Ethics, transplantation, and the changing role of anatomists

Profiting from public dissection: A new era of unethical practices

Historically, adverse events have reflected poorly on both the practice of dissection and the perception of the discipline of anatomy. The recent public dissection of a body donor is a regression to an unethical historical practice and was strongly denounced by anatomists around the world. The individual whose donated body was sourced from a 'for-profit" company in the United States had not given consent for a public dissection. This violates the ethics surrounding consent and body donation and potentially places the future of body donor programs in jeopardy as it compromises community frameworks around epistemic trust. Recent guiding frameworks by international anatomical associations on the ethical use of bodies have cemented the way in which body donor programs should operate. This viewpoint reflects on past and current events pertaining to public dissections and questions how these indignities may influence the public's interaction with human bodies. The authors argue that public dissection should be prohibited as it is against social mores. Social pressure should be applied to individuals or companies who wish to profit from unethical anatomical practice and legislation prohibiting public dissection should be introduced in those countries where it does not yet exist.

The place of ethics in practice of anatomical sciences: have we left our dark past behind and looking towards a bright future?

INTRODUCTION

Anatomical sciences involve handling of human tissues and, therefore, application of principles of bioethics is central to anatomical practice. For a considerable period of time, anatomy was practiced without ethical norms as concept of ethics developed during second half of twentieth century. Hence, possible glimpse into contrast in ethical standards between anatomy in the past and present was deemed as an intriguing research theme.

METHODS

A literature search was undertaken from indexed databases (Medline and Pubmed, Scopus, Embase, CINAHL Plus, Web of Science and Google Scholar). Relevant data were extracted from 37 articles that were selected from an initial pool of 752 articles based on search criteria set for the study.

RESULTS

Prevalent anatomical practices in the past such as dissection of executed criminals, acts of vivisection, illegal procurement of human remains, use of human tissues obtained as part of war crimes and dissection of human fetuses as well as their archival were analyzed through prism of established ethical norms in present day. The observations from past were presented vis-à-vis ethical practices undertaken in present times such as use of donated bodies and/or body parts procured through legal means for dissection, adherence to ethical norms during dissection, archival of human tissues mandating stringent regulation and dignified disposal of human remains. Existing loop holes were identified and future prospects regarding ethical standards in anatomy were highlighted based on rational judgment of existing trends.

CONCLUSION

The article concludes with defense on future prospects of ethics in anatomy based on documented arguments.

Economic Imperialism in Education Research: A Conceptual Review

In this review, we explore economic imperialism, a concept that captures the phenomenon of a single discipline's power over so many facets of social life and policy-including education. Through a systematic search, we examine how economic imperialism has been conceptualized and applied across fields. We uncovered three key, interconnected elements of economic imperialism that hold relevance for education research. First, economics has colonized other disciplines, narrowing the lens through which policymakers have designed education reforms. Second, an overreliance on economic rationales for human behavior neglects other explanations. Third, a focus on economic outcomes of education has subjugated other important aims of education. We share implications for researchers to use economic theory in ways that are interdisciplinary but not imperialist.

The Law, Ethics and Body Donation: A Tale of Two Bequeathal Programs

Historically, legislature has been utilized to facilitate appropriate use of cadavers in the anatomical sciences. However, cadaver acquisition and use have also been guided by ethically appropriate and morally acceptable principles. Various global and regional frameworks of "ethical practice" guide body donation, including the use of unclaimed bodies by institutions. These frameworks are responsive to, and reciprocal with the various ethical, moral and legal factors that influence the development of body donation programs. This reciprocity supports the notion that anatomists and anatomical societies have a responsibility to advocate for legal reform when required. In this study, two body bequest programs from geopolitically and socially disparate countries are used as cases to contrast existing legal and governance frameworks for body donation and to examine whether anatomists can direct the acquisition of ethically donated cadavers. The study includes an Australian donor program that has exclusively accepted bequests since its inception, and a South African program that has recently transitioned to a bequest system. Elements such as consent by next-of-kin and Inspector of Anatomy, use of unclaimed bodies and ethics committee approval amongst others, are compared. It is acknowledged that legal frameworks for cadaver acquisition generally deliver broad guidance on acceptable utilization of bodies for the anatomical sciences. However, professional discretion is of importance in adapting to societal needs and values. Thus, while anatomists have been able to progress toward more ethical practice than that which is required by the law, they must continue to do so as societal values evolve.

Transplant tourism and organ trafficking

Organ availability for transplantation has become an increasingly complex and difficult question in health economics and ethical practice. Advances in technology have seen prolonged life expectancy, and the global push for organs creates an ever-expanding gap between supply and demand, and a significant cost in bridging that gap. This article will examine the ethical implications for the nursing profession in regard to the procurement of organs from an impoverished seller’s market, also known as ‘Transplant Tourism’. This ethical dilemma concerns itself with resource allocation, informed consent and the concepts of egalitarianism and libertarianism. Transplant Tourism is an unacceptable trespass against human dignity and rights from both a nursing and collective viewpoint. Currently, the Australian Nursing and Midwifery Council, the Royal college of Nursing Australia, The Royal College of Nursing (UK) and the American Nurses Association do not have position statements on transplant tourism, and this diminishes us as a force for change. It diminishes our role as advocates for the most marginalised in our world to have access to care and to choice and excludes us from a very contemporary real debate about the mismatch of organ demand and supply in our own communities. As a profession, we must have a voice in health policy and human rights, and according to our Code of Ethics in Australia and around the world, act to promote and protect the fundamental human right to healthcare and dignity.

Body Worlds’ plastinates, the human/nonhuman interface, and feminism

Body Worlds is a hugely popular exhibition that claims to offer a reverential and educational experience of the ‘real human body’ through the display of plastinated dead human bodies. However, because they are posed, staged, and composed of significant nonhuman artifice, plastinates are ambivalently ‘real’ as human bodies, let alone ‘real’ as humans. Plastinates are as much nonhuman as human, and neither category fully accounts for them. In this article, I discuss the consequences of this for feminist theory. Approaches in feminist theory that reify, either implicitly or explicitly, a human/nonhuman binary framework are challenged by plastinates. I show that locating plastinates within either ontological category, though not fully accounting for them, enables feminist critiques of the exhibition; however, these categories also paradoxically permit forms of violence with which feminists are typically concerned. In this way, I argue that plastinates force feminist thought to the very interface of the human/nonhuman divide. When applied to Body Worlds, these concepts at best form a heuristic ontological hinge whose angle is determined by ethical and political commitments, illustrating the ways in which key ontologies should be seen as political strategies more or less amenable to feminist goals, but not more or less true. I argue that what lies at the crux of this hinge, in the case of plastinates, is death, and suggest that Body Worlds demands that the interface of death with life become a key feminist concern.