Donors' attitudes towards body donation for dissection

Influence of religio-cultural beliefs on whole-body donation: A quantitative analysis of a predominantly South African Pedi Community

BACKGROUND

Body donation is a predominant mode of body sourcing in many countries including South Africa; however, it continues to be limited among the different ethnic groups in the Black African population of South Africa which have been observed to be largely unwilling to provide consent to donate their bodies. Religious and cultural beliefs have been suggested to influence willingness to donate one's body to science, with most religions regarded as accepting of body donation globally. In contrast, cultural beliefs and practices in the African continent impede body donation. Therefore, it is crucial to understand the factors that influence willingness to participate in body donation among the various ethnic groups of the Black African population of South Africa, particularly the Pedi ethnic group.

PURPOSE

This study sought to investigate factors that determine the disposition to participate in body donation and the influence of religious and cultural beliefs on willingness to consent to donate one's body among a predominantly Pedi community of the Black African population of South Africa in the Limpopo province.

METHODS

In this cross-sectional study, 300 four-page questionnaires were distributed to conveniently sampled individuals from the GaMaphale (Pipa) village of the Limpopo province of South Africa. Descriptive statistics (frequency tables and Pearson's chi-square test for independence) followed by a stepwise backward regression were conducted to obtain key factors determining willingness to donate one's body, the influence of religious and cultural beliefs, and also the likelihood of willingness to participate in body donation in this community. A p-value of < 0.05 was considered statistically significant.

RESULTS

A total of 190 (63 %) responses were obtained. The level of awareness about body donation was 30 % (n= 57/190), and 41 % (n= 78/190) of respondents were willing to donate their bodies. Age (p = 0.001), educational level (p = 0.037), belief in a higher entity (p = 0.007), ancestral (p < 0.001), and religious (p < 0.001) beliefs allowing for body donation were statistically associated with willingness to donate one's body. The elderly respondents were less likely to agree to donate their bodies compared to younger adults. Respondents who understood that religion allowed them to self-donate were 50 times more likely to agree to donate their bodies than those who did not.

DISCUSSION AND CONCLUSION

Findings reflect that a high percentage of respondents were unaware of body donation while a considerable number of respondents were willing to donate their bodies to science based on their religious and cultural beliefs allowing them to do so. Potential body donors from this community will likely be younger and belong to religions that allow body donation. The need to increase awareness about body donation programs through awareness campaigns, especially among religious organizations that may allow for body donation, is warranted in this community. This work was supported by the National Research Foundation (TTK220214660416).

Do religious and cultural considerations militate against body donation? An overview and a Christian perspective

The development of anatomy as a scientific undertaking appears to have left little room for religious and cultural input into the conduct of anatomical investigations. This has been brought to the fore by questionnaires regarding the willingness or otherwise of individuals to donate their bodies for dissection, with higher levels of willingness from those without religious affiliations. This has led to the assumption that there is inherent opposition to body donation by those with a religious stance, although there has been little exploration of this. This is increasingly important with growing awareness that anatomy is an international discipline, leading to increasing attention to the religious and cultural contexts within which it is practiced. There is a diversity of responses toward body donation within different countries, as well as by those influenced by Islam, Hinduism, and Buddhism. Additionally, there are diverse cultural attitudes within Confucianism in Asia, Zulu in Africa, and Māori in New Zealand. Even those within the Christian church are influenced by a variety of values, some of which are in tension, with emphasis on the sacredness of life and the significance of burial being negative toward body donation, with informed consent and altruism pointing in a positive direction. The challenge for anatomists is to understand those within their communities, seek to appreciate their perspectives, and also make known the potential of body donation and dissection for enhancing medical practice and improving the education of future health workers.

Donor memorialization practices at religious institutions in the United States

Many institutions worldwide honor the gift of human body donors through memorial services, ceremonies, and various other means, such as guided reflection or art activities. Memorial services can vary when it comes to the name, who is involved in the planning, and who may attend. Within the United States, the role of religion in the planning and delivery of these ceremonies at religious institutions has yet to be actively explored. This study aimed to collect information about human body donor memorialization practices at religious institutions in the United States to help guide further suggestions for enhancing inclusivity in these practices. This study utilized a voluntary survey that was distributed to anatomy educators and human body donor programs to complete if they were from a religious institution that utilized human body donors. Based on the data collected in this study (n = 39), most religious institutions have some form of donor memorialization practices, which may or may not include a formal memorial service. In these practices described by survey participants, religion was commonly represented using an interfaith approach, in which campus ministry often assisted in planning and facilitating the memorialization. Those with masses/services refer to them by different names, and most occur in a religious-specific place on campus. In conclusion, among survey participants at religious institutions that utilize and memorialize human body donors, most take an inclusive interfaith approach to their memorialization practices, as this can be more representative of the body donors and students who learn from them.

Dog owners' awareness of and motivations towards pet cadaver donation

BACKGROUND

Animal cadavers still play an essential role in veterinary education. Many veterinary schools would like to participate in pet cadaver donation schemes for many reasons, including ethical resourcing of cadavers, but finding owners willing to donate their pet is challenging. The aim of this study was to investigate dog owners' awareness of pet cadaver donation.

METHODS

The study was conducted using Jisc online surveys with the survey being distributed via social media. In total, 708 people answered a 10-question online questionnaire.

RESULTS

The most common reason given for why a dog owner might donate was to assist in the education of future veterinarians (n = 396, 56%). When asked to rank the options given to them upon the passing of their pet, single animal cremation was overwhelmingly the participants' favoured option (n = 483, 68.2%).

LIMITATIONS

Factors that might affect the findings, such as religion, financial status and cultural differences, were not explored in this study.

CONCLUSIONS

The only incentive shown to increase the likelihood of pet owners donating to a pet cadaver scheme was the return their pet's ashes to them after the cadaver had served its purpose. This study revealed that dog owners currently have very little knowledge of pet cadaver donation.

Knowledge levels and attitudes of medical faculty students related to whole body donation in Türkiye

BACKGROUND

Cadaver is a very important educational material for medical faculty students, students of health sciences, residents of any specialty in medicine and specialists. In developed countries, cadavers are mainly obtained by individual donations. However, like in other developing or underdeveloped countries, whole-body donations for cadaveric use in Türkiye are extremely scarce. This study sought to investigate the knowledge and awareness levels of medical faculty students about body donation and the factors that might influence their attitudes to body donation. The aim of the study is, with the results of the questionnaire, to raise public awareness for whole-body donation by creating public spots and by giving place in the official website of the Ministry of Health and make medical faculties to put lectures about body donation and its importance into their anatomy curriculum.

