Body donation

Body donation, anatomical donation, or body bequest is the donation of a whole body after death for research and education. Donated bodies are mostly used for medical education and research. They are used for gross anatomy, surgical anatomy and for furthering medical education. For years, only medical schools accepted bodies for donation, but now private programs also accept donors. Depending on the program's need for body donation, some programs accept donors with different specifications.

Body donation is important for understanding the human body and for making advancements in science. There is usually no cost to donate a body to science; donation programs will often provide a stipend and/or cover the cost of cremation or burial once a donated cadaver has served its purpose and is returned to the family for interment.

Any person wishing to donate their body may do so through a willed body program. The donor may be required, but not always, to make prior arrangements with the local medical school, university, or body donation program before death. Individuals may request a consent form, and will be supplied information about policies and procedures that will take place after the potential donor is deceased.

Anatomical donation is still relatively rare, and in attempts to increase these donations, many countries have instituted programs and regulations surrounding the donation of cadavers or body parts. For example, in some states within the United States and for academic-based programs, a person must make the decision to donate their remains themselves prior to death; the decision cannot be made by a power of attorney. If a person decides not to donate their whole body, or they are unable to, there are other forms of donation via which one can contribute their body to science after death, such as organ donation and tissue donation.

Mortui prosumus vitae - Bremgartenfriedhof
"Even in death do we serve life": Inscription on a communal grave dedicated to body donors

Religion

Many religions show support for anatomical donations. The Hindu,[1] Buddhist,[2] Muslim,[3] and Christian,[4] religions all support the idea of body donation and/or organ donation for the betterment of the world. The support of these religions is critical in many parts of the world as many people actively practice these religions.

India

In 1948, the Anatomy Act was passed in all of India’s states. This allows bodies to be donated by the donor and bodies to be claimed for medical and research use if there is no claim to one’s body within a 48-hour timeframe.[5] Similar to the US, India also has specific guidelines for accepting bodies for donations. Donations that are not deemed suitable include bodies with HIV/AIDS, hepatitis (A, B, and C), donated organs, extreme BMI, or skin diseases.

Some leaders have donated their bodies for medical research, such as communist leader Jyoti Basu[6] and Jana Sangh leader Nanaji Deshmukh.[7] Nowadays, many people in India donate their bodies after death by signing a pledge form with two accompanying witness signatures.[8]

United Kingdom

Body donation in the UK is governed by the Human Tissue Authority (HTA) under the auspices of the Human Tissue Act 2004. The HTA licenses and inspects establishments, such as medical schools, which teach anatomy using donated bodies. Under the Human Tissue Act, written consent must be given prior to death; consent cannot be given by anyone else after death. [9] The minimum age to consent to donate one's body in the UK is 17.

The Human Tissue Authority provides information to donors about where they can donate and answers many prevalent questions related to tissue donation on their website. The Human Tissue Authority provides the links to each establishment’s information, but each establishment has its own guidelines for body donation. The HTA also provides the tools to find donation sites local to the person wishing to donate their body, or tissues.

Although most establishments accept most donations, donors who have had an autopsy may be declined from a program. Certain programs also may decline bodies of donors who have died abroad.[10]

United States

Only the legal next-of-kin of the deceased can provide the necessary consent for donation if the donor did not provide it to the specific accepting program prior to death.

Body donation is not regulated through licensure and inspection by the federal government and most states. However, United States House Bill 5318 was introduced on July 31, 2014 under the Energy and Commerce Committee. If passed as written, Health and Human Services would oversee the industry. Any entity (including U.S. Medical Schools) are subject to this legislation if tissue crosses state lines.

Body brokers (or non-transplant tissue banks) engage in the acquisition of cadavers, often via offers of free cremation, and then subsequently process the cadaver and resell body parts in a largely unregulated national market.[11]

The legal right for an individual to choose body donation is governed by the Uniform Anatomical Gift Act, which has been largely adopted by most states. Laws relating to the transportation and disposition of human bodies currently apply, regardless of the recent House Bill introduced.

The American Association of Tissue Banks (AATB) provides accreditation to non-transplant tissue bank research and education programs to establish that the level of medical, technical, and administrative performance meets or exceeds the standards set by the AATB. Whole body donation and non-transplant tissue banking remains an industry with limited regulation, and while it is not a legal requirement, accreditation allows for individuals choosing to donate their body to medical research or education programs to choose a program with the highest quality standards.

