School of Anatomical Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
Department of Anatomy, School of Medical Sciences, University of New South Wales, Sydney, Australia.
Anat Sci Educ. 2020 Jul;13(4):512-519. doi: 10.1002/ase.1922. Epub 2019 Oct 29.
Historically, legislature has been utilized to facilitate appropriate use of cadavers in the anatomical sciences. However, cadaver acquisition and use have also been guided by ethically appropriate and morally acceptable principles. Various global and regional frameworks of "ethical practice" guide body donation, including the use of unclaimed bodies by institutions. These frameworks are responsive to, and reciprocal with the various ethical, moral and legal factors that influence the development of body donation programs. This reciprocity supports the notion that anatomists and anatomical societies have a responsibility to advocate for legal reform when required. In this study, two body bequest programs from geopolitically and socially disparate countries are used as cases to contrast existing legal and governance frameworks for body donation and to examine whether anatomists can direct the acquisition of ethically donated cadavers. The study includes an Australian donor program that has exclusively accepted bequests since its inception, and a South African program that has recently transitioned to a bequest system. Elements such as consent by next-of-kin and Inspector of Anatomy, use of unclaimed bodies and ethics committee approval amongst others, are compared. It is acknowledged that legal frameworks for cadaver acquisition generally deliver broad guidance on acceptable utilization of bodies for the anatomical sciences. However, professional discretion is of importance in adapting to societal needs and values. Thus, while anatomists have been able to progress toward more ethical practice than that which is required by the law, they must continue to do so as societal values evolve.
从历史上看，立法机构一直被用于促进解剖科学中对尸体的合理使用。然而，尸体的获取和使用也受到道德上适当和可接受的原则的指导。各种全球和地区的“道德实践”框架指导着尸体捐赠，包括机构对无人认领的尸体的使用。这些框架响应并相互影响着影响尸体捐赠计划发展的各种道德、法律和法律因素。这种相互作用支持了这样一种观点，即解剖学家和解剖学会有责任在需要时倡导法律改革。在这项研究中，来自地缘政治和社会背景截然不同的两个国家的两个遗体遗赠项目被用作案例，对比现有的遗体捐赠法律和治理框架，并探讨解剖学家是否可以指导符合伦理的捐赠遗体的获取。该研究包括一个自成立以来一直只接受遗赠的澳大利亚捐赠者计划，以及一个最近过渡到遗赠制度的南非计划。例如，近亲同意和解剖督察员、无人认领的尸体的使用以及伦理委员会的批准等因素都进行了比较。人们认识到，尸体获取的法律框架通常为解剖科学对尸体的可接受利用提供了广泛的指导。然而，在适应社会需求和价值观方面，专业判断力很重要。因此，尽管解剖学家已经能够朝着比法律要求更符合伦理的实践方向发展，但随着社会价值观的演变，他们必须继续这样做。