METHODS

A 31-item questionnaire with close-ended statements was administered to 291 students at Istanbul University-Cerrahpaşa, Cerrahpaşa Medical Faculty.

RESULTS

Only two of the participants (0.7%) stated that they had already donated their bodies to be used as a cadaver. Of note, those who reported considering whole body donation had higher maternal education levels (p = 0.002). The presence or absence of religious belief and the degree of religiosity were also significant factors, for significantly higher rates of non-believers and those who defined themselves as having a low degree of religiosity were in favor of body donation (p < 0.0001).

CONCLUSIONS

According to the religion of Islam, we should inform the relevant media that there is no harm in donating a body. In addition, considering the effect of mother's education level on the decisions of young people on this issue, we can state that we see once again how important women's education is in order to make progress in every field.

Applicability and usefulness of the Declaration of Helsinki for forensic research with human cadavers and remains

Bodies of deceased persons and human remains and their specimens (i.e., organs, bones, tissues, or biological samples) are essential in forensic research but ad hoc worldwide-recognized ethical standards for their use are still lacking. Such standards are needed both to avoid possible unethical practices and to sustain research in the forensic field. Pending consensus within the forensic science community regarding this topic, with this article we aim to stimulate a debate as to the applicability and usefulness of the Declaration of Helsinki in the field of forensic research involving human cadavers and remains. Considering the fundamental differences compared to clinical research involving human beings and the different moral obligations involved, we focus on the risks, burdens, and benefits of research, ethics committee approval, and informed consent requirements. The Declaration of Helsinki framework allows forensic researchers to focus on substantial ethical principles promoting the consistency, integrity, and quality of research. Consensus regarding ethical standards and the adoption of national and supranational laws that clearly regulate the use of human cadavers and remains, including those from autopsies, continues to be of primary importance for the forensic science community.

Understanding beliefs, preferences and actions amongst potential body donors

Body donation is a prosocial act providing a unique learning experience to students, ultimately impacting on patient care and science. With an increasing number of training professionals, there is an increasing need for body donors, yet little is understood about donors' beliefs and preferences. A four-center study aimed to understand donors' perceptions, 843 responses highlighted a significant relationship between completing a body donor consent form and being both an organ donor and having ever donated blood (p < 0.01). In exploring donor intentions, 69% had been considering donation for fewer than five years, 40% knew another body donor, and 27% had a family member or friend currently registered. Of those who had requested donor information packs, 97% had completed body donation consent forms. Of these, 92% had not selected any time restriction for their donation and 96% had consented to images being taken. Almost all (98%) were aware that their donation might not be accepted. Donors' motives highlighted a wish to: improve education, improve health care, advance science, and contribute to the greater good. A bimodal response was observed with body donation being used to save relatives money and inconvenience. Donors felt comfortable with their bodies being used by medical, dental, and allied health professionals; however, donors were less comfortable with their bodies being used by other groups. Only 57% were comfortable with artists, beauticians and yoga teachers using their remains. Understanding donors' motivations and decision-making process is vital to ensure resources for future and to meet any changing requirements of both donors and those studying them.

Altruism in death: Attitudes to body and organ donation in Australian students

Health education, research, and training rely on the altruistic act of body donation for the supply of cadavers. Organ transplantation and research rely on donated organs. Supply of both is limited, with further restrictions in Australia due to requirements for a next-of-kin agreement to donation, irrespective of the deceased's pre-death consent. Research suggests health workers are less likely to support the donation of their own bodies and/or organs, despite recognizing the public good of donation, and that exposure to gross anatomy teaching may negatively affect support for donation. Attitudes to body and organ donation were examined in Australian students studying anatomy. Support for self-body donation (26.5%) was much lower than support for self-organ donation (82.5%). Ten percent of participants would not support the election of a family member or member of the public to donate their body, and just over 4% would not support the election of a family member to donate their organs, with one-to-two percent not supporting this election by a member of the public. Exposure to gross anatomy teaching was associated with an increased likelihood of consideration of issues about body and organ donation, whether for self, family, or the public, and registration as an organ donor. Exposure decreased participants' willingness to donate their own body, with those who practiced a religion least likely to support body donation. Gross anatomy courses provide an opportunity to inform future healthcare workers about altruistic donation, albeit with a recognition that religious or cultural beliefs may affect willingness to donate.

The evolving ethics of anatomy: Dissecting an unethical past in order to prepare for a future of ethical anatomical practice

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.

A Novel Cadaveric Embalming Technique for Enhancing Visualisation of Human Anatomy

Within the discipline of anatomical education, the use of donated human cadavers in laboratory-based learning activities is often described as the 'gold standard' resource for supporting student understanding of anatomy. Due to both historical and educational factors, cadaveric dissection has traditionally been the approach against which other anatomy learning modalities and resources have been judged. To prepare human donors for teaching purposes, bodies must be embalmed with fixative agents to preserve the tissues. Embalmed cadavers can then be dissected by students or can be prosected or plastinated to produce teaching resources. Here, we describe the history of cadaveric preservation in anatomy education and review the practical strengths and limitations of current approaches for the embalming of human bodies. Furthermore, we investigate the pedagogic benefits of a range of established modern embalming techniques. We describe relevant cadaveric attributes and their impacts on learning, including the importance of colour, texture, smell, and joint mobility. We also explore the emotional and humanistic elements of the use of human donors in anatomy education, and the relative impact of these factors when alternative types of embalming process are performed. Based on these underpinnings, we provide a technical description of our modern Newcastle-WhitWell embalming process. In doing so, we aim to inform anatomy educators and technical staff seeking to embalm human donors rapidly and safely and at reduced costs, while enhancing visual and haptic tissue characteristics. We propose that our technique has logistical and pedagogic implications, both for the development of embalming techniques and for student visualisation and learning.

Bodies and bureaucracy: The demise of the body snatchers in 19th century Britain

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.

