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 <front>
  <journal-meta>
   <journal-id journal-id-type="nlm-ta">Ulutas Med J</journal-id>
   <journal-title-group>
    <journal-title>The Ulutas Medical Journal</journal-title>
    <abbrev-journal-title>Ulutas Med J</abbrev-journal-title>
   </journal-title-group>
   <issn pub-type="ppub">2149-0430</issn>
   <issn pub-type="epub">2149-388X</issn>
   <publisher>
    <publisher-name>Hayriye Zehra Ulutaş</publisher-name>
   </publisher>
  </journal-meta>
  <article-meta>
   <article-id pub-id-type="doi">10.5455/umj.20201229101758</article-id>
   <article-id pub-id-type="publisher-id">79751</article-id>
   <article-categories>
    <subj-group subj-group-type="heading">
     <subject>Review Article</subject>
    </subj-group>
    <subj-group subj-group-type="subject">
     <subject>Medical Education</subject>
    </subj-group>
   </article-categories>
   <title-group>
    <article-title>Ethical Considerations in the Use of Unclaimed Bodies for Anatomical Dissection: A Call for Action</article-title>
   </title-group>
   <contrib-group>
    <contrib contrib-type="author" corresp="yes">
     <contrib-id contrib-id-type="orcid" authenticated="false">https://orcid.org/0000-0002-3257-459X</contrib-id>
     <name name-style="western">
      <surname>Chia</surname>
      <given-names>Terkuma</given-names>
     </name>
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     <contrib-id contrib-id-type="orcid" authenticated="false">https://orcid.org/0000-0001-6720-8453</contrib-id>
     <name name-style="western">
      <surname>Oyeniran</surname>
      <given-names>Oluwatosin Imoleayo</given-names>
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     <label>1</label>
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      <institution-id institution-id-type="ror">https://ror.org/05saqv884</institution-id>
      <institution>Department of Anatomy, Faculty of Basic Medical Science, College of Health Sciences, Nile University of Nigeria, Abuja, Nigeria</institution>
     </institution-wrap>
    </aff>
    <aff id="aff2">
     <label>2</label>
     <institution-wrap>
      <institution-id institution-id-type="ror">https://ror.org/05saqv884</institution-id>
      <institution>Department of Physiology, Faculty of Basic Medical Science, College of Health Sciences, Nile University of Nigeria, Abuja, Nigeria.</institution>
     </institution-wrap>
    </aff>
   </contrib-group>
   <pub-date publication-format="electronic" date-type="pub" iso-8601-date="2020-03-17">
    <day>17</day>
    <month>03</month>
    <year>2020</year>
   </pub-date>
   <pub-date publication-format="print" date-type="collection">
    <year>2020</year>
   </pub-date>
   <volume>6</volume>
   <issue>1</issue>
   <fpage>5</fpage>
   <lpage>8</lpage>
   <history>
    <date date-type="received" iso-8601-date="2019-12-23">
     <day>23</day>
     <month>12</month>
     <year>2019</year>
    </date>
    <date date-type="rev-recd" iso-8601-date="2020-01-11">
     <day>11</day>
     <month>01</month>
     <year>2020</year>
    </date>
    <date date-type="accepted" iso-8601-date="2020-01-28">
     <day>28</day>
     <month>01</month>
     <year>2020</year>
    </date>
   </history>
   <permissions>
    <copyright-statement>© 2020 The Author(s)</copyright-statement>
    <copyright-year>2020</copyright-year>
    <license>
     <ali:license_ref>https://creativecommons.org/licenses/by-nc/4.0/</ali:license_ref>
     <license-p>This is an open access article distributed under the CC BY-NC 4.0 licence.</license-p>
    </license>
   </permissions>
   <self-uri xlink:href="https://www.ulutasmedicaljournal.com/?mno=79751"/>
   <self-uri content-type="pdf" xlink:href="https://www.ulutasmedicaljournal.com/pdf/79751.pdf"/>
   <abstract>
    <p>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.</p>
   </abstract>
   <kwd-group kwd-group-type="author">
    <kwd>Anatomy</kwd>
    <kwd>dissection</kwd>
    <kwd>unclaimed bodies</kwd>
    <kwd>ethics</kwd>
   </kwd-group>
   <funding-group>
    <funding-statement>Funding information was not reported in the published version of this article.</funding-statement>
