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同意与共识——关于获取尸体进行解剖的伦理视角

Consent and consensus-ethical perspectives on obtaining bodies for anatomical dissection.

作者信息

Winkelmann Andreas

机构信息

Institute of Anatomy, Brandenburg Medical School, Neuruppin, Germany.

出版信息

Clin Anat. 2016 Jan;29(1):70-7. doi: 10.1002/ca.22651. Epub 2015 Nov 4.

Abstract

Biomedical research and education benefit from the use of human cadavers. These are usually acquired from donors who have willed their body to science during their lifetime. This concept of donation through "informed consent" respects the personal autonomy of the donor and the dignity of the dead body (extended from the dignity of the living person). The concept of informed consent is taken from research on living human subjects regulated in the Helsinki Declaration. This transfer to the domain of anatomical donation, however, has several problems. For example, the dead cannot speak for themselves and the ethical status of the human cadaver remains ambiguous. It is therefore suggested that an element of consensus is added to the concept of consent, a consensus between donors, relatives, anatomists, and the wider community. A consensus can give difficult decisions surrounding body donation and dissection a broader basis and can help bridge the gap between donors and families on the one side and anatomists, researchers and students on the other side. This approach can help to establish relationships of trust with local communities, on which body donation programs depend.

摘要

生物医学研究与教育受益于人体尸体的使用。这些尸体通常来自生前将遗体遗赠给科学事业的捐赠者。这种通过“知情同意”进行捐赠的理念尊重了捐赠者的个人自主权以及尸体的尊严(这种尊严由生者的尊严延伸而来)。知情同意的概念源自《赫尔辛基宣言》所规范的对在世人类受试者的研究。然而,这种概念应用到解剖捐赠领域存在若干问题。例如,死者无法为自己发声,人体尸体的伦理地位仍不明确。因此,有人建议在同意的概念中加入共识的要素,即捐赠者、亲属、解剖学家以及更广泛社区之间的共识。共识能够为围绕遗体捐赠和解剖的艰难决策提供更广泛的基础,并有助于弥合捐赠者及其家人与解剖学家、研究人员和学生之间的差距。这种方法有助于与当地社区建立信任关系,而遗体捐赠项目正是依赖于这种关系。

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