Mortui Prosumus Vitae
‘Even in death do we serve life’
After one of my many trips past our University’s dissecting room, I couldn’t help but think of all the bodies which lay inside; waiting to meet their fate at the hands of our medical students. This got me wondering – how did those individuals go about donating their bodies and what will they be used for?
The donation of a body, or parts of a body to science is a concept that many are familiar with, but in fact it is often poorly understood. Indeed, the topic is not often spoken about which, when you think about it, makes sense since those who donate their bodies are not around afterwards to talk about the experience.
However, after trawling the internet for information I came across a fair amount, including several websites detailing the various levels of body donation. It’s interesting to note that, along with whole body donation, there are many ways to contribute to science without offering your entire body both in life and after death:
At the lowest end of the scale, individuals can volunteer for scientific experiments, most commonly performing psychological tests or receiving brain scans. Following these procedures the body is (generally!) returned intact.
At the next level you can volunteer for a more invasive and intensive experiment such as trials for drug treatments, with a significant risk to the individual.
The third level, partial temporary donation, involves donation of a physical aspect of your body that is not permanently missed, such as blood.
The penultimate level involves permanent donation of a part of your physical body, most commonly organs. This type of donation usually occurs post-humously when an organ may be donated to another individual in a transplant procedure, or used for medical research.
Finally, the ultimate scientific contribution, complete body donation.
However, this was not always the case. Indeed, although the bodies used by our current medical students were generously donated with prior consent, at the beginning of the 19th century, bodies used for teaching were usually those of criminals put to death for their crimes. As the study of surgery and anatomy began to explode, alongside a dramatic decrease in the number of executions, there developed a huge demand for bodies that exceeded supply. At this time in Edinburgh, demand was exploited by the infamous William Burke and Hare who were known to have killed more than 20 people before selling the bodies to anatomists. The success of this lucrative ‘business’ was short-lived when their plan was exposed, leading to creation and introduction of the original 1832 Anatomy Act.
At least in the UK, body donation is a tightly regulated process with many strict legal requirements. Regulation is necessary in order to secure a body for donation, since human tissues can be hazardous and may pose a risk to those who come into contact with it. The Human Tissue Authority (HTA) are the regulatory body in charge of controlling the use of organs and body materials. The Human Tissue Act (2004) requires that a written and witnessed consent to anatomical dissection is given prior to death and a copy left in your will. Donations needs to be in a relatively ‘normal and healthy’ state and individuals must not have died from any communicable disease but from natural causes. Bodies are usually required to be whole with no amputations or transplants given during life.
After donation, the body is embalmed in formaldehyde in order to stop the decomposition process and preserve the tissue. They are also pumped with phenol to prevent the growth of mould. The body is then transferred to a fridge for 3 months to allow the formalin to work (changing proteins in the body and halting degradation).
Donated tissue can be used for several purposes including: teaching, furthering research into human health and anatomical examination or educational displays (such as in museums). Therefore, the donation of tissue is vitally important to society.
The Royal College of Surgeons predicts that there will soon be a shortage of body donations which could threaten teaching and medical research. In 2008 there were approximately 45,000 trainee doctors and surgeons, but only 600 bodies were donated to medical schools for teaching. A number that the RCS predict will continue to fall as fewer people are made aware of this vital practice. The College predicts that the UK medical schools will need around 1,000 bodies each year to maintain sufficient teaching levels, but predict a 30% shortage in 2012.
I was first made aware of body donation after visiting the Body Worlds exhibition in Manchester several years ago. I found myself faced with an intriguing collection of various human and animal forms partially dissected to expose their internal anatomy. The bodies were posed into various forms and positions, with the purpose of educating the lay person about the human body. Some displays also highlighted how disease affects the body, leading to better health awareness. The exhibition exploits a process known as plastination, invented in 1977 by German anatomist Gunther Von Hagen. Bodies are preserved by replacement of bodily fluids with a polymer to preserve tissues and cause rigidity. This also allows the body to be displayed in a desired position. This may be viewed as an extreme way of raising awareness, and it is one that has created its fair share of controversy. It cannot be denied that body donation is an important process, one which certainly requires greater public attention.
As a lasting thought:
‘By donating your body, you will be doing everything possible as a layman to improve doctors’ level of training. You will be passing the medical care given to you, which started with the treatment your mother received before you were born, on to future generations.’ GUNTHER VON HAGEN.
Post by: Sam Lawrence