The centrality of the dead human body for teaching and research – social, cultural and ethical issues

Abstract

Study of the cadaver is integral to both medical education and research, but how is cadaveric material to be obtained in the 21st-century world? Historical precedents are of little assistance, built as they are on the most unethical of practices, including body snatching and murder. This constitutes a major challenge for modern anatomy: has it been able to cast off all semblance of this unsavoury past? In this paper it is contended that the continued use of unclaimed bodies has proved problematic, ignoring as it does the fundamental ethical impetus of altruism. The use of bequeathed bodies is regarded as ethically preferable, even though cultural practices vary significantly, with the result that the availability of cadavers is uneven across societies. Recent legislation has brought the role of informed consent to the fore, and this is a welcome development. Nevertheless, immense challenges remain for anatomists, a major one being that posed by the large-scale public exhibitions of plastinated bodies, the prime exponent of which is Body Worlds. In assessing the manner in which the plastinates are displayed, those with Renaissance allusions have most in common with an educational rationale, although lacking a research ethos. The contemporary genre plastinates are the furthest removed from any traditional anatomical approach, and generally lack any teaching focus. They are also the most problematic ethically when assessed in terms of the principles of beneficence and non-maleficence. Additionally, the character of donation is changed within the context of these public exhibitions.