Tag: cadavers

Bioethics Blogs

The Aftergift

“… and maybe then you’ll hear the words I’ve been singing;
Funny, when you’re dead how people start listen’n…”
If I Die Young (2010)
by The Band Perry

It was in the fall of 2015 that I received a call from a Mrs. Jones.  She went on to detail how her husband, Robert, had died from cancer and donated his body to our anatomy lab in 2006.  She further explained that she and her children had finally come to terms with his passing and now, 9 years later, were finally ready to spread his ashes at the family cemetery plot.  She stated that she wanted to hold a ceremony and perhaps have the students that worked on her husband write something about their experience that could be read at the service…

I went on to explain that, although we kept thorough records and could account for her husband, we really did not track which 5 students were assigned to him.  As a conciliatory gesture, I did offer to contact the “class of 2010” (freshman in 2006) and ask them to reflect upon Mr. Jones or the use of their respective assigned cadavers.  She agreed and I fired off an email designed to reach a group of doctors not only nine years removed from anatomy, but now practicing medicine all over the country. I had little hope of a response.

The first reply arrived within 10 minutes from Dr. Susan Anzalone.

Dear Mrs. Jones,

I’m sorry to hear about the loss of your husband.  I hope you are doing OK and are surrounded by loving family and friends.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Memento Mori- Reflecting on my Death and the Education of Medical Students

By Laura Creel

As part of their undergraduate medical education, students discuss end-of-life care; they hear lectures about valuing the lives and deaths of future patients; they are instructed in the legal issues surrounding advance directives and care planning.  They see death, too—see it in the cadavers that they incise, see it in patients who die surrounded by family members and in patients who die alone.  Sometimes these experiences with death are personal; many times the experiences are stripped of emotion because they occur in clinical environments.  But although students see death in medical school, some recent research shows that approximately half of residents do not feel well-prepared to deal with the deaths of patients.[i]

I do not see death in the way that medical students, residents, or physicians do; my experience working in medical education is limited to accreditation.  But I have long listened to Death reminding me that one day, he will take me. Memento mori, Death whispers; he will not let me forget.

I have spent half of my 28 years reeling—recovering from and sinking back into the claws of major depressive and generalized anxiety disorders.  And Death was present there.  He was present on a visceral level in a brain and body wracked by fear and sadness; one would expect him to be there.  But death is present even now, when the SSRIs and cognitive behavioral therapy have done their work.  And, I posit here, the memory of my own mortality can be a good thing.

In my own experience, the reminder of my eventual death encourages me to live with purpose. 

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

Trend Away from Cadavers in Medical Education


For anyone who has gone through
medical school, you have the experience of working with a cadaver. 
Anatomy class is the
common
rite of passage
every first year medical student goes through.  For some students, this is a dreaded
experience.
  For other students, it is
the best part of first year medical school.
 
All students walk away with first-hand knowledge of the human body.  Students learn to do their first incision
without harm to a live patient.
  Students
experience the process of death, from the biological to the social aspects.
  Some patients even learn empathy as they
learn the bodily intimacies of the deceased.
 
Medical schools will commonly provide burial services for these cadavers
after the class is over.
  Some
institutions will allow the students to meet the family to express gratitude
for the experience.
 No matter what
institution a medical student comes from, it is an unforgettable experience.


Recently, there has been movement
away from use of cadavers in medical school, for better or for worse. 
There may be a combination of reasons for
this trend.
  For example, legislation is
New
York just passed banning the use of unclaimed dead as cadavers in medical
schools
.  Although this legislation
has good intentions of increasing respect for the dead, it will force medical
schools in New York to depend move heavily on private body donations.
 In addition, there also has been emerging technologies
that are replacing cadavers, such as holograms, computer-simulations, or even
apps.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

More donating their bodies to science

More and more people are leaving their bodies to American medical schools as subjects for dissection, according to an article from Associated Press. The surge in donation has been a bonanza for medical schools, which use the cadavers for anatomy classes or for practicing surgical techniques.

“Not too long ago, it was taboo. Now we have thousands of registered donors,” said Mark Zavoyna, operations manager for Georgetown University’s body donation program. Other universities also report increases, although some have actually declined in recent years. ScienceCare, which describes itself as “the world’s largest accredited whole body donation program”, now gets 5,000 cadavers a year, twice as many as it did in 2010.

ScienceCare’s sales pitch appeals to generosity and altruism: “By providing a vital service and a pathway to greater knowledge and discovery, together we can help save lives, advance medical research and education, and improve quality of life for families and the community.”

But other factors are at work as well. The first is the cost of cremation and funerals. Bodies used by medical schools are cremated and returned to families, often at no expense. This is an important consideration when the average cost of a burial is US$8-10,000. The second is the weakening of religious objections to dissection and cremation. According to Time magazine, for the first time in the US, more people were cremated than buried in 2015. In 1980, fewer than 10% of people chose cremation. 

