 15.8%, P = 0.24) had managed to use donated cadavers. Anatomy departments' major reasons for using unclaimed cadavers were education (45.9%), unclaimed cadavers being the only source (24.3%), and receiving inadequate donations (21.6%). Nine out of seventy-four departments (12.2%) provided information regarding body donation on their websites. Body procurement remains as a serious problem in Turkey and it is apparent that current legislature does not provide a sufficient cadaver inflow. Similarly, anatomy departments' effectiveness in public awareness of body donation and support in the National Body Donation Campaign seems questionable. Anat Sci Educ 11: 155-165. © 2017 American Association of Anatomists.
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MESH Headings
- Anatomists
- Anatomy/education
- Awareness
- Cadaver
- Dissection
- Education, Medical, Undergraduate/economics
- Education, Medical, Undergraduate/methods
- Education, Medical, Undergraduate/organization & administration
- Faculty, Medical
- Female
- Human Body
- Humans
- Legislation, Medical
- Schools, Medical/economics
- Schools, Medical/organization & administration
- Surveys and Questionnaires
- Time Factors
- Tissue and Organ Procurement/economics
- Tissue and Organ Procurement/legislation & jurisprudence
- Tissue and Organ Procurement/methods
- Tissue and Organ Procurement/statistics & numerical data
- Turkey
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Affiliation(s)
- İlke Ali Gürses
- Department of Anatomy, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Osman Coşkun
- Department of Anatomy, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Adnan Öztürk
- Department of Anatomy, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
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Yiasemidou M, Gkaragkani E, Glassman D, Biyani CS. Cadaveric simulation: a review of reviews. Ir J Med Sci 2017; 187:827-833. [PMID: 29139057 DOI: 10.1007/s11845-017-1704-y] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 10/20/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Traditional surgical training, largely based on the Halstedian model "see one, do one, teach one" is not as effective in the era of working time restrictions and elaborate shift-patterns. As a result, contemporary surgeons turned to educational methods outside the operating theatre such as simulation. Cadavers are high fidelity models but their use has ethical and cost implications and their availability may be limited. In this review, we explore the role of cadaveric simulation in modern surgical education. METHODS All the Evidence-Based Medicine databases were searched for relevant reviews. The resulting studies were assessed for inclusion to this review, according to pre-determined criteria. Data extraction was performed using a custom-made spreadsheet, and the quality of included reviews was assessed using a validated scoring system (AMSTAR). RESULTS The literature review yielded 33 systematic reviews; five of which matched the inclusion criteria and were included in this review of reviews. Cadaveric simulation was found to have good face (subjective assessment of usefulness) and content validity (whether a specific element adds or retracts to the educational value) while trainees improved their surgical skills after practicing on cadavers. However, concerns have been raised about ethical issues, high cost and availability. CONCLUSION Cadavers are an effective medium for surgical teaching, and it may be appropriate for them to be used whenever surrounding conditions such cost and availability allow. Further research is required to provide evidence on whether there is equivalence between cadavers and other educational media which may not bear the same shortcomings.
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Affiliation(s)
- M Yiasemidou
- Leeds Institute of Biomedical and Clinical Sciences, Leeds, LS9 7TF, UK. .,St. James' University Hospital, 7.26 Clinical Sciences Building, Leeds, West Yorkshire, LS9 7TF, UK.
