How tough yet fragile we are at the same time. Friday afternoon SLU held a memorial service for the families and friends of those that chose to donate their bodies to our Gift Body Program in the past year. Organized by the medical students, it included other programs that use the bodies such as Occupational Therapy, Physical Therapy, Physician Assistants and Masters in Anatomy. It started filling up over an hour before the ceremony began, while I was still getting in some last music rehearsals with my fellow musicians.
The program is held each year, and this year we were celebrating the lives of over generous people that donated their bodies so that we could learn.
The inter-faith memorial service shared prayers from seven different religions and reflections from students on what learning from these bodies has meant from them. They are the ones teaching me. We are so grateful. After the service, students mingled with families at the reception.
It was so soothing to talk to these families about their loved ones. I spoke to two sisters who were there remembering their mother. Now, after attending two of these services, one of the sisters said she had chosen told do the same. A friend and I expressed our deepest gratitude and shared how important and special it was for us to get to learn in such an intimate way from their loved ones.
We asked questions and got to know not only the sisters, but also a little bit about their generous, selfless parents. We are so blessed to learn to be healers.
We have the potential to touch so many lives. What an amazing opportunity. We were all pretty nervous leading up to Anatomy. An I Know Nothing Day. Love it? Share it! Comment Policy I value and appreciate each and every comment I get on my posts. The supply of human cadavers to the medical schools was further worsened by United States Welfare Legislation and better health care for the poor leading to a sharp decline in the availability of unclaimed bodies between and [ 86 ].
During the early s, a confusing conglomeration of anatomy acts, common laws and state statutes made body donation a legally complicated matter.
UAGA was a turning point in terms of body donation as it established the human body as a property such that a donor's wish now superseded those of next of kin in court [ 83 ].
Within the next four years majority of the states followed suit and enacted laws that were similar to UAGA [ 75 ]. A second act was signed inwhich served to clarify the donation process further. Together these two acts, often together referred to as the UAGA were instrumental in standardizing and streamlining the process of body donation in the United States [ 86 ].
During the later part of the 20th century, initiatives were undertaken in different parts of the world to promote body donation for the purpose of anatomical studies. UAGA's successful promotion of body donation led to stabilization of willed-body programs towards the end of 20th century and eventually satisfied the demands of most of the medical schools across the United States [ 86 ].
The rise in body donation could be attributed to changes in social beliefs and practices as well as changing cultural landscapes in the United States [ 61 ]. Moreover social awareness also played a crucial role in enhancing body donation programs as medical professionals frequently donated their bodies because they had learnt firsthand the value of cadavers.
Further doctors in US have been actively involved in discussing body bequest with their patients thereby encouraging them to donate their bodies [ 86 ]. However there was a provision for the surviving spouse or any other surviving relative of the deceased to object to the body being used for anatomical dissection [ 89 ].
Subsequently the Human Tissue Act was introduced inwhich formulated a hierarchy of qualifying relationships ranked with regard to provision of consent, so that the primacy of wishes can be determined [ 90 ]. Since the introduction of the Anatomy Act inmost of the medical schools in the UK rely heavily on donated human cadavers for anatomical activities [ 89 ]. Body donation constitutes the chief source of human cadavers in the medical schools of most of the European countries and the European Federation for Experimental Morphology EFEM has recommended certain measures into ensure good practice in the domain of body donation.
It stresses the need for informed consent, with donors being given clear information upon which to base their decision and emphasize on the openness with donors and their relatives at every stage from the receipt of an initial enquiry to the final disposal of the remains. Finally, it suggests special lectures in ethics related to the bequest of human remains should be offered to all students studying anatomy to encourage development of appropriate sensitivities in relation to the conduct and respect that is expected while handling human remains for anatomical education and research [ 91 ].
Memorial services at the end of anatomy courses began in UK in and in the United Sates in the s to sensitize students towards their cadavers [ 92 ]. In Nanjing, China, an annual public memorial ceremony for those who have donated their bodies to medical education and research is held since and is attended by volunteer donors, deceased donors' families, anatomy teaching faculty and medical students [ 93 ]. Towards the end of the 20th century, transition of religious and social ethics in the Korean Peninsula led to a significant rise in the number of people donating their bodies to medical schools in South Korea.
In order to boost the body donation programs, Korean medical schools have begun to hold funeral ceremonies to honour body donors. These ceremonies are considered as a mark of respect for the dead and useful to promote awareness about body donation programs [ 94 ].
