The Ethics of Sourcing a Cadaver Population–A Perspective from South Africa

Abstract

We cannot deny the early, turbulent unethical history of the sourcing of human bodies for dissection during the 18th and 19th Centuries, but we most certainly can learn from the past. While the International Federation for the Associations of Anatomists (IFAA) has recommended ethical guidelines for the sourcing of bodies from donors only (IFAA, 2021), many institutions around the world have not been able to fulfil these recommendations. In South Africa, as an ethical imperative, most departments of anatomy have converted from the use of unclaimed bodies (although legal by South African law) to body donor programs which are founded on ethics and informed consent. South Africa has a diverse multicultural population derived from four main population groups (Black, Coloured, White and Indian) with health sciences classes being made up of predominantly Black students. As a consequence of the transformation from the use of unclaimed bodies to donor programs, the population diversity of the more recent cadaver populations has been impacted and White bodies now predominate. This transformation of the cadaver population will in time also impact the large skeletal collections in South Africa which are used for teaching and research by both local and international researchers. The change in the cadaver population with respect to population affinity particularly, may also impact our students and how they view the body they dissect. In South Africa and Africa, a number of factors including religious and cultural practices have a bearing on the diversity of the donors in donor programs. Donor programs are extremely important from the ethical perspective, and so too is the informed consent aligned to registration for these programs. In considering establishing diversity in the cadaver population of our donor programs for the future, some of the questions which should be pondered by South African anatomists and anatomists in general are: Is it important to have a body donor cohort that is representative of the demographics of the student population? How do we overcome the religious and cultural challenges which are prevalent in some of the population in order to maintain a donor program that is based on sound ethical behaviour and which is representative of the population at large? In addition, will anatomists be able to maintain ethical standards of sourcing bodies in the light of unexpected crises such as the recent pandemic? There is no doubt that in South Africa, widespread communication, educational programs and community outreach, particularly through the traditional leaders of each community, would assist with increasing the diversity of the donors.ReferenceIFAA. 2012. International Federation of Anatomical Associations. Federative International Committee on Ethics and Medical Humanities (FICEM). Recommendations of good practice for the donation and study of human bodies and tissues for anatomical examination. Plexus 2012: 4‐5.