| | | | | | - C S Biyani
- Urology Department, Leeds Teaching Hospitals, Leeds, UK
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Nikolić V, Savić S, Antunović V, Marinković S, Andrieux C, Tomić I. Decapitation in reality and fine art: A review. Forensic Sci Int 2017; 280:103-112. [DOI: 10.1016/j.forsciint.2017.09.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2017] [Revised: 08/07/2017] [Accepted: 09/18/2017] [Indexed: 12/27/2022]
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Hildebrandt S, Seidelman WE. Where do they come from? A call for complete transparency regarding the origin of human tissues in research. ESMO Open 2017; 2:e000201. [PMID: 28761755 PMCID: PMC5519783 DOI: 10.1136/esmoopen-2017-000201] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2017] [Indexed: 11/30/2022] Open
Affiliation(s)
- Sabine Hildebrandt
- Division of General Pediatrics, Department of Medicine, Boston Children’s Hospital, Boston, Massachusetts, USA
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - William E Seidelman
- Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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Winkelmann A. Guidelines for reporting original anatomical studies-Quality and ethics. Clin Anat 2017; 30:425-426. [DOI: 10.1002/ca.22833] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Accepted: 02/01/2017] [Indexed: 11/10/2022]
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Ceremonies of gratitude following the dissection course: A report on procedures in departments of anatomy in German speaking countries. Ann Anat 2017; 210:18-24. [DOI: 10.1016/j.aanat.2016.10.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Revised: 10/06/2016] [Accepted: 10/06/2016] [Indexed: 11/21/2022]
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40
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Gürses İA, Coşkun O, Gürtekin B, Kale A. The amount of information provided in articles published in clinical anatomy and surgical and radiologic anatomy regarding human cadaveric materials and trends in acknowledging donors/cadavers. Surg Radiol Anat 2016; 38:1225-1231. [PMID: 27151088 DOI: 10.1007/s00276-016-1684-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Accepted: 04/28/2016] [Indexed: 11/25/2022]
Abstract
AIM Appreciating the contribution of donor-cadavers to medical education is a well observed practice among anatomists. However, the appreciation of their contribution in research and scientific articles remains dubious. We aimed to evaluate how much data anatomists provide about specimens they have used and how frequently anatomists acknowledge their cadavers in published articles. MATERIALS AND METHODS We evaluated all articles performed on human cadaveric specimens that were published in Clinical Anatomy and Surgical and Radiologic Anatomy between January 2011 and December 2015. We evaluated how much data on the demographics, preservation method(s), source, and ethical/legal permissions regarding cadavers were provided. We also evaluated the number of articles that acknowledged donor-cadavers. RESULTS The majority of articles provided demographic data (age and sex) and preservation method used in the article. The source of the specimens was not mentioned in 45.6 % of the articles. Only 26.2 % of the articles provided a degree of consent and only 32.4 % of the articles reported some form of ethical approval for the study. The cadavers and their families were acknowledged in 17.7 % of the articles. We observed that no standard method for reporting data has been established. CONCLUSIONS Anatomists should collaborate to create awareness among the scientific community for providing adequate information regarding donor-cadavers, including source and consent. Acknowledging donor-cadavers and/or their families should also be promoted. Scientific articles should be used to create a transparent relationship of trust between anatomists and their society.
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Affiliation(s)
- İlke Ali Gürses
- Department of Anatomy, Istanbul University, Istanbul Faculty of Medicine, Millet Caddesi, Fatih, Istanbul, 34093, Turkey.
| | - Osman Coşkun
- Department of Anatomy, Istanbul University, Istanbul Faculty of Medicine, Millet Caddesi, Fatih, Istanbul, 34093, Turkey
| | - Başak Gürtekin
- Department of Biostatistics and Medical Informatics, Istanbul University, Istanbul Faculty of Medicine, Millet Caddesi, 34093, Fatih, Istanbul, Turkey
| | - Ayşin Kale
- Department of Anatomy, Istanbul University, Istanbul Faculty of Medicine, Millet Caddesi, Fatih, Istanbul, 34093, Turkey
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The Anatomical Institute at the University of Greifswald during National Socialism: The procurement of bodies and their use for anatomical purposes. Ann Anat 2016; 205:103-12. [PMID: 26970502 DOI: 10.1016/j.aanat.2016.02.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Revised: 02/04/2016] [Accepted: 02/20/2016] [Indexed: 11/23/2022]
Abstract
This is the first comprehensive account of body procurement at the Anatomical Institute at Greifswald University during National Socialism (NS). As in all other German anatomical departments, the bodies received during this period included increasing numbers of victims of the NS regime. Prior to 1939, 90% of all bodies came from hospitals, state nursing homes and mental institutions (Heil- und Pflegeanstalten), but dropped to less than 30% after 1941. While the total catchment area for body procurement decreased, the number of suppliers increased and included prisons, POW camps, Gestapo offices and military jurisdiction authorities. Among the 432 documented bodies delivered to the institute, 132 came from state nursing homes and mental institutions, mainly from Ueckermünde. These were bodies of persons, who probably were victims of "euthanasia" crimes. The Anatomical Institute also procured 46 bodies of forced laborers, of whom at least twelve had been executed. Other groups of victims included 21 bodies of executed Wehrmacht soldiers and 16 Russian prisoners of war from the camp Stalag II C in Greifswald, who had died of starvation and exhaustion. From 1941 onwards, the number of bodies delivered from prisons and penitentiaries greatly increased. In total, 60 bodies of prisoners, mainly from the penitentiary in Gollnow, were delivered to the Anatomical Institute. Greifswald Anatomical Institute was not just a passive recipient of bodies from all of these sources, but the anatomists actively lobbied with the authorities for an increased body supply for teaching and research purposes.