Medical schools in Australia and New Zealand solely depend on body donation for anatomical teaching and research [ 9596 ]. Similarly, donation is the only means of obtaining cadavers for use in medical schools in Thailand, however traditional beliefs result in an insufficient number of donated cadavers [ 97 ].
Human cadaveric dissection has a long history in Japan, and like their western counterparts, medical schools in Japan in the mid Edo era late 17th to early 19th century relied on bodies of executed criminals for anatomical studies followed by a shift towards unclaimed bodies after the Meiji Restoration in [ 98 ].
It was difficult to acquire bodies through donation programs due to unique social culture and understanding surrounding the family of the deceased.
However from mid s the scenario started to change and the enactment of the Body Donation Law in ensured sufficient number of donated bodies for anatomical studies at the medical schools throughout Japan. The law ensured the cultural acceptance of the concept of body donation as it was verified by the government, facilitated the true wishes of the deceased and not that of the family members and resolved possible disputes between family members [ 99 ].
In India, although there is an increasing demand of human cadavers used in medical education, however there is an insufficient supply of donated cadavers available for dissection. This could be attributed to lack of awareness along with firm religious beliefs and customs, apprehensions concerning handling of donated bodies and lack of mindset to accept dissection of one's own body [ ]. The fact that there is no uniform national body donation law till date has not helped either.
In most of the states in India, anatomical activities are still regulated by the Anatomy Act of and its subsequent amendments [ ]. However the very recently introduced Odisha Anatomy Amendment Billwhich has been adopted by many other states in the country, has made body donation hassle free [ ]. Voluntary donors now have to sign simple forms to pledge their bodies for use in medical education. Further relatives of a dead person can also donate the body for anatomy teaching without any problem.
Body bequest programs have been in slow in African countries like Nigeria and Republic of South Africa, resulting in limited number of cadavers available for anatomical dissection and this could be attributed to the political climate and ocioeconomic status of the population . Traditional spiritual beliefs, psychological factors and prevailing social norms adversely affect body donation programs even in some European countries like Turkey and Greece .
The success of body donation programs has not been uniform across the world. This is an area where the society as such can collectively contribute towards advancement of medical education. Persistent efforts needs to be undertaken to sensitize the medical community as well as the general population to promote voluntary donation of dead bodies, which is critical to the human anatomy training for health professionals.
Human cadaveric dissection has been the primary medium of teaching gross anatomy to medical students for centuries [ 1 ].
However, in recent times, teaching anatomy by dissection no longer commands the same number of class hours as it once did as more and more educational material is being inducted into medical school curricula over the past few decades [ ]. Moreover, medical programs in some countries have replaced cadaver dissection with virtual dissection in cyberspace and some others are seriously considering such measures, possibly due to economical factors as well as ethical concerns .
Nevertheless, recent literature suggests that the dissected cadaver remains the most powerful means of delivering fundamental regional, relational and topographical anatomical knowledge to medical students, which is indispensable to ensure safe and efficient clinical practice .
Researchers have documented that decreased use of dissection as teaching tool is one of the factors that can have a negative influence on the anatomical knowledge of medical students [ ].
Evidence suggests that learning anatomy by active exploration through cadaveric dissection actually contributes to improvement of anatomic knowledge [ 3 ]. Medical students have opined that cadaveric dissection deepens their understanding of anatomical structures, provides them with a three dimensional perspective of structures and helps them to recall what they learnt.
It is noteworthy that the innovative modes of learning anatomy such as the interactive multimedia resources have not replaced student's perception about the importance of cadaveric dissection [ ]. In some medical schools, newer radiological imaging techniques which permit in vivo visualization of anatomy structures have supplanted traditional cadaver dissection in teaching human anatomy. However, it has been observed that despite its important strengths, radiology cannot simply substitute cadaveric dissection, which provides students with deep insights into meaning of human embodiment and mortality and represents a profound rite of passage into the medical profession [ ].
The current trend of a steady decline in the number of contact hours in relation to human dissection and consequent suboptimal anatomy knowledge is an area of concern not only for undergraduates but also at the post graduate level for specialities where surgical anatomy is essential [ ].
In present times, when medicine is becoming more practical, technical, and specialized, physicians should be aware of the details related to the anatomy of the region they deal with as this will provide them with an intimate knowledge of their science [ ].