Assessment of Ethical Compliance of Handling and Usage of the Human Body in Anatomical Facilities of Ethiopian Medical Schools

Background

Human anatomy has historically been a cornerstone in medical education and is special in that it uses human remains kept in various anatomical facilities like a morgue, gross anatomy laboratory, or museums for instruction and research. While serving knowledge advancement facilitating clinical practice and research, human cadaver handling, and usage at all levels, such as cadaver sourcing, transportation, storage, preservation, dissection, and final disposal deserves in return the utmost respect. In Ethiopia, even though there is not enough information on when, where, and by whom the first cadaver dissection was conducted, dissection is being conducted in many of its medical schools. Despite ethical necessity surrounding human body usage in every anatomical setting, there is still ethical and legal uncertainty due to several challenging barriers which is severe in developing nations including Ethiopia. The aim of this study is, therefore, to assess ethical practices of handling and usage of the human body to promote, in the near future, formulation and implementation of acceptable, respectful, and ethical guidelines for the anatomy dissection laboratories and related settings in Ethiopia.

Methods

A multicentered cross-sectional study was used at selected anatomy facilities of eight Ethiopian medical schools. The collected data through structured questionnaires and checklists were cleaned, preset and entered in to SPSS version 20 for analysis. Internal consistency and reliability were measured by using Cronbach’s alpha.

Results

The study result showed vivid human body ethical breaches that ranged from lack of power by anatomy unit to oversee the process during sourcing, transportation, embalming, caring, and dissection of cadavers in the anatomy laboratories to student’s mistreatment of cadavers.

Conclusion

In addition to lack of compliance due to lack of standard ethical guidelines or policies regarding human body usage, the compliance-based professional development is also nonexistent. The ethical way of body sourcing is through body donation; however, in Ethiopia, anatomy teaching exclusively depends on unclaimed bodies. Using a body for dissection that is solely sourced unethically may generate a negative emotional sense of life for anatomy instructors, technical assistants, morticians, and medical students. We inspire better provision of moral and ethical exercise with the good practice concerning the human body through recognizing the humanity and uniqueness of the deceased person. The results of this study serve as a serious condemnation of practices in Ethiopian anatomy facilities and we urge the Anatomical Society of Ethiopia to play its part in changing the present practices related to ethical and legal uncertainty of the human body usage.

Mississippi's whole body donors: Analysis of donor pool demographics and their rationale for donation

BACKGROUND

Whole body donation (WBD) is fundamental to anatomical education and research because human dissection provides an educational tool for training healthcare professionals. Investigation into the demographics and rationale of whole body donors can provide insight on who donates their bodies to science. Literature reports a typical donor who is a 60 to 70-year-old, white, married, educated man with the reason for donating to be altruism. Because there are no studies in the United States (US) about the rationale of WBD in correlation with the donor characteristics, this study seeks to accomplish two aims: (1) analyze the demographics of the University of Mississippi Medical Center's (UMMC) current donor registrants and (2) analyze their reasons for donation.

METHODS

Data from authorization forms from living preregistered donors were analyzed. A survey was sent to registrants who filled out these forms between 2017 and 2019 about their reasons for body donation.

RESULTS

UMMC has an average donor registrant population consisting of 69-year-old white (95.2%), females (56.5%) who acquired a college degree (24.9%) and are in good health at the time of donation (50.8%). Males and females differed in their marital status (p = 0.001), with more married males (67.2%) than females (46.2%) donating their bodies to science. Seven hundred eighty-one registrants completed the survey (56.3% response rate, n = 1,387). Their primary and secondary reasons for donation were furthering medical education/research (57.4%) and giving their body purpose after life (49.2%), respectively. In addition, thematic analysis of 62 donor rationale statements revealed that the majority of registrants wanted to donate their bodies for the purpose of being useful.

CONCLUSIONS

These results indicate that UMMC's current registrant demographic data deviates from what is presented in the literature. The study also found that the main reason for donation for this registrant population was altruism with the purpose of being useful. Information from this study adds current US data to the published literature on WBD.

Attitudes of Anatomy Students toward Commemorations for Body Donors: A Multicultural Perspective

Many medical schools practice commemorative ceremonies to honor body donors. Attitudes of medical education stakeholders toward these ceremonies have not yet been fully investigated. The aim of this study was to explore anatomy students' attitudes toward commemorations at a multicultural institution which has not introduced these ceremonies yet. A survey was carried out on different groups of anatomy students that were exposed and not yet exposed to human remains. The survey was used to record basic demographic data from the respondents, ask if they would support the establishment of an anatomy commemoration and in which format. A total of 756 anatomy students participated in the survey (response rate 69.8%). The majority (76.3%) were in favor of introducing a commemoration for donors. The associations of students' gender, attitude toward body donation, and level of exposure to human remains with attitudes toward commemoration for donors were identified (P < 0.05), whereas ethnicity and religion seemed to have no influence on attitudes (P > 0.05). Most students believed that anatomy staff and students should organize the commemoration. There was a preference for the commemoration to be secular with revealed identities of donors, and not recorded for social media. The support for the establishment of commemorations transcended cultural and religious differences and confirmed students' respectful attitude toward donors. Anatomy commemorations seem to have potential not only to engage students with one another, and donor families, but also to pave the way for students to become life-long ethical and empathetic learners and practitioners.

Demographic and motivational factors affecting the whole-body donation programme in Nanjing, China: a cross-sectional survey

OBJECTIVES

To investigate the demographics and motivations of whole-body donors in China, and help suggest a solution to the problem of low body donation numbers.

DESIGN

A cross-sectional study on body donors in China. Demographic analysis of the donating information of deceased donors and in-depth interviews of potential body donors.

SETTING

Eleven districts in Nanjing, China.

PARTICIPANTS

Deceased whole-body donors who had donated their bodies to the body donation receiving station of Nanjing Medical University between 1 July 2009 and 30 June 2019 (n=835), and living registered whole-body donors (n=68).

RESULTS

Among the whole-body donor population, the numbers of males, people older than 65 years and those working as teachers, government officials, medical staff and farmers were significantly higher than those of the general Nanjing population. Donors with an education level of college or above accounted for nearly half of the deceased donors, and considered donating their bodies earlier in their lives than others. Cancer and heart disease were the major causes of death among donors. Interviews of the 68 living donors revealed the following major motivations for the decision to donate: to support medical education; to reduce their children's funeral burden; no longer holding traditional Chinese views on life and death; influence by role models and annoyance at complex funeral ceremonies.

CONCLUSIONS

Older people, people with an education level of college or above, labourers, teachers, government officials and farmers are the major groups that donate their bodies. Although people's motivations for donation are complex, their desire to support medical education is the most prevalent motivation. By helping focus on target groups for promotional messaging and identifying their prime motivations, this study's findings can provide a reference for promoting body donation in China.

A Good Death - Can the Concept Be Applied to Anatomy?