The American Medical Education and Research Association (AMERA) is a peer-recognized national accrediting body in the United States that provides accreditation to organizations using standards developed solely for non-transplant organizations. This includes whole body donor organizations, university anatomical programs, bio-repository programs, and end users of human tissue. AMERA encourages the industry to become accredited and involved in establishing standards that are relevant to non-clinical tissue organizations.

Many medical programs in the United States now hold student-led memorial services for the donated bodies. This is to show respect for the donors and their families, and to shine a positive light on the process of body donation.[12]

There are many private body donation programs in the US. Each of these private programs accepts bodies from certain surrounding areas. Most programs also have guidelines for bodies they will and will not accept. Generally, programs will not accept bodies that are positive for Hepatitis (A, B, and C), HIV/AIDS, history of illegal drug use, or fall within an extreme category for their BMI. The embalming process adds even more weight to a donor's body, so if they have a high BMI the programs may not take them because they cannot handle the weight of the donor after embalming.[13] If a donor has a specific disease prior to death, which is not contagious, and would like to be a part of a program’s study they may contact that research program specifically.

Germany

Body disposal and donation are regulated by the Bestattungsgesetze (funeral laws) of the states. In Germany, the right to autonomy extends beyond death, as a result of which the instructions given by a deceased during their lifetime must be respected when dealing with their body. A body donation can only take place if the deceased signed a declaration of last will in their lifetime, stating the intention of donating their body to an anatomical institute. Relatives of the deceased can neither give permission nor deny body donation against said declaration, the institute however may deny the body. Denial of the body may occur if it carries infectious diseases, has had organs or body parts removed for donation or surgery, is gravely injured or otherwise unfit for teaching, if the body is located too far away from the institute or for reasons of storage capacity. Most institutes require an advance fee to be deposited to pay for funeral costs. [14]

Motives behind the decision

The decision to become a body donor is influenced by factors such as: social awareness, cultural attitudes and perceptions of body donation, cultural attitudes and perceptions of death, religion, and perceptions of the body-mind relationship.[15] Studies indicate most donors are primarily driven by altruism and their desire to aid the advancement of medical knowledge and to be useful after death.[16] Other reasons include helping future generations, expressing gratitude for life and good health or for the medical field, to avoid a funeral or to avoid waste.[17]

The offering of financial incentives as a way to increase donor numbers or as an acknowledgement for donors is generally considered to detract from the act of donation and serve as a deterrent.[18] However, a US study showing a positive correlation between body donation numbers and funeral cover cost savings offered as compensation suggests that, in reality, the added incentive could be a persuasive factor for donors.[19]

Use of donors

Bodies donated to any organization are used for scientific research and medical training. Bodies are used to teach medical students anatomy, but they are also used to improve and create new medical technologies. Many programs that accept body donations have specific research affiliations, these can be viewed by looking at each programs website. These can include cancer research, Alzheimer’s research, and research into improving surgeries.[20]

Listed below are examples of research conducted with donated bodies:

  • Arthritis
  • Cancer
  • Cardiovascular Diseases
  • Diabetes
  • Hip Replacement
  • Knee Replacement
  • Neurological Conditions
  • Paramedic Training
  • Shoulder Replacement
  • Spinal Disorders
  • Tumor Removal

Some programs accept whole bodies but distribute different body parts based on need. This ensures a maximum benefit from each donation. These programs can assist with research as shown above, technical training, or improvement/research of medical devices.[21]

After bodies are accepted for donation, a timeframe of six months to three years is expected before the donor's body will be returned to the family. This takes into account embalming, research, and the number of bodies the program has access to at the time.[22]