Reports of patient misadventure due to inadequate anatomical knowledge have prompted researchers to come up with the idea of barrier assessment halts further progress until satisfactorily completed while teaching dissection based anatomy [ ]. Authors have opined that long term consequence of this shortage of anatomical knowledge could have serious implications on patient safety and have suggested that medical schools should shift to dissection as the core method for teaching gross anatomy [ 2 ].
Apart from imparting essential anatomical knowledge, the human dissection room can serve as an ideal ground for cultivating humanistic values among medical students. Medical training essentially begins with the cadaveric dissection and nearly all clinicians remember the details of their first interaction with the human cadaver [ ].
Hence, the dissection lab premises provide the educator with an immediate opportunity to teach and encourage humanistic qualities of respect, empathy and compassion among first semester medical students [ ]. Moreover the students can be guided to use the experience of handling a human cadaver as a potential launching pad for them to mature into effective as well as empathetic clinicians [ ].
Attention to concepts of humanistic care is a challenge in present day medical education curriculum when physicians and medical care as such are becoming mechanized by the day with increasing focus on procedures and technical aspects. The rise of the body donation programs has been instrumental in fostering social responsibilities among medical students. In some parts of the world, students get the opportunity to interact with the families of the deceased persons whom they are dissecting [ ].
The University of Oklahoma College of Medicine have introduced the unique concept of "Donor Luncheon," whereby medical students meet the families of the donor prior to dissection in the anatomy course and findings suggest that such an opportunity enables the students to maintain humanistic attitudes at the beginning of their medical career [ ].
Also the students can possibly use the dissection lab experience pedagogically to better prepare themselves for the stress of the medical world, especially issues surrounding death and dying [ ]. Human cadaveric dissection has survived the test of time and till date the importance of student-cadaver encounter remains paramount in medical education. The dissection room provides multifaceted education experiences while accomplishing the traditional objectives within the allotted time.
In other words, in the dissection lab, medical students can learn to do their scheduled work without neglecting their emotions or developing an attitude of detached concern.
Accordingly anatomists have presented arguments in favour of continuation of the use of cadaver material in anatomical sciences education which would be beneficial to future physicians and pivotal in strengthening a close and symbiotic association between anatomists and surgeons .
The rise of ancient Greek medicine paved the way for the inception of human cadaveric dissection as a tool for teaching anatomy in 3rd century BC. Unfortunately the practice of human dissection was prohibited in Europe during the Middle Ages due to religious and popular beliefs. However from its revival at the beginning of 14th century, human dissection has been an integral part of anatomy teaching in medical schools. However by the beginning of 15th century, cadaveric dissection became a regular event in European universities and the supply of criminal bodies proved insufficient.
Taking advantage of the Papal sanction of post-mortem examination to investigate the cause of death, anatomists started performing dissection on bodies meant for post-mortem autopsy. From the later part of the 15th century, human dissection became extremely popular as the wave of European Renaissance started to influence the domain of anatomical sciences and from the middle of 16th century, after Papal approval of human dissection for anatomical studies, formal university dissection sessions assumed a full blown public character being attended by large audiences, eventually leading to establishment of permanent anatomical theatres across Europe.
Conventional sources of human cadavers proved inadequate to the task in the face of such unprecedented demand and consequently anatomists began to rely on extralegal sources which involved grave-robbing, body snatching and even murder for anatomical dissection.
In response to the strong public outcry against these ongoing malpractices, Dead Body Collection - Lesson From The Dissecting Table (CDr), many European countries passed legislations during the 18th and 19th centuries, legalising the procurement of unclaimed bodies of poor from workhouses and charitable hospitals for dissection in medical schools. The most prominent among these legislations was the Anatomy Act passed by the British government which not only allowed the use of unclaimed bodies but also prohibited the tradition of using corpses of executed criminals for anatomical dissection.
Although the Anatomy Act was successful in curtailing the illegal practice of grave-robbing, it led to deep societal divide between the rich and poor with regards to the attitude towards practice of human dissection as in most cases it was the bodies of individuals from the economically backward sections of the society that underwent dissection. Incidentally, the National Socialist regime in Germany set a disgraceful example of neglecting human rights and dignity by providing the bodies of victims of their atrocities to anatomists for research and education.
Till the first part of the 20th century, instances of voluntary body donation was very low as socio-cultural prejudice against human dissection remained high. However, in the second half of 20th century, the approval of the UAGA in the United States of America in ensured a steady supply of human bodies to the medical schools through body bequest.