The importance of patient-centered decisions is embedded throughout clinical practice. The principle that the patient is at the center of all decisions has helped form the contemporary approach to death and dying. The concept of a "good death" will naturally mean different things to different individuals, but is based on the foundation of being pain free, comfortable, and able to make informed decisions. Potential donors are faced with many personal, ethical, and often spiritual considerations when they come to think about their wishes after death. One consideration is that of a "good death." This article explores how the concept of a "good death" may be applied to anatomy. Where first-person consent is in place, the motivating factors frequently include the wish for others to learn from the donation, and this notion may form part of the "good death" for the donor. Such motivations may impact positively on how students feel about dissecting and may provide comfort, assuaging feelings of discomfort, and allowing students to focus on anatomical learning. For donors where second-person consent is in place, the concept of a "good death" must depend on whether the individual wanted to donate their body in the first instance. The notion of a "bad death" may also be considered with body donation where no consent for donation is in place. This article proposes that there is ultimately a place for the concept that a "good death" may involve an individual donating their body to medical education.

The practice of ethics in the context of human dissection: Setting standards for future physicians

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.

Analysis of Population Representation Among Willed Whole-Body Donors to Facilitate the Construction of a Body Donation Program in China: From the Perspective of Medical Students and Anatomists

The body donation program of Peking Union Medical College was established in May 1999. From May 1999 to December 2017, a total of 5,576 registrants registered and 1,459 donors donated their bodies. Demographic and medical characteristics of the donors were analyzed. The top four causes of death were neoplasms, heart diseases, respiratory diseases, and cerebrovascular diseases. Age at death among donors who died of neoplasms were significantly lower than other causes of death (all p < .05), and the interval between registration and donation among donors who died of neoplasms was significantly shorter than that among donors with other causes (all p < .001). The age of donors when they registered (p < .001) and donated (p < .001) was significantly older than that of general Beijing population. This study may provide a guide for medical colleges or research institutions to establish or enhance their own body donation programs.

'Life after Death - the Dead shall Teach the Living': a Qualitative Study on the Motivations and Expectations of Body Donors, their Families, and Religious Scholars in the South Indian City of Bangalore

In India, there has been a shift from using unclaimed bodies to voluntary body donation for anatomy dissections in medical colleges. This study used in-depth qualitative interviews to explore the deeper intent, values and attitudes towards body donation, the body and death, and expectations of the body donor (N = 12), as well as their next of kin (N = 7) and representative religious scholars (N = 12). All donors had enrolled in a body bequest programme in a medical school in South India. This study concludes that body donors are philanthropists with deep-rooted values of altruism and service, who are often willing to forgo traditional religious and cultural death rituals. The next of kin are often uncomfortable with the donor's decision, and this suggests that it is important that dialogue/counselling occurs at the time of the bequest, if the donor's wishes are to be respected. Religious injunctions are often misinterpreted; this implies that religious leaders/scholars can play a significant role in addressing these misconceptions which are barriers to body donation. Body bequest programmes in India may be enhanced by positioning body donation as 'daana'-giving without any expectation of return for a higher purpose, including ceremonies of respect in medical colleges. Furthermore, increased public engagement and awareness about body bequest programmes are also important to enhance participation. When medical students internalise what body donors expect of them, i.e. altruism, empathy with patients and becoming 'good doctors', it will help to ensure that the donation was not in vain and that the dead truly teach the living.

Effects of Commemorations and Postdonation Services on Public Willingness to Donate Bodies in China

Multiple body donation programs have been established throughout China over the last 20 years, but these programs remain challenged by an insufficient supply of cadavers for medical education. The commemoration of body donors is a feature of many successful programs, and adopting this practice throughout the country could be an important element of raising public awareness and encouraging body donation among the public. The present study aimed to investigate public views on the commemoration of whole-body donors and postdonation services in China by analyzing the factors that influence participants' willingness to donate. A survey was conducted using convenience sampling with a non-probability sampling method, and data were analyzed using chi-square and post hoc multiple comparisons tests. A total of 1,800 questionnaires were distributed, 1,717 were returned, and 1,605 were considered valid. Of the respondents, 20.87% were willing to donate, and 64.80% thought that it is necessary to commemorate donors. The results of multiple comparisons demonstrated that the elderly and those with a higher educational level were more willing to donate than participants in other groups. Education was also found to influence views on donation memorial activities, and the chi-square test revealed that conducting commemorations and improving postdonation services can promote the establishment of successful donor programs in China and improve the social acceptance of body donation.

A descriptive study of community-based profile and attitudes of body donors of an urban conglomeration in Western India

Background

Body donation is considered an altruistic act done by people for advancement of science. There has been a significant depreciation in the availability of cadavers for teaching and research all over the world. Unlike India, many countries have studied the profile and attitudes of potential body donors to improve body donation. With a huge health sector, this Indian study studied the profile and attitudes of body donors and their role in aiding science through body donation.

Methods

Four hundred thirty-one survey forms with informed consent were sent to registered body donors. The questionnaire focused on demographic parameters and their perception on body donation. The data were collated, compared and interpreted with similar studies done worldwide.

Results

The study shows an interesting pattern among the Indian donors in comparison to the West. An Indian donor is a male individual in 70s, highly educated and religious with good social background. Despite many similarities, there are important distinguishing features unique to our country and many myths surrounding body donation.

Conclusion

The Indian donor is highly educated male and charitable with strong belief in God. He believes in aiding medical science through body donation.

Enabling Posthumous Medical Data Donation: An Appeal for the Ethical Utilisation of Personal Health Data

This article argues that personal medical data should be made available for scientific research, by enabling and encouraging individuals to donate their medical records once deceased, similar to the way in which they can already donate organs or bodies. This research is part of a project on posthumous medical data donation developed by the Digital Ethics Lab at the Oxford Internet Institute at the University of Oxford. Ten arguments are provided to support the need to foster posthumous medical data donation. Two major risks are also identified-harm to others, and lack of control over the use of data-which could follow from unregulated donation of medical data. The argument that record-based medical research should proceed without the need to secure informed consent is rejected, and instead a voluntary and participatory approach to using personal medical data should be followed. The analysis concludes by stressing the need to develop an ethical code for data donation to minimise the risks, and offers five foundational principles for ethical medical data donation suggested as a draft code.

