The Ulutas Medical Journal p-ISSN 2149-0430 e-ISSN 2149-388X

The Ulutas Medical Journal · ISSN 2149-0430 (print), 2149-388X (online) · https://www.ulutasmedicaljournal.com/?mno=79751

Review Article · Open access

Ethical Considerations in the Use of Unclaimed Bodies for Anatomical Dissection: A Call for Action

  • Terkuma Chia1
  • Oluwatosin Imoleayo Oyeniran2
  1. Department of Anatomy, Faculty of Basic Medical Science, College of Health Sciences, Nile University of Nigeria, Abuja, Nigeria ROR
  2. Department of Physiology, Faculty of Basic Medical Science, College of Health Sciences, Nile University of Nigeria, Abuja, Nigeria. ROR
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Abstract

Introduction
The continued practice of anatomical dissection in medical training has placed great demands on body acquisition. This paper aims to provide an overview of the ethical considerations in the use of unclaimed bodies for anatomical dissection.
Materials and Methods
We explored major databases such as PubMed, MEDLINE, Ovid MEDLINE, Researchgate, Google Scholar, Web of Science, and Science Direct, from January 2004 to October 2019, using selected keywords to identify and extract articles relating and peculiar to the use of unclaimed bodies for anatomical dissection.
Results
This review yielded 40 publications with 28 meetings of our quality and inclusion requirements. This paper highlighted the use of unclaimed bodies for anatomical dissection as seen in some medical schools, and the various ethical considerations associated with its continuous use in medical training globally.
Conclusion
In conclusion, the continuous use of unclaimed bodies for anatomical dissection still carries strong ethical and legal uncertainties. It is therefore recommended that there is a need to formulate an all-inclusive regulation to control the use of cadavers for anatomical dissection. If appropriate legislation and guidelines are not put in place with strict monitoring, we may soon return to the cadaver trafficking era to meet up with the demand.

Keywords

Full text

Introduction

The importance of anatomical dissection in the training of healthcare professionals cannot be overemphasized (1, 2). It is well documented that because the emergence of anatomy, cadaveric dissection has thrived as a major means of teaching and learning anatomy (3–5). While the debate for and against its continued use is still ongoing, dissection is widely practiced alongside didactic lectures and other methods of learning anatomy (6–8).

The continued practice of dissection has placed great demands on body acquisition to meet up with the demand for anatomical dissection. In time past, the criminal supply of cadavers which involves the stealing of buried corpses and murder was accepted as a means of making up for cadaver scarcity (9). For instance, in Nigeria, a study conducted by (10) reported that only around 10% of medical schools in the country had sufficient cadavers for dissection. Without other means of sourcing for bodies, the use of unclaimed bodies has become unprecedented in many countries (6, 11). A three-year study by (12) at the University of Ibadan, Nigeria, revealed that all bodies used for dissection were unclaimed bodies. Of the figure, 78.6% were bodies of suspected felons who died during gunfire with law enforcement agencies while the remaining 21.4% where accident victims or some other form of unclaimed bodies (12). This situation is not very different in many parts of the world as reported by (8).

The use of unclaimed bodies remains an ethical burden (13). A study conducted by (14) noted that ethical consideration for cadavers falls under respect for human life, whether donated or unclaimed bodies. Authors have concurred that voluntary donation remains the most ethical method of body acquisition available (15, 16). Not until recently much attention was not directed at how cadavers were procured (17). A study carried out by (18) proposed that anatomists ought to lead the campaign against the use of unclaimed bodies as the practice contravenes ethical principles of beneficence and non-maleficence. Findings from this study (19) also supported the view that accepting unclaimed bodies in the first instance is simply acting to meet the demand at hand. Therefore, (16) advocates that good body donation practices should be adopted wherever possible. According to him, this will prevent the use of unclaimed bodies whose origin may even be suspicious. Already, in some places, there is a move towards eliminating the use of unclaimed bodies (9). Brazil is a case in point where the use of unclaimed bodies for studies is even supported by law (20).

However, the Department of Anatomy at the Federal University of Health Sciences of Porto Alegre, Brazil initiated body donation program to enlighten their immediate community about voluntary body donation and the process thereto. A report by (21) stated that, since its inception, there has been a gradual increase of bodies resulting from willed donations. Details of bodies used for dissection at the department of anatomy showed that 50% were those of individuals who voluntarily donated themselves while alive, 46.4% were donated by family, and only 3.5% were unclaimed bodies (21). This sort of approach according to (18) is more about ethics than legality.

While we gravitate towards total elimination of the use of unclaimed bodies, in the interim, we can adopt palliative measures. These measures will standardize the use of human tissues for learning. The UK in this regard appointed Inspectors of Anatomy as far back as 1832 (22). Although their roles were recently overtaken by the Human Tissue Authority following a new law “the UK Human Tissue Act of 2004” (23). Similarly, In South Africa, Anatomy Inspectors liaise with institutions to ensure that bodies used for dissection are legally and ethically acquired and proper records kept. In doing this, they pay visits to departments of anatomy where they assess storage facilities (24).

Conclusion

The practice of cadaver dissection itself ‘‘still carries ethical and legal uncertainties’’ as stated by Winkelmann (25), and it is problematic to delineate (26). How much more the use of unclaimed bodies! Looking back at the criminal history of cadaver acquisition, coupled with ethical considerations, Jones and Whitaker (9) advocated for an active shift from the use of unclaimed bodies entirely. In creating acceptable means of voluntary body donation, sociocultural and religious considerations must be made (27). A study carried out by (28) proposed that an all-inclusive regulation be made to regulate the use of cadavers for dissection as a whole. If appropriate legislation and guidelines are not put in place with strict monitoring, we may soon return to the cadaver trafficking era to meet up with the demand.

Declarations

Author contributions (CRediT)
All authors contributed equally to all 14 CRediT roles (Conceptualization, Data curation, Formal analysis, Funding acquisition, Investigation, Methodology, Project administration, Resources, Software, Supervision, Validation, Visualization, Writing – original draft, Writing – review & editing).
Funding

Funding information was not reported in the published version of this article.

Conflicts of interest
The authors have declared no conflict of interest for the present article.
Ethics approval
Ethics committee approval was not required for this article, as it is based on previously published literature and does not involve human participants, patient data or animals.
Data availability
Data sharing is not applicable to this article as no new data were created or analysed in this study.

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How to cite this article

Chia T, Oyeniran OI. Ethical Considerations in the Use of Unclaimed Bodies for Anatomical Dissection: A Call for Action. Ulutas Med J. 2020;6(1):5-8. doi:10.5455/umj.20201229101758

Chia, T., & Oyeniran, O. I. (2020). Ethical Considerations in the Use of Unclaimed Bodies for Anatomical Dissection: A Call for Action. The Ulutas Medical Journal, 6(1), 5–8. https://doi.org/10.5455/umj.20201229101758

Chia, T. and Oyeniran, O.I. (2020) 'Ethical Considerations in the Use of Unclaimed Bodies for Anatomical Dissection: A Call for Action', The Ulutas Medical Journal, 6(1), pp. 5–8. doi: 10.5455/umj.20201229101758.

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