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Hildebrandt S. Insights into the Freiburg Anatomical Institute during National Socialism, 1933-1945. Ann Anat 2016; 205:90-102. [PMID: 26965250 DOI: 10.1016/j.aanat.2016.01.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2015] [Revised: 01/07/2016] [Accepted: 01/26/2016] [Indexed: 10/22/2022]
Abstract
The Anatomical Institute at the Albert-Ludwigs-Universität Freiburg is among the anatomical departments for which a comprehensive account of its history during National Socialism (NS) is still missing. Previous investigations (such as in: Grün et al., 2002) have revealed the political activities of some anatomists, but, in the absence of relevant body-registers, a more comprehensive examination of the anatomical body procurement has not been attempted. The inspection of records in university and municipal archives allows insight into the activities in the institute within the historical context. The Freiburg Institute shared the experience of the impact of NS politics with other German anatomies. Four anatomists were dismissed because of NS racial discrimination, and chairman von Möllendorf left for political reasons. His successor Nauck's appointment was politically motivated, as he was a staunch Nazi. His colleagues were also members of NS political organizations. Body procurement was controversial between the public and the anatomists in Freiburg prior to and following the Third Reich, and much of the anatomists' efforts focused on the improvement of the body supply. In 1935, and, again during the war, the number of bodies was sufficient for anatomical education. Among the traditional sources of body procurement were increasing numbers of NS victims. Forty-four of them can be identified, among them 21 forced laborers and their children who died of so-called natural causes, and 22 men who had been executed at Stuttgart prison on April 6, 1943. While the victims' names have been ascertained, their biographies still need restoration to ensure an appropriate commemoration.
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Winkelmann A, Heinze AK, Hendrix S. Acknowledging tissue donation: Human cadaveric specimens in musculoskeletal research. Clin Anat 2015; 29:65-9. [PMID: 26475573 DOI: 10.1002/ca.22650] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Revised: 08/14/2015] [Accepted: 09/07/2015] [Indexed: 11/12/2022]
Abstract
Human cadaveric specimens are an important resource for research, particularly in biomechanical studies, but their use also raises ethical questions and cannot simply be taken for granted. It was asked how much information authors publishing musculoskeletal research actually give about such specimens and about how they were acquired. The aim was to formulate recommendations on how this reporting might be improved. Relevant articles published between 2009 and 2012 in four North American or European journals were scanned for information regarding the characteristics of the human specimens used, their institutional source and the ethical or legal context of their acquisition. While the majority of articles report biological characteristics of specimens (sex, age at death, preservation method), only 40% of articles refer to body donation, only 23% report the institution that provided specimens, and only 17% refer to some kind of formalized approval of their research. There were regional and journal-to-journal differences. No standard for reporting studies involving human specimens could be detected. It is suggested that such a standard be developed by researchers and editors. Information on the source of specimens and on the ethical or legal basis should be regularly reported to acknowledge this unique research resource and to preserve the good relationship between researchers and the communities, that provide the required specimens by body donation and upon which researchers depend.