Profile and Motivations of Registered Whole-Body Donors in Turkey: Istanbul University Experience

Little is known regarding the profiles of whole body donors in Muslim majority countries where donation is scarce. Therefore, this study aims to profile registered donors in Turkey by means of a survey. The explored data could be used to improve ongoing campaign efforts and ethical practices such as commemoration services. Registered donors of the donation programs at the two faculties of medicine of Istanbul University were compared with the national population and a cluster analysis was performed to reveal any concealed sub-groups. Data from 188 respondents were analyzed. The majority of registered donors were married (42%), male (65.4%), aged over 50 years (76%), held a tertiary education degree (49.7%), and were irreligious (58.5%). Cluster analysis revealed two groups with significantly different educational levels, marital statuses, and religious choices. Regarding whether their bodies could be used for education or research, the majority (64.5%) of the respondents left the decision to the anatomy department. Similarly, 73.8% approved indefinite use of their organs, body parts and/or skeletons. The respondents were also willing to share their medical history (94.2%) and personal information (81.6%) if needed. Motivational themes for body donation including usefulness, impermanence, religion, awareness, and kinship were devised after a thematic analysis. Among the respondents, 56.5% were registered organ donors and 63.3% were frequent blood donors. The results of this study provide data that may help revising informed consent forms, developing and implementing thanksgiving ceremonies, and selecting additional targets for supporting body donation campaign activities such as organ and blood donation units.

Three-dimensional Printing in Anatomy Education: Assessing Potential Ethical Dimensions

New technological developments have frequently had major consequences for anatomy education, and have raised ethical queries for anatomy educators. The advent of three-dimensional (3D) printing of human material is showing considerable promise as an educational tool that fits alongside cadaveric dissection, plastination, computer simulation, and anatomical models and images. At first glance its ethical implications appear minimal, and yet the more extensive ethical implications around clinical bioprinting suggest that a cautious approach to 3D printing in the dissecting room is in order. Following an overview of early groundbreaking studies into 3D printing of prosections, organs, and archived fetal material, it has become clear that their origin, using donated bodies or 3D files available on the Internet, has ethical overtones. The dynamic presented by digital technology raises questions about the nature of the consent provided by the body donor, reasons for 3D printing, the extent to which it will be commercialized, and its comparative advantages over other available teaching resources. In exploring questions like these, the place of 3D printing within a hierarchical sequence of value is outlined. Discussion centers on the significance of local usage of prints, the challenges created by regarding 3D prints as disposable property, the importance of retaining the human side to anatomy, and the unacceptability of obtaining 3D-printed material from unclaimed bodies. It is concluded that the scientific tenor of 3D processes represents a move away from the human person, so that efforts are required to prevent them accentuating depersonalization and commodification.

Does Confucianism allow for body donation?

Confucianism has been widely perceived as a major moral and cultural obstacle to the donation of bodies for anatomical purposes. The rationale for this is the Confucian stress on xiao (filial piety), whereby individuals' bodies are to be intact at death. In the view of many, the result is a prohibition on the donation of bodies to anatomy departments for the purpose of dissection. The role of dissection throughout the development of anatomy within a Confucian context is traced, and in contemporary China the establishment of donation programs and the appearance of memorial monuments is noted. In reassessing Confucian attitudes, the stress laid on a particular interpretation of filial piety is questioned, and an attempt is made to balance this with the Confucian emphasis on a moral duty to those outside one's immediate family. The authors argue that the fundamental Confucian norm ren (humaneness or benevolence) allows for body donation as people have a moral duty to help others. Moreover, the other central Confucian value, li (rites), offers important insights on how body donation should be performed as a communal activity, particularly the necessity of developing ethically and culturally appropriate rituals for body donation. In seeking to learn from this from a Western perspective, it is contended that in all societies the voluntary donation of bodies is a deeply human activity that is to reflect the characteristics of the community within which it takes place. This is in large part because it has educational and personal repercussions for students. Anat Sci Educ 11: 525-531. © 2018 American Association of Anatomists.

Communication Apprehension About Death, Religious Group Affiliation, and Religiosity: Predictors of Organ and Body Donation Decisions

Communication willingness has previously been identified as an important communication factor in influencing individuals' decisions to become an organ donor. Missing from this conversation is the role of communication apprehension about death and its impact on donation decisions. The purpose of this study was to examine the relationships between communication apprehension about death, religiosity, religious affiliation, and donation decisions. Three hundred and thirty-three individuals participated in an online survey. Findings suggest that communication apprehension about death, especially communication avoidance about death, negatively impact donation decisions. In addition, religiosity and affiliation with a specific religion also negatively impact donation decisions. These variables were also predictors of organ and body donation. The findings show a need for more research on what prevents conversations about donation. In addition, the stark difference between organ donation likelihood and body donation likelihood underscores the need for communication scholars to examine communication about body donation.

Generosity and compliance: Recruitment-work and the pathways to participation in bone marrow donation

This study examines challenges involved in recruiting bone marrow donors. Data comes from participant observation with a recruitment organization in the United States. Findings reveal that recruiters try to express bone marrow donation with common "gift of life" messaging, which emphasizes a singular event involving generosity. Potential recruits, however, respond by focusing on pain and time commitments. These concerns draw attention to the many stages and requirements involved in bone marrow donation and make issues of compliance salient. The juxtaposition of generosity and compliance creates practical difficulties for recruiters. The study contributes to existing literature, by illustrating how logistics shape altruism and gift arrangements involved in medical donation.

A preliminary survey of professionalism teaching practices in anatomy education among Indian Medical Colleges

Professionalism and ethics have gained widespread recognition as competencies to be fulfilled, taught, and assessed within medical education. The role of the anatomy course in developed nations has evolved over time and now encompasses multiple domains, including knowledge, skills, and the inculcation of professionalism and ethics. The Medical Council of India recently recommended the integration of professionalism teaching in undergraduate medical curricula. The authors investigated whether the initial orientation lectures and instructions given by faculty at the outset of undergraduate medical anatomy courses throughout India served a "hidden curriculum" regarding professionalism practices, and whether these orientation messages could serve as an early exposure to medical professionalism and ethics for medical students. An online survey was carried out among 102 anatomy faculty members across India requesting details about specific professionalism protocols and instructions regarding behavior in the dissection hall that are routinely given to preclinical students, as well as the importance that they placed on professional behavior. It was found that most faculty members regularly instruct students regarding expected behavior during the anatomy course, including dissection practices. These instructions stress attributes of professionalism like humanism, accountability, and honesty. However, there needs to be a more concentrated effort by educators to prohibit such unprofessional practices like dissection hall photography, and better information is required regarding biomedical waste disposal. Despite the absence of clear guidelines for professionalism teaching in medical education in India, the existing framework of anatomy education provides an opportunity to introduce the concept of professionalism to the first-year medical student. This opportunity may provide an early foundation for designing a professionalism-integrated curriculum. Anat Sci Educ 10: 433-443. © 2017 American Association of Anatomists.