References

  1. ^ "Gift a Life". Gift a Life.
  2. ^ "Buddhism". Organ Donation.
  3. ^ "Islam". Organ Donation.
  4. ^ "Christianity". Organ Donation.
  5. ^ Rokade, S (February 2013). "Body Donation Review" (PDF). Medical Journal of Western India. Retrieved 2016-03-27.
  6. ^ "Body donation: Buddha, Biman and many more ready to follow suit". The Indian Express. 21 January 2010. Retrieved 25 July 2013.
  7. ^ "68 BJP leaders pledge to donate their bodies". Times of India. 23 July 2013. Retrieved 25 July 2013.
  8. ^ "110 to pledge body donation to further medical education". Times of India. 7 June 2013. Retrieved 25 July 2013.
  9. ^ Human Tissue Authority Body Donation FAQs in the UK
  10. ^ "Human Tissue Authority".
  11. ^ In the U.S. market for human bodies, almost anyone can dissect and sell the dead, Reuters, Brian Grow and John Shiffman, 25 October 2017
  12. ^ Riederer, B. M. (2016), Body donations today and tomorrow: What is best practice and why?. Clin. Anat., 29: 11–18. doi: 10.1002/ca.22641
  13. ^ "NBC News". NBC News.
  14. ^ Marburg University Häufig gestellte Fragen zur Körperspende (FAQ on body donation) (German), retrieved 6 February 2018
  15. ^ Savulescu, J. (2003). Death, Us and Our Bodies: Personal Reflections. Journal of Medical Ethics, 29(3), 127-130.
  16. ^ Bolt, S., Venbrux, E., Eisinga, R., Kuks, J. B. M., Veening, J. G., Gerrits, P. O. (2010). Motivation for body donation to science: More than an altruistic act. Annals of Anatomy, 192(2), 70-74.
  17. ^ Bolt, S., Venbrux, E., Eisinga, R., Kuks, J. B. M., Veening, J. G., Gerrits, P. O. (2010). Motivation for body donation to science: More than an altruistic act. Annals of Anatomy, 192(2), 70-74.
  18. ^ Ajita, R. & Singh, I. (2007). Body Donation and Its Relevance in Anatomy Learning – A Review. Journal of the Anatomical Society of India, 56(1), 44-47.
  19. ^ Harrington, D. E. & Sayre, E. A. (2007). Paying for Bodies, But Not for Organs. Regulation, 29(4), 14-19.
  20. ^ "Life Legacy". Life Legacy. Archived from the original on 2016-11-30.
  21. ^ "donate-body-to-science". BioGift.
  22. ^ "Body Donation FAQ". OHSU.

External links

American Association of Tissue Banks

The American Association of Tissue Banks (AATB); a transplant trade organization that is dedicated to ensuring that human tissues intended for transplantation are safe and free of infectious disease, of uniform high quality, and available in quantities sufficient to meet national needs.

The AATB provides accreditation for over 100 tissue banks. According to their website, AATB is a voluntary association of organizations committed to obtaining tissues for allografts (transplant) and providing the general public and the medical community with the safest products possible. The program is not regulatory in nature, but educational.

The AATB also accommodates accreditation to non-transplant tissue banks and whole body donation programs.

To avoid violating the Health Insurance Portability and Accountability Act, AATB must through their legal anatomical authorizations obtain consent which allows AATB representatives access to donor information for accreditation reviews.

Cadaver

A cadaver is a dead human body that is used by medical students, physicians and other scientists to study anatomy, identify disease sites, determine causes of death, and provide tissue to repair a defect in a living human being. Students in medical school study and dissect cadavers as a part of their education. Others who study cadavers include archaeologists and artists.The term cadaver is used in courts of law to refer to a dead body, as well as by recovery teams searching for bodies in natural disasters. The word comes from the Latin word cadere ("to fall"). Related terms include cadaverous (resembling a cadaver) and cadaveric spasm (a muscle spasm causing a dead body to twitch or jerk). A cadaver graft (also called “postmortem graft”) is the grafting of tissue from a dead body onto a living human to repair a defect or disfigurement. Cadavers can be observed for their stages of decomposition, helping to determine how long a body has been dead.Cadavers have been used in art to depict the human body in paintings and drawings more accurately.

Dead on arrival

Dead on arrival (DOA), also dead in the field and brought in dead (BID), indicates that a patient was found to be already clinically dead upon the arrival of professional medical assistance, often in the form of first responders such as emergency medical technicians, paramedics, or police.

In some jurisdictions, first responders must consult verbally with a physician before officially pronouncing a patient deceased, but once cardiopulmonary resuscitation is initiated, it must be continued until a physician can pronounce the patient dead.

Death messenger

Death messengers, in former times, were those who were dispatched to spread the news that an inhabitant of their city or village had died. They were to wear unadorned black and go door to door with the message, "You are asked to attend the funeral of the departed __________ at (time, date, and place)." This was all they were allowed to say, and were to move on to the next house immediately after uttering the announcement. This tradition persisted in some areas to as late as the mid-19th century.