   </funding-group>
  </article-meta>
 </front>
 <body>
  <sec id="sec-1">
   <title>Introduction</title>
   <p id="b-1">The importance of anatomical dissection in the training of healthcare professionals cannot be overemphasized (    <xref ref-type="bibr" rid="ref1">1</xref>
,    <xref ref-type="bibr" rid="ref2">2</xref>
). It is well documented that because the emergence of anatomy, cadaveric dissection has thrived as a major means of teaching and learning anatomy (    <xref ref-type="bibr" rid="ref3">3</xref>
–    <xref ref-type="bibr" rid="ref5">5</xref>
). 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 (    <xref ref-type="bibr" rid="ref6">6</xref>
–    <xref ref-type="bibr" rid="ref8">8</xref>
).</p>
   <p id="b-2">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 (    <xref ref-type="bibr" rid="ref9">9</xref>
). For instance, in Nigeria, a study conducted by (    <xref ref-type="bibr" rid="ref10">10</xref>
) 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 (    <xref ref-type="bibr" rid="ref6">6</xref>
,    <xref ref-type="bibr" rid="ref11">11</xref>
). A three-year study by (    <xref ref-type="bibr" rid="ref12">12</xref>
) 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 (    <xref ref-type="bibr" rid="ref12">12</xref>
). This situation is not very different in many parts of the world as reported by (    <xref ref-type="bibr" rid="ref8">8</xref>
).</p>
   <p id="b-3">The use of unclaimed bodies remains an ethical burden (    <xref ref-type="bibr" rid="ref13">13</xref>
). A study conducted by (    <xref ref-type="bibr" rid="ref14">14</xref>
) 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 (    <xref ref-type="bibr" rid="ref15">15</xref>
,    <xref ref-type="bibr" rid="ref16">16</xref>
). Not until recently much attention was not directed at how cadavers were procured (    <xref ref-type="bibr" rid="ref17">17</xref>
). A study carried out by (    <xref ref-type="bibr" rid="ref18">18</xref>
) 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 (    <xref ref-type="bibr" rid="ref19">19</xref>
) also supported the view that accepting unclaimed bodies in the first instance is simply acting to meet the demand at hand. Therefore, (    <xref ref-type="bibr" rid="ref16">16</xref>
) 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 (    <xref ref-type="bibr" rid="ref9">9</xref>
). Brazil is a case in point where the use of unclaimed bodies for studies is even supported by law (    <xref ref-type="bibr" rid="ref20">20</xref>
).</p>
   <p id="b-4">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 (    <xref ref-type="bibr" rid="ref21">21</xref>
) 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 (    <xref ref-type="bibr" rid="ref21">21</xref>
). This sort of approach according to (    <xref ref-type="bibr" rid="ref18">18</xref>
) is more about ethics than legality.</p>
   <p id="b-5">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 (    <xref ref-type="bibr" rid="ref22">22</xref>
). Although their roles were recently overtaken by the Human Tissue Authority following a new law “the UK Human Tissue Act of 2004” (    <xref ref-type="bibr" rid="ref23">23</xref>
). 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 (    <xref ref-type="bibr" rid="ref24">24</xref>
).</p>
  </sec>
  <sec id="sec-2">
   <title>Conclusion</title>
   <p id="b-6">The practice of cadaver dissection itself ‘‘still carries ethical and legal uncertainties’’ as stated by Winkelmann (    <xref ref-type="bibr" rid="ref25">25</xref>
), and it is problematic to delineate (    <xref ref-type="bibr" rid="ref26">26</xref>
). How much more the use of unclaimed bodies! Looking back at the criminal history of cadaver acquisition, coupled with ethical considerations, Jones and Whitaker (    <xref ref-type="bibr" rid="ref9">9</xref>
) 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 (    <xref ref-type="bibr" rid="ref27">27</xref>
). A study carried out by (    <xref ref-type="bibr" rid="ref28">28</xref>
) 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.</p>
  </sec>
 </body>
 <back>
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