Using body donor demographics to assist the implementation of donation programs in Brazil

The use of human material in anatomy education depends upon the generosity of body donors. However, little is known regarding the demographics of body donors in Brazil, where voluntary body donation is a relatively rare phenomenon. Hence, the aim of the present study was to elucidate the demographic profile of applicants to the Body Donation Program (BDP) at the Federal University of Health Sciences of Porto Alegre in Brazil, as well as to assess whether the observed characteristics of body donors are unique to that sample, or if they merely reflect the characteristics of the regional population. Information derived from the specific forms filled out by donors between January 2008 and June 2016 at the time of registration were collected. Data from 416 forms were analyzed. Based on this study, the typical applicant in Brazil is typically a white female (67.4%), over 60 years of age (60.3%), unmarried or single (70.6%), affiliated with a religious group (89.1%), of middle class background (40.4%), who has completed high school and/or holds a university degree (93.8%). The motivation of donors was, in most cases, an altruistic gesture, represented by the desire to help society and science. Elucidating these demographic characteristics of potential donors may help identify the target public to which information regarding body donation campaigns could be directed. Anat Sci Educ 10: 475-486. © 2017 American Association of Anatomists.

Paying respect to human cadavers: We owe this to the first teacher in anatomy

Every human cadaver which undergoes anatomical dissection enriches medical science and deserves to be treated with utmost respect. The aim of the present study is to identify the practices followed by medical schools across the globe to ensure that the human cadaver is treated with respect and dignity while it is utilized within the domain of medical education. The article undertakes a review of the literature and takes note of the practice of students taking an oath prior to dissecting cadavers whereby they reflect on their conduct and habits in the dissection room. It emphasizes the guidelines adopted by medical schools to ensure respectful handling of human cadavers during dissection and highlights traditional ways to honor them followed in some parts of the world. The article attempts to focus on the noble endeavor of funeral ceremonies to pay homage to the departed soul who enlightened the students with the knowledge of human anatomy. Finally it converges on the memorial services incorporated into anatomy programs to instill in students an appreciation of the humanity of those who went under the knife as a service to mankind. Based on the observations made in the present study some recommendations are also proposed regarding good practices in human cadaveric dissection. In order to bind science and humanity it is critical to realize our responsibility to reciprocate the anatomical gift of a human body with respect, compassion, care and dignity.

Improvements in anatomy knowledge when utilizing a novel cyclical "Observe-Reflect-Draw-Edit-Repeat" learning process

Innovative educational strategies can provide variety and enhance student learning while addressing complex logistical and financial issues facing modern anatomy education. Observe-Reflect-Draw-Edit-Repeat (ORDER), a novel cyclical artistic process, has been designed based on cognitivist and constructivist learning theories, and on processes of critical observation, reflection and drawing in anatomy learning. ORDER was initially investigated in the context of a compulsory first year surface anatomy practical (ORDER-SAP) at a United Kingdom medical school in which a cross-over trial with pre-post anatomy knowledge testing was utilized and student perceptions were identified. Despite positive perceptions of ORDER-SAP, medical student (n = 154) pre-post knowledge test scores were significantly greater (P < 0.001) with standard anatomy learning methods (3.26, SD = ±2.25) than with ORDER-SAP (2.17, ±2.30). Based on these findings, ORDER was modified and evaluated in the context of an optional self-directed gross anatomy online interactive tutorial (ORDER-IT) for participating first year medical students (n = 55). Student performance was significantly greater (P < 0.001) with ORDER-IT (2.71 ± 2.17) when compared to a control tutorial (1.31 ± 2.03). Performances of students with visual and artistic preferences when using ORDER were not significantly different (P > 0.05) to those students without these characteristics. These findings will be of value to anatomy instructors seeking to engage students from diverse learning backgrounds in a research-led, innovative, time and cost-effective learning method, in the context of contrasting learning environments. Anat Sci Educ 10: 7-22. © 2016 American Association of Anatomists.

Willingness to Donate Organs and Tissues in Vietnam

Context

Few studies on public attitudes toward organ and tissue donation have been carried out in Asia.

Objective

To determine demographic influences on attitudes toward organ and tissue donation in Vietnam.

Design

Face-to-face interviews.

Setting

Tan Binh District, Ho Chi Minh City, Vietnam.

Participants

Random sample of adults (N=785).

Main Outcome Measures

Awareness of donation and transplantation, acceptance of organ and tissue donation.

Results

75% of respondents stated they had heard of organ or tissue donation, but only 55% were aware of organ and tissue transplantation taking place in Vietnam. Forty-eight percent of Buddhists and 27.5% of Christians had either no knowledge or incorrect knowledge about their religion's official position toward donation and transplantation. Sixty-four percent stated they would give consent for the donation of their deceased relative's tissues and organs, 66% would themselves become posthumous donors, and 21% to 22% would donate multiple organs and tissues. A significant association was found between respondents' acceptance of organ and tissue donation and their educational level, sex, occupation, and awareness of transplantation. Most respondents stated that their willingness to donate depended on whether other family members agreed. Many noted the importance of preventing commerce in organ and tissue transplantation but were in favor of providing healthcare for the donor's family or monetary incentives as a reward for donating.

Conclusion

Nearly two thirds of urban Vietnamese surveyed were willing to donate organs or tissues after death. Their willingness was related to awareness of transplantation, sex, education level, and occupation.

"Mortui vivos docent" or who gives his body to science? The analysis of the personal questionnaires of Polish donors in the Conscious Body Donation Program

The Conscious Body Donation Program conducted since 2003 by the Department of Human Anatomy, Medical University of Silesia in Katowice was the first innovative project aimed at obtaining informed donors' bodies for the purpose of teaching anatomy in Poland. The aim of this prospective study was to determine the declared donors' characteristics and to establish the possible motivation for body donation. A total of 244 application files were reviewed and the following information was analyzed: donor’s age, age at which the decision to donate the body was made, donor’s place of residence and declared nationality, family background, education and profession, family structure and religion. Our results showed that mainly elderly people decided to donate their bodies (68.5 ± 11.84 years), living mostly in large and medium-sized cities. Men - donors often lived in small towns. Most of the donors were of blue-collar parentage, completed secondary education and at the time of taking decision to donate where married and retired. Widows were more likely to make the decision to donate than widowers. Most of our donors were Catholic. Our analysis of the profile of Polish donors may be useful to understand better for which groups of people death is not to be perceived as the end, and may become a value, which can be beneficial to living people.