Death rattle

Terminal respiratory secretions (or simply terminal secretions), known colloquially as a death rattle, are sounds often produced by someone who is near death as a result of fluids such as saliva and bronchial secretions accumulating in the throat and upper chest. Those who are dying may lose their ability to swallow and may have increased production of bronchial secretions, resulting in such an accumulation. Usually, two or three days earlier, the symptoms of approaching death can be observed as saliva accumulates in the throat, making it very difficult to take even a spoonful of water. Related symptoms can include shortness of breath and rapid chest movement. While death rattle is a strong indication that someone is near death, it can also be produced by other problems that cause interference with the swallowing reflex, such as brain injuries.It is sometimes misinterpreted as the sound of the person choking to death, or alternatively, that they are gargling.

Dignified death

Dignified death is a somewhat elusive concept often related to suicide. One factor that has been cited as a core component of dignified death is maintaining a sense of control. Another view is that a truly dignified death is an extension of a dignified life. There is some concern that assisted suicide does not guarantee a dignified death, since some patients may experience complications such as nausea and vomiting. There is some concern that age discrimination denies the elderly a dignified death.

Dysthanasia

In medicine, dysthanasia means "bad death" and is considered a common fault of modern medicine.Dysthanasia occurs when a person who is dying has their biological life extended through technological means without regard to the person's quality of life. Technologies such as an implantable cardioverter defibrillator, artificial ventilation, ventricular assist devices, and extracorporeal membrane oxygenation can extend the dying process.

Dysthanasia is a term generally used when a person is seen to be kept alive artificially in a condition where, otherwise, they cannot survive; sometimes for some sort of ulterior motive. The term was used frequently in the investigation into the death of Formula One driver Ayrton Senna in 1994.

Funeral

A funeral is a ceremony connected with the final disposition of a corpse, such as a burial or cremation, with the attendant observances. Funerary customs comprise the complex of beliefs and practices used by a culture to remember and respect the dead, from interment, to various monuments, prayers, and rituals undertaken in their honor. Customs vary between cultures and religious groups. Common secular motivations for funerals include mourning the deceased, celebrating their life, and offering support and sympathy to the bereaved; additionally, funerals may have religious aspects that are intended to help the soul of the deceased reach the afterlife, resurrection or reincarnation.

The funeral usually includes a ritual through which the corpse receives a final dispositon. Depending on culture and religion, these can involve either the destruction of the body (for example, by cremation or sky burial) or its preservation (for example, by mummification or interment). Differing beliefs about cleanliness and the relationship between body and soul are reflected in funerary practices. A memorial service or celebration of life is a funerary ceremony that is performed without the remains of the deceased person.The word funeral comes from the Latin funus, which had a variety of meanings, including the corpse and the funerary rites themselves. Funerary art is art produced in connection with burials, including many kinds of tombs, and objects specially made for burial like flowers with a corpse.

JSS Medical College

JSS Medical College (JSSMC) is a prestigious medical college based in Mysore, Karnataka, India. The graduate and post-graduate programs of the college are recognized by the Medical Council of India. The courses offered are also recognized by General Medical Council (UK), Sri Lanka Medical Council and WHO. The college has been recognized by the Royal College of Obstetricians and Gynaecologists, UK, for the award of MRCOG. After the formation of JSS University (Established under Section-3 of UGC Act), JSS Medical College became a constituent college of the JSS University (now JSS Academy of Higher Education and Research-JSSAHER) from the Academic year 2008-2009, which is among the country's top 5 and world's top 500 universities as per The Times Higher Education Ranking, 2019 which also ranked JSSAHER as India's most impactful university with an international ranking between 101-150. JSSAHER has been accredited by NAAC with an A+ grade. The students of this college are from all corners of India as well as from abroad.

Attached to one of the biggest hospitals in India, it is one of the first institutions in the country to establish a plastination museum. JSS Body Donation Camp is also one of the biggest body donation camps in India.It has been ranked as one of the top medical colleges by Careers 360 and Outlook. JSSAHER also has a QS 4 star rating along with Autonomous Status granted by MHRD on recommendations of UGC for maintaining high standards in medical education.

Lazarus sign

The Lazarus sign or Lazarus reflex is a reflex movement in brain-dead or brainstem failure patients, which causes them to briefly raise their arms and drop them crossed on their chests (in a position similar to some Egyptian mummies). The phenomenon is named after the Biblical figure Lazarus of Bethany, whom Jesus raised from the dead in the Gospel of John.

Megadeath

Megadeath (or megacorpse) is one million human deaths, usually caused by a nuclear explosion. The term was used by scientists and thinkers who strategized likely outcomes of all-out nuclear warfare.