This article is published by Michael Cook and BioEdge under a Creative Commons licence.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

Many U.S. Medical Schools Are Seeing a Surge in the Number of People Leaving Their Bodies to Science

August 17, 2016

(Associated Press) – Many U.S. medical schools are seeing a surge in the number of people leaving their bodies to science, a trend attributed to rising funeral costs and growing acceptance of a practice long seen by some as ghoulish. The increase has been a boon to medical students and researchers, who dissect cadavers in anatomy class or use them to practice surgical techniques or test new devices and procedures.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

Bill Would Require Relatives’ Consent for Schools to Use Cadavers

Ever since grave robbers haunted American cemeteries and medical students paid for fresh corpses, New York State law has appropriated unclaimed bodies on behalf of medical schools that teach anatomical dissection

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

Pigs with Human Hearts, and Other Wild Tales from the Future of Organ Donation

April 13, 2016

(Quartz) – In the meantime, an average of 22 people in the US die each day while waiting for organ transplants. In the European Union, an average 14 people on organ waiting lists die per day, and in India, 90% of all people on waiting lists die without getting an organ. Now scientists are exploring a number of high-tech alternatives to obtaining organs from human cadavers. These options may one day solve the organ shortage problem—but they raise ethical questions of their own.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

The Curious Case of Informed Consent for Egg Donation

Guest Post by Alana Rose Cattapan

As Michael Dunn writes in a recent editorial for the JME, “no medical ethicist worth their salt would deny that consent is a foundational concept in contemporary medical ethics,” and it is an extraordinary understatement to say that much ink has been spilled on the topic. The spaces between consent in theory and in practice is the subject of Dunn’s editorial, where he describes the ways that scholarship about consent fails, at times, to account for the messiness of the real-life process.

Obtaining consent for egg donation is a particularly messy endeavour. We still know relatively little about the long term effects of egg donation, and donors are sometimes seen as secondary players while the recipient of the eggs – the woman carrying a pregnancy and having a child – is viewed as the primary patient. Like other corporeal donations – blood, organ, bone marrow – egg donation presents a curious case of medical treatment in which there are no physiological benefits to the donor. However, in the case of egg donation, the intervention occurs not to save a life, but rather to fulfil someone else’s desire to have a child.

In Canada, where laws prohibit payment and a grey market in paid donors has emerged, the complexities of obtaining informed consent for egg donation are particularly fraught. Donors that receive payment (are they really donors if they are paid?) have to navigate a system where they are seemingly engaged in something illegal and they may not feel empowered to demand the kind of treatment (including follow-up care) to which they are entitled.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics News

Human cryopreservation. Technique and ethical and moral assessment

Cryopreservation consists of preserving human individuals or organs at very low temperatures (less than -130°) in order to preserve them. The low temperatures decrease the metabolism and facilitate preservation.

Technique

Cryopreservation begins by bringing the person to a state of hypothermia as quickly as possible in order to reduce cell damage. Anticoagulants (heparin) and vasodilators (nimodipine) must also be administered.

When cardiorespiratory arrest has occurred, the patient must be placed in a support or container that is suitable for inducing hypothermia (iced water or other alternative systems). Cardiopulmonary support manoeuvres are performed, treatments are administered and intravenous lines are inserted that allow the blood to be exchanged for cryoprotectant solutions.

At least one artery and one vein must then be cannulated in order to enable the exchange of blood for a cryoprotectant solution (usually ethylene glycol, dimethyl sulfoxide or other components) that prevents the formation of ice crystals, allowing vitrification of the cells while preventing damage due to the crystals. Exchanging the blood for a cryoprotectant solution takes place at hypothermia temperatures — preferably less than 10°C — since at these temperatures the solution can transport as much oxygen as blood. Once the blood has been exchanged for the cryoprotectant, rapid cooling below 0°C should be performed. This cooling can be carried out with dry ice, which allows the temperature to be lowered to -79°C, or with liquid nitrogen, which enables a temperature of -196°C to be reached. Nevertheless, once a temperature of -130°C has been reached, arrest of the cell’s biological time is complete and the procedure can continue slowly until it reaches the -196°C of liquid nitrogen.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.

Bioethics Blogs

In the Journals, October 2015 – Part II by Sultana Banulescu

This month’s “In the Journals…” brings us a body of articles discussing pregnancy, childbirth, nursing, female anatomy, substance abuse, and addiction, with a focus on risk, secrecy, stigma, and strategies of coping and self-preservation.

Critical Public Health

What’s the story on addiction? Popular myths in the USA and Finland

Matilda Hellman & Robin Room

The study inquires into popular myths on addiction in two countries: Finland and the USA. It provides evidence of the manners in which the typical media narratives incorporate basic value traits from their context of origin. We distinguish some main features in the narrative set-ups that support different solution repertoires for dealing with addiction. Belief and hope are crucial story elements associated with the US emphasis on group formation and local empowerment. The individual is assigned obligations and can be morally condemned. In the Finnish journalistic prose, there seems to be an inherent belief that the agenda-setting in itself will propel the question into the institutionalised welfare state solution machinery. The occurrence of a story resolution was customary in the US stories, whereas the Finnish stories were typically left pending. The evidence produced has implications for the ongoing debate regarding the mainstreaming of both definitions of and solutions to addiction problems.

Low income, high risk: the overlapping stigmas of food allergy and poverty

Leia M. Minaker, Susan J. Elliott & Ann Clarke

The aim of this study was to explore experiences and coping strategies of low-income families affected by food allergies. Of particular interest were experiences of allergy-related stigma within the context of poverty stigma.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.