Predicting People's Intention to Donate Their Body to Medical Science and Research

Predictors of people's intention to register with a body bequest program for donating their deceased body to medical science and research were examined using standard theory of planned behavior (TPB) predictors (attitude, subjective norm, perceived behavioral control) and adding moral norm, altruism, and knowledge. Australian students (N = 221) at a university with a recently established body bequest program completed measures of the TPB's underlying beliefs (behavioral, normative, and control beliefs) and standard and extended TPB predictors, with a sub-sample reporting their registration-related behavior 2 months later. The standard TPB accounted for 43.6%, and the extended predictors an additional 15.1% of variance in intention. The significant predictors were attitude, subjective norm, and moral norm, partially supporting an extended TPB in understanding people's body donation intentions. Further, important underlying beliefs can inform strategies to target prospective donors.

An investigation of red fox (Vulpes vulpes) and Eurasian badger (Meles meles) scavenging, scattering, and removal of deer remains: forensic implications and applications

Within northwest Europe, especially the United Kingdom, the red fox (Vulpes vulpes) and the Eurasian Badger (Meles meles) are the largest wild scavengers capable of modifying a set of remains through scavenging. Knowledge of region-specific and species-typical scavenging behaviors of scavengers within the crime scene area and surroundings can aid in more efficient and accurate interpretations. The scavenging behaviors of captive and wild foxes and badgers were recorded and compared through actualistic methods and direct observation. The scavenging by wild foxes and badgers of surface-deposited baits and whole deer (Cervus nippon; Capreolus capreolus) in a woodland was observed and analyzed. Wild foxes were found to scavenge deer more frequently than badgers. The scavenging of deer remains by foxes was also compared with forensic cases. The scavenging pattern and recovery distances of deer and human remains scavenged by foxes were similar but were potentially affected by the condition and deposition of a body, and the presence of clothing.

An overview of the roles and responsibilities of Chinese medical colleges in body donation programs

The use of human tissue is critical for gross anatomy education in the health professions. Chinese medical colleges have faced a shortage of anatomical specimens over the past decade. While body donation plays an important role in overcoming this gap, this practice has only recently been introduced in China, and the donation rate is relatively low and fraught with a number of difficulties. In the past, traditional Chinese culture focused on preserving the human body intact, which often limited body donation. In recent years, the public has become more open toward body donation. At Nanjing Medical University, only 20 bodies were donated in 2001. After the university became involved in an organized body donation program, this number increased to 70 donated bodies per year (2007 to 2012). This article describes and reviews Chinese medical colleges as a special case study among body donation programs, particularly in terms of the multiple responsibilities and roles that such institutions must assume in the course of adopting these programs. Medical colleges in China must serve as advocates, coordinators, builders, managers, educators, and beneficiaries in undertaking body donation programs. It is important for medical colleges to recognize these pluripotent roles and educate the public in order to promote body donation programs. This case study may also effectively guide and encourage Chinese medical colleges in refining their own body donation programs in the future.

An experimental study of vertebrate scavenging behavior in a Northwest European woodland context

Vertebrate scavengers can modify surface deposited human remains which can hinder forensic investigations. The effects of such scavenging vary between species and regions. Published research into the effects of the scavenging of human remains is dominated by work from North America with few studies covering Northwestern Europe. Forensic scientists, investigators, and police search officers in Northwestern Europe are often left questioning on a basic level as to which scavengers are active and how they might affect human remains. This paper presents the results of a field study utilizing deer (Cervus nippon; Capreolus capreolus) as surface deposits observed by motion detection cameras in a British woodland. The most common avian and rodent scavenger species recorded included the buzzard (Buteo buteo), carrion crow (Corvus corone), wood mouse (Apodemus sylvaticus), and gray squirrel (Sciurus carolinensis). The scavenging behaviors observed were affected by seasonality, rates of decomposition, and insect activity. Scavenging by buzzards, unlike carrion crows, was most frequent during fall to winter and prior to insect activity. Overall, avian scavengers modified and scavenged soft tissue. Rodents scavenged both fresh and skeletonized remains with gray squirrels only scavenging skeletal remains. Wood mice were most active in winter and scavenged both soft tissue and bone.

Attitudes of Australian chiropractic students toward whole body donation: a cross-sectional study

Cadavers play an important role in anatomy education. In Australia, bodies for anatomy education are acquired only through donations. To gain insight into educational dynamics in an anatomy laboratory as well as to facilitate body donation programs and thanksgiving ceremonies, it is important to understand students' attitudes toward body donation. In this cross-sectional study, the attitudes of Macquarie University's first, second, and fifth year chiropractic students toward body donation were investigated. Macquarie University chiropractic students have a four semester long anatomy program, which includes cadaver-based instruction on prosected specimens. A questionnaire was used to record respondents' demographics and attitudes toward body donation: personal, by a relative, and by a stranger. It was found that ethnicity and religion affect attitudes toward body donation, with Australian students being more willing to donate a stranger's body and atheists and agnostics being more willing to donate in general. Furthermore, willingness to donate one's own or a family member's body decreases as year of study increases, suggesting a possible negative impact of exposure to cadavers in the anatomy laboratory. This was only true, however, after controlling for age. Thus, the impact of viewing and handling prosected specimens, which is the norm in anatomy classes in Australia, may not be as strong as dissecting cadavers. It is suggested that anatomists and educators prepare students for cadaver-based instruction as well as exhibit sensitivity to cultural differences in how students approach working with cadavers, when informing different communities about body donation programs and in devising thanksgiving ceremonies.

Who donates their bodies to science? The combined role of gender and migration status among California whole-body donors

The number of human cadavers available for medical research and training, as well as organ transplantation, is limited. Researchers disagree about how to increase the number of whole-body bequeathals, citing a shortage of donations from the one group perceived as most likely to donate from attitudinal survey data - educated white males over 65. This focus on survey data, however, suffers from two main limitations: First, it reveals little about individuals' actual registration or donation behavior. Second, past studies' reliance on average survey measures may have concealed variation within the donor population. To address these shortcomings, we employ cluster analysis on all whole-body donors' data from the Universities of California at Davis, Irvine, Los Angeles, and San Francisco. Two donor groups emerge from the analyses: One is made of slightly younger, educated, married individuals, an overwhelming portion of whom are U.S.-born and have U.S.-born parents, while the second includes mostly older, separated women with some college education, a relatively higher share of whom are foreign-born and have foreign-born parents. Our results demonstrate the presence of additional donor groups within and beyond the group of educated and elderly white males previously assumed to be most likely to donate. More broadly, our results suggest how the intersectional nature of donors' demographics - in particular, gender and migration status - shapes the configuration of the donor pool, signaling new ways to possibly increase donations.