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Affiliation(s)
| | - Anne-Kathrin Heinze
- Institute of Vegetative Anatomy, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Sven Hendrix
- Department of Morphology, Biomedical Research Institute, Hasselt University, Hasselt, Belgium
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Brehm TT, Korf HW, Benzenhöfer U, Schomerus C, Wicht H. Notes on the history of the Dr. Senckenbergische Anatomie in Frankfurt/Main. Part II. The Dr. Senckenbergische Anatomie during the Third Reich and its body supply. Ann Anat 2015. [DOI: 10.1016/j.aanat.2015.04.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Ghosh SK. Human cadaveric dissection: a historical account from ancient Greece to the modern era. Anat Cell Biol 2015; 48:153-69. [PMID: 26417475 PMCID: PMC4582158 DOI: 10.5115/acb.2015.48.3.153] [Citation(s) in RCA: 165] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Revised: 07/24/2015] [Accepted: 08/19/2015] [Indexed: 11/27/2022] Open
Abstract
The review article attempts to focus on the practice of human cadaveric dissection during its inception in ancient Greece in 3rd century BC, revival in medieval Italy at the beginning of 14th century and subsequent evolution in Europe and the United States of America over the centuries. The article highlights on the gradual change in attitude of religious authorities towards human dissection, the shift in the practice of human dissection being performed by barber surgeons to the anatomist himself dissecting the human body and the enactment of prominent legislations which proved to be crucial milestones during the course of the history of human cadaveric dissection. It particularly emphasizes on the different means of procuring human bodies which changed over the centuries in accordance with the increasing demand due to the rise in popularity of human dissection as a tool for teaching anatomy. Finally, it documents the rise of body donation programs as the source of human cadavers for anatomical dissection from the second half of the 20th century. Presently innovative measures are being introduced within the body donation programs by medical schools across the world to sensitize medical students such that they maintain a respectful, compassionate and empathetic attitude towards the human cadaver while dissecting the same. Human dissection is indispensable for a sound knowledge in anatomy which can ensure safe as well as efficient clinical practice and the human dissection lab could possibly be the ideal place to cultivate humanistic qualities among future physicians in the 21st century.
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Affiliation(s)
- Sanjib Kumar Ghosh
- Department of Anatomy, ESI-PGIMSR & ESIC Medical College, Kolkata, West Bengal, India
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Fernandez E. Moral justification of anatomical dissection and conquest in the Spanish Chronicles of the Indies. ENDEAVOUR 2015; 39:85-94. [PMID: 26051986 DOI: 10.1016/j.endeavour.2015.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Revised: 05/11/2015] [Accepted: 05/12/2015] [Indexed: 06/04/2023]
Abstract
Three cases of dissections of dead bodies are included in the Spanish Chronicles of the Indies. By reporting on these advanced medico-scientific practices, the chroniclers appear to be confirming the superiority of the conquistadors over the natives and justifying the conquest. However, they problematize this supposed superiority by framing the events in complex scenarios that resound of some of the controversies surrounding dissection in the period. This contradictory treatment of dissection can be interpreted as a manifestation of the conquistadors' anxiety around being physically identical to the natives except for a fragile, skin-deep veneer of civilized behaviour.
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Affiliation(s)
- Enrique Fernandez
- Department of French, Spanish and Italian, University of Manitoba, Winnipeg R3T2N2, Canada.
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Anatomists’ views on human body dissection and donation: An international survey. Ann Anat 2014; 196:376-86. [DOI: 10.1016/j.aanat.2014.06.004] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Revised: 06/03/2014] [Accepted: 06/10/2014] [Indexed: 11/18/2022]
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Nystrom KC. The Bioarchaeology of Structural Violence and Dissection in the 19th-Century United States. AMERICAN ANTHROPOLOGIST 2014. [DOI: 10.1111/aman.12151] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Kenneth C. Nystrom
- Department of Anthropology; State University of New York at New Paltz; New Paltz NY 12561
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Hansson N, Hildebrandt S. Swedish–German contacts in the field of anatomy 1930–1950: Gösta Häggqvist and Hermann Stieve. Ann Anat 2014; 196:259-67. [DOI: 10.1016/j.aanat.2014.05.037] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Revised: 05/19/2014] [Accepted: 05/19/2014] [Indexed: 10/25/2022]
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50
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Hildebrandt S. Current status of identification of victims of the National Socialist regime whose bodies were used for anatomical purposes. Clin Anat 2013; 27:514-36. [DOI: 10.1002/ca.22305] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2013] [Revised: 07/18/2013] [Accepted: 07/18/2013] [Indexed: 11/10/2022]
Affiliation(s)
- Sabine Hildebrandt
- Boston Children's Hospital; Harvard Medical School; Boston Massachusetts
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