J.L. Habicht is a third-year medical student, Medical School Brandenburg, Brandenburg Campus, Brandenburg an der Havel, Germany. C. Kiessling is head of the assessment department, Medical School Brandenburg, Neuruppin Campus, Neuruppin, Germany; ORCID: http://orcid.org/0000-0003-4104-4854. A. Winkelmann is full professor, Institute of Anatomy, Medical School Brandenburg, Neuruppin Campus, Neuruppin, Germany, and chair, Federative International Committee for Ethics and Medical Humanities, International Federation of Associations of Anatomists (IFAA); ORCID: http://orcid.org/0000-0003-1047-2477.
Acad Med. 2018 Sep;93(9):1293-1300. doi: 10.1097/ACM.0000000000002227.
The International Federation of Associations of Anatomists (IFAA) recommended in 2012 that only donated bodies be used for anatomy teaching and research. However, in many countries around the world, anatomists still depend on bodies that do not stem from voluntary donations by the deceased but, rather, are "unclaimed." A broad search of the literature was conducted to produce a baseline overview of the sources of cadavers used for anatomy teaching in undergraduate medical curricula on a global scale. Information from the literature search was supplemented with data from a 2016-2017 survey of selected senior local anatomists. Of 165 countries with medical schools, information was gathered for 71. In 22 (32%) of the 68 countries that use cadavers for anatomy teaching, body donation is the exclusive source of bodies. However, in most other countries, unclaimed bodies remain the main (n = 18; 26%) or exclusive (n = 21; 31%) source. Some countries import cadavers from abroad, mainly from the United States or India. In one country, bodies of executed persons are given to anatomy departments. The heterogeneous geographical distribution of body sources cannot easily be accounted for, but religion, culture, and folk beliefs about what should happen to bodies after death seem to play a role. Implementation of the IFAA recommendations still has a long way to go, but it is encouraging that functioning body donation programs exist on all continents and that there are examples of recent rises in donations and of anatomists initiating new donation programs.
国际解剖学家协会联合会(IFAA)在 2012 年建议,仅使用捐赠的尸体用于解剖教学和研究。然而,在世界上许多国家,解剖学家仍然依赖于并非来自死者自愿捐赠的尸体,而是“无人认领”的尸体。我们进行了广泛的文献检索,以了解全球范围内用于本科医学课程解剖教学的尸体来源。文献检索的信息辅以 2016-2017 年对选定的当地解剖学资深专家的调查数据。在有医学院的 165 个国家中,有 71 个国家提供了信息。在 68 个使用尸体进行解剖教学的国家中,有 22 个(32%)国家的尸体捐赠是唯一的来源。然而,在大多数其他国家,无人认领的尸体仍然是主要(n=18;26%)或唯一的来源(n=21;31%)。一些国家从国外进口尸体,主要来自美国或印度。在一个国家,被处决者的尸体被交给解剖部门。尸体来源的地理分布不均,难以解释,但宗教、文化和民间信仰认为死后尸体应该如何处理,这似乎起到了一定作用。IFAA 建议的实施还有很长的路要走,但令人鼓舞的是,所有大洲都有运作良好的尸体捐赠计划,并且有最近捐赠增加和解剖学家发起新的捐赠计划的例子。