Presently, body donation constitutes the sole source of human bodies for dissection in medical schools in most parts of the world. Even in those countries, where body donation programs have had limited success, measures are being undertaken to promote voluntary donation of dead bodies.
Although the number of hours devoted to human dissection have been reduced in most of the medical schools over the past few decades, however research findings clearly emphasizes on the indispensability of dissection in anatomical sciences. Moreover the anatomy dissection lab in coherence with the body donation programs has the potential to cultivate humanistic values among medical students which could possibly contribute invaluably towards the making of empathetic physicians of tomorrow.
National Center for Biotechnology InformationU. Journal List Anat Cell Biol v. Anat Cell Biol. Published online Sep Sanjib Kumar Ghosh. Find articles by Sanjib Kumar Ghosh.
Author information Article notes Copyright and License information Disclaimer. Corresponding author. Corresponding author: Sanjib Kumar Ghosh. This article has been cited by other articles in PMC. Abstract The review article attempts to focus on the practice of human cadaveric dissection during its inception in ancient Greece in 3rd century BC, revival in medieval Italy at the beginning of 14th century and subsequent evolution in Europe and the United States of America over the centuries.
Introduction Human cadaveric dissection has been used as the core teaching tool in anatomy for centuries [ 1 ]. Inception and Disappearance of Human Dissection The introduction of systemic human cadaveric dissection is a remarkable moment in the history of science.
Revival of Human Dissection and Its Rise in Popularity In Medieval Europe, considerable advances in the field of science could only be achieved during the 12th century and early 13th century, with the setting up of universities in ParisBolognaOxfordMontpellier and Padua [ 12 ]. Open in a separate window. A woodcut illustration from Fasciculus medicinae depicting human dissection in medieval Italy.
The anatomist Lector over viewing the dissection, which is being performed by a barber surgeon Sector under directions from the Ostensor, who is pointing to the part of the body to be dissected. Fasciculus medicinae was edited by Johannes de Ketham, a German physician who practiced in medieval Italy. Image in public domain. An anonymous engraving of an anatomical dissection session being conducted in full public view in the anatomical theatre in University of Leiden the Netherlands which was built in The illustration is based on a drawing by J.
Andreas Vesalius undertaking an anatomical lecture in Padua. A notable shift from the prevalent trend in medieval Italy as he is dissecting the human body himself. He is referring to Galen's text prevalent textbook in anatomy in those days which is open by the side of the cadaver.
Vesalius is surrounded by his students in Padua and the general public viewing the dissection from the gallery. The anatomy lesson of Dr. Nicolaes Tulp, official city anatomist of the Amsterdam Guild of Surgeons, drawn by Rembrandt in Anatomical dissection sessions were social events in those days being attended by students as well as the general public on payment of an entrance fee.
All the spectators were properly dressed for a solemn social occasion. Crunch in Supply of Cadavers through Capital Punishment and Passage of the Murder Act in Human cadaveric dissection was prohibited in England until 16th century which could be due to the overwhelming influence of the Catholic Church on the monarchs as well as the general population and until this period anatomical knowledge in England was largely based on manuscripts from classical Greece and medieval Italy and dissection of animals [ 5253 ].
Prevalence of Illegal Practices and the Anatomy Act of During the 17th and 18th centuries, when academic anatomical dissections were open to public in most cases, legislators throughout Europe tried to capitalize on the general perception that undergoing dissection was a matter of great dishonour for an individual as the corpse was rendered unrecognizable and denied a conventional funeral [ 62 ].
Dark Period in the History of Human Dissection Recent studies provide penetrating and discomforting insights into the Dead Body Collection - Lesson From The Dissecting Table (CDr) of anatomists in England and associated Commonwealth countries post the introduction of Anatomy Act in [ 4961 ]. The Rise of Body Donation Programs across the Globe During the later part of the 20th century, initiatives were undertaken in different parts of the world to promote body donation for the purpose of anatomical studies.
The Relevance of Human Dissection in the 21st Century Human cadaveric dissection has been the primary medium of teaching gross anatomy to medical students for centuries [ 1 ]. Conclusion The rise of ancient Greek medicine paved the way for the inception of human cadaveric dissection as a tool for teaching anatomy in 3rd century BC. References 1. Magee R. Art macabre: resurrectionists and anatomists.
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