Mellified man

A mellified man, or a human mummy confection, was a legendary medicinal substance created by steeping a human cadaver in honey. The concoction is detailed in Chinese medical sources, most significantly the Bencao Gangmu of the 16th-century Chinese medical doctor and pharmacologist Li Shizhen. Relying on a second-hand account, Li reports a story that some elderly men in Arabia, nearing the end of their lives, would submit themselves to a process of mummification in honey to create a healing confection.This process differed from a simple body donation because of the aspect of self-sacrifice; the mellification process would ideally start before death. The donor would stop eating any food other than honey, going as far as to bathe in the substance. Shortly, his feces (and even his sweat, according to legend) would consist of honey. When this diet finally proved fatal, the donor's body would be placed in a stone coffin filled with honey.After a century or so, the contents would have turned into a sort of confection reputedly capable of healing broken limbs and other ailments. This confection would then be sold in street markets as a hard to find item with a hefty price.

Necronym

A necronym (from the Greek words νεκρός, nekros, "dead" and ὄνομα ónoma, "name") is a reference to, or name of, a person who has died. Many cultures have taboos and traditions associated with referring to such a person. These vary from the extreme of never again speaking the person's real name, often using some circumlocution instead, to the opposite extreme of commemorating it incessantly by naming other things or people after the deceased.

For instance, in some cultures it is common for a newborn child to receive the name (a necronym) of a relative who has recently died, while in others to reuse such a name would be considered extremely inappropriate or even forbidden. While this varies from culture to culture, the use of necronyms is quite common.

Obituary

An obituary (obit for short) is a news article that reports the recent death of a person, typically along with an account of the person's life and information about the upcoming funeral. In large cities and larger newspapers, obituaries are written only for people considered significant. In local newspapers, an obituary may be published for any local resident upon death. A necrology is a register or list of records of the deaths of people related to a particular organization, group or field, which may only contain the sparsest details, or small obituaries. Historical necrologies can be important sources of information.

Two types of paid advertisements are related to obituaries. One, known as a death notice, omits most biographical details and may be a legally required public notice under some circumstances. The other type, a paid memorial advertisement, is usually written by family members or friends, perhaps with assistance from a funeral home. Both types of paid advertisements are usually run as classified advertisements.

Pallor mortis

Pallor mortis (Latin: pallor "paleness", mortis "of death"), the first stage of death, is an after-death paleness that occurs in those with light/white skin.

S Nijalingappa Medical College, HSK (Hanagal Shree Kumareshwar) Hospital and Research Centre

S Nijalingappa Medical College, HSK (Hanagal Shree Kumareshwar) Hospital and Research Centre (SNMC) is a medical college based in Bagalkot, Karnataka, India. The graduate and post-graduate programs of the college are recognized by the Medical Council of India. The courses offered are also recognized by General Medical Council (UK), Sri Lanka Medical Council and WHO. The college has been recognized by the Royal College of Obstetricians and Gynaecologists, UK, for the award of MRCOG. After the formation of JSS University (Established under Section-3 of UGC Act) JSS Medical College has become a constituent college of the JSS University from the Academic year 2008-2009. The students of this college are from all corners of India as well from Abroad.

Shri B. M. Patil Medical College

Shri B. M. Patil Medical College is situated at Solapur road in Bijapur, Karnataka. The college offers educational courses in medicine and surgery leading to MBBS degree. The college was established in the year 1986.The college has a well equipped hospital attached to it.

Tissue bank

A tissue bank is an establishment that collects and recovers human cadaver tissue for the purposes of medical research, education, and allograft transplantation. A tissue bank may also refer to a location where biomedical tissue is stored under cryogenic conditions, and is generally used in a more clinical sense.The United States Navy Tissue Bank is generally accepted as the first full tissue banking service of its kind in the world although it is not the largest or only tissue bank today.

University of Tennessee Anthropological Research Facility

The University of Tennessee Anthropological Research Facility, better known as the Body Farm and sometimes seen as the Forensic Anthropology Facility, was started in late 1971 by anthropologist William M. Bass as a facility for study of the decomposition of human remains. It is located a few miles from downtown Knoxville, Tennessee, USA, behind the University of Tennessee Medical Center.

It consists of a 2.5-acre (10,000 m2) wooded plot, surrounded by a razor wire fence. Bodies are placed in different settings throughout the facility and left to decompose. The bodies are exposed in a number of ways in order to provide insights into decomposition under varying conditions. The Facility has expanded from just 20 exposed bodies in 2003 to around 150 in 2007.

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