Brenna Connor T A
Department of Medicine, University of Toronto, Toronto, ON, Canada.
Rambam Maimonides Med J. 2021 Jan 19;12(1):e0008. doi: 10.5041/RMMJ.10423.
Anatomical dissection is almost ubiquitous in modern medical education, masking a complex history of its practice. Dissection with the express purpose of understanding human anatomy began more than two millennia ago with Herophilus, but was soon after disavowed in the third century BCE. Historical evidence suggests that this position was based on common beliefs that the body must remain whole after death in order to access the afterlife. Anatomical dissection did not resume for almost 1500 years, and in the interim anatomical knowledge was dominated by (often flawed) reports generated through the comparative dissection of animals. When a growing recognition of the utility of anatomical knowledge in clinical medicine ushered human dissection back into vogue, it recommenced in a limited setting almost exclusively allowing for dissection of the bodies of convicted criminals. Ultimately, the ethical problems that this fostered, as well as the increasing demand from medical education for greater volumes of human dissection, shaped new considerations of the body after death. Presently, body bequeathal programs are a popular way in which individuals offer their bodies to medical education after death, suggesting that the once widespread views of dissection as punishment have largely dissipated.
解剖在现代医学教育中几乎无处不在,但其复杂的实践历史却鲜为人知。以了解人体解剖为明确目的的解剖始于两千多年前的希罗菲卢斯,但在公元前三世纪后不久就被摒弃了。历史证据表明,这一立场基于一种普遍观念,即死后身体必须保持完整才能进入来世。解剖学解剖几乎1500年没有恢复,在此期间,解剖学知识主要由(通常有缺陷的)通过动物比较解剖得出的报告主导。当人们越来越认识到解剖学知识在临床医学中的实用性,使得人体解剖再次流行起来时,它在有限的范围内重新开始,几乎只允许解剖被定罪罪犯的尸体。最终,这种做法引发的伦理问题,以及医学教育对更多人体解剖的需求不断增加,塑造了人们对死后身体的新思考。目前,遗体捐赠项目是个人在死后将自己的身体提供给医学教育的一种流行方式,这表明曾经将解剖视为惩罚的普遍观点已基本消失。