The dissection room experience: A factor in the choice of organ and whole body donation--a Nigerian survey

The psychosocial impact of human dissection on the lives of medical and health science students has been noted. To assess the impact of the dissection room experience on one's willingness to become a whole body and organ donor, the attitudes of 1,350 students and professionals from the medical, health, and non-health related disciplines to body and organ donation were studied. The participants were broken into categories according to degree of exposure to human dissection. Participants who were never exposed to the dissection experience showed more willingness to donate their bodies than those who were exposed. With the exception of the physiotherapy department, the students and professionals from the health science departments who were exposed to the dissection room but never engaged in dissection showed the most unwillingness to donate their bodies (P < 0.001). An unwillingness to donate oneself was noted as one of the negative impacts associated with exposure to the dissection room. Willingness to donate an organ correlated positively with the level of exposure to the dissection room (P < 0.001). Most of the reasons for unwillingness were traceable to negative perceptions of the dissection room as a result of poor and disrespectful management of the human cadavers.

Evaluation of the willingness for cadaveric donation in Greece: a population-based study

Despite the importance of body donation for medical education and the advancement of medical science, cadaveric donation remains suboptimal worldwide. The purpose of this study was to evaluate the willingness of body donation in Greece and determine the characteristics of donors. This cross-sectional questionnaire survey was conducted from January to June 2011. A specially designed questionnaire was distributed to 1,700 individuals who were randomly selected from five major Greek cities. It was found that higher educational levels (P = 0.002), annual family income below 30,000 Euros (P = 0.001), guaranteed employment status (P = 0.02), and the presence of comorbid conditions (P = 0.004) seemed to affect potential donors' willingness for cadaveric donation. Those with strong religious beliefs were found to be unwilling to donate their bodies to medical science. Interestingly, the majority of participants who believed that hospitalized patients are deceived or are used for harmful experiments were willing to become whole body donors (P = 0.043). In Greece, the rate of body donation to medical science remains low, and most Greek citizens are not willing to become body donors. Efforts to encourage discussions about whole body donation should be implemented in order to improve current low levels of donation.

Dissecting the dissectors: Knowledge, attitude, and practice of body bequests by Nigerian anatomists

Anatomy education in most African countries is limited by an insufficient number of cadavers for students to undertake dissection. This already significant shortage is exacerbated by an increasing number of medical schools and students. Virtual dissections are impractical in alleviating such a shortfall in African anatomy education, and further cadaver supply is challenged by unethical and dubious sources. This study was designed to assess the knowledge, attitudes, and practice of whole body and organ donation by Nigerian anatomists with the aim of finding solutions to the problems associated with the availability of cadavers in Nigerian medical schools. Out of 46 anatomists that participated in the survey, only 23.9% would consider donating their whole bodies and 60.9% their organs. More than 95% of respondents did not believe that body bequests could become the sole source of cadavers for anatomic dissection in Nigeria. Age and gender were not statistically significant in the choice of being a body or organ donor. The unacceptability to one's family members regarding body donation was the major reason for respondents' unwillingness to make a whole body donation. None of the 14 medical schools sampled in this study have yet instituted a body registration and donation program. The anatomists showed a high level of knowledge and awareness of body bequest programs, which were not reflected by their attitudes and practice. The authors recommend proactive measures aimed at improving the perception and attitudes of Nigerian anatomists.

Voices of donors: case reports of body donation in Hong Kong

Body donation is important for medical education and academic research. However, it is relatively rare in Hong Kong when compared with many Western countries. Comprehensive research has been performed on the motivation for body donation in Western countries; however, there is still insufficient research on body donation in Hong Kong to provide information on how to increase the body-donation rate. To understand the factors involved in the decision to donate one's body, the authors interviewed a registered donor and the daughter of another donor in Hong Kong. The authors interpreted the information collected in light of the available published reports, which mostly focus on body donation in Western countries. Despite the consistency of some demographic factors and motivations between the participants in our study and those investigated in the published reports from Western countries, there are differences in education level and socioeconomic status between the donors in our study and those from Western studies. The authors also suggest that Confucianism and Buddhism in Chinese culture may motivate potential body donors in Hong Kong. Other important factors that influence the body-donation decision may include family members' body donation, registration as organ donors, and good doctor-patient relationships. Although case report studies have their limitations, this study allows us to explore the complexity of events and establish the interconnectivity of factors involved in body donation, which could not be achieved in previous survey-based studies.

Individuals' decision to co-donate or donate alone: an archival study of married whole body donors in Hawaii

Background

Human cadavers are crucial to numerous aspects of health care, including initial and continuing training of medical doctors and advancement of medical research. Concerns have periodically been raised about the limited number of whole body donations. Little is known, however, about a unique form of donation, namely co-donations or instances when married individuals decide to register at the same time as their spouse as whole body donors. Our study aims to determine the extent of whole body co-donation and individual factors that might influence co-donation.

Methods and Findings

We reviewed all records of registrants to the University of Hawaii Medical School’s whole body donation program from 1967 through 2006 to identify married registrants. We then examined the 806 married individuals’ characteristics to understand their decision to register alone or with their spouse. We found that married individuals who registered at the same time as their spouse accounted for 38.2 percent of married registrants. Sex differences provided an initial lens to understand co-donation. Wives were more likely to co-donate than to register alone (p = 0.002). Moreover, registrants’ main occupational background had a significant effect on co-donations (p = 0.001). Married registrants (regardless of sex) in female-gendered occupations were more likely to co-donate than to donate alone (p = 0.014). Female-gendered occupations were defined as ones in which women represented more than 55 percent of the workforce (e.g., preschool teachers). Thus, variations in donors’ occupational backgrounds explained co-donation above and beyond sex differences.

Conclusions

Efforts to secure whole body donations have historically focused on individual donations regardless of donors’ marital status. More attention needs to be paid, however, to co-donations since they represent a non-trivial number of total donations. Also, targeted outreach efforts to male and female members of female-gendered occupations might prove a successful way to increase donations through co-donations.