With the ongoing and expanding use of willed bodies in medical education and research, there has been a concomitant rise in the need for willed bodies and an increase in the means of supplying these bodies. A relatively recent development to enlarge this supply has been the growth of for‐ profit willed body companies (“body brokers”) in the United States. These companies advertise for donors, cover all cremation and other fees for the donor, distribute the bodies or body parts nationally and internationally, and charge their users for access to the body or body parts. In doing so, they generate substantial profits. This review examines the historical development of willed body programs, the legal and economic aspects of willed body programs, and then provides an ethical framework for the use of willed bodies. The ethical principles described include detailed informed consent from the donors, comprehensive and transparent information about the process from the body donation organizations, and societal input on the proper and legal handling of willed bodies. Based on the ethical principles outlined, it is recommended that there be no commercialization or commodification of willed bodies, and that programs that use willed bodies should not generate profit.

University of Michigan Medical School (UMMS) students attending a seminar on the history and ethics of anatomical dissection were fascinated by a report on the dissection room experience in Thailand that relates the body donor's status as a teacher. The students felt that they had naturally adopted the "body as teacher" approach in their dissection course, rather than the "body as first patient" approach that is encouraged by faculty. It was decided to explore the question whether other medical students shared these perceptions. A questionnaire was sent out to all UMMS students who had finished the anatomical dissection course. One hundred twenty-eight responses from a population of 500 students were received. Results indicate that students believe the "body as teacher" approach is more effective in engendering respect and empathy towards the body and towards future patients, and in facilitating students' emotional development. Students also reported wanting a more personal relationship with their donors. Eighty four percent of students preferred the "body as teacher" approach to the currently taught "body as first patient" approach. The results support the hypothesis that students' desired closer personal relationship with donors might be better facilitated by the "body as teacher" approach, and that this closer relationship engenders empathy and respect towards the donor and future patients. A new model for anatomy programs could introduce the donor first as a teacher and later transition into viewing the donor as a patient.

Anatomical science has used the bodies of the executed for dissection over many centuries. As anatomy has developed into a vehicle of not only scientific but also moral and ethical education, it is important to consider the source of human bodies for dissection and the manner of their acquisition. From the thirteenth to the early seventeenth century, the bodies of the executed were the only legal source of bodies for dissection. Starting in the late seventeenth century, the bodies of unclaimed persons were also made legally available. With the developing movement to abolish the death penalty in many countries around the world and with the renunciation of the use of the bodies of the executed by the British legal system in the nineteenth century, two different practices have developed in that there are Anatomy Departments who use the bodies of the executed for dissection or research and those who do not. The history of the use of bodies of the executed in German Anatomy Departments during the National Socialist regime is an example for the insidious slide from an ethical use of human bodies in dissection to an unethical one. There are cases of contemporary use of unclaimed or donated bodies of the executed, but they are rarely well documented. The intention of this review is to initiate an ethical discourse about the use of the bodies of the executed in contemporary anatomy.

Seventy‐seven patients with Raynaud's disease were studied for a mean of 4 years (range 1–11 years) to determine the relationship between autoantibodies and long‐term clinical outcome. Anticentromere antibodies (ACA) were assayed by indirect immunofluorescence and by immunoblotting of HeLa cell chromosome extracts. Antibodies to topoisomerase I (anti–topo I) were assayed by immunodiffusion and immunoblotting. Antibodies to the major centromeric protein, CENP‐B, and anti–topo I were studied by enzyme‐linked immunosorbent assay (ELISA). Eight patients developed telangiectasias, 4 developed skin tightening, and 4 developed a connective tissue disease other than scleroderma. The presence of ACA at the start of the study was associated with the development of telangiectasias (P < 0.003). An initial 100‐kd band on immunoblot in conjunction with a positive anti–topo I ELISA result was associated with the development of tight skin (P < 0.0025), while a 100‐kd band with a negative anti–topo I ELISA result was associated with the subsequent development of a connective tissue disease other than scleroderma (P < 0.0073). Patients who were initially ACA positive, had the 100‐kd band on immunoblot, or had positive ELISA results for anti–topo I or for anti‐CENP‐B were 63‐fold more likely to develop signs of connective tissue disease by the end of the study (P < 0.000009). The presence of any of these autoantibodies was more sensitive (100%), although less specific (75%), than were findings from nailfold capillaroscopy (sensitivity 67% and specificity 95%) in predicting subsequent clinical progression. We conclude that findings of assays for anti–topo I and ACA complement the findings from nailfold capillaroscopy in providing useful prognostic information in Raynaud's disease.

Eduard Pernkopf's Topographical Anatomy of Man has been a widely used standard work of anatomy for over sixty years. International inquiries about the National Socialist (NS) political background of Eduard Pernkopf and the use of bodies of NS victims for the atlas were first directed at the University of Vienna in 1996. A public discussion about the further use of the book followed and led to the creation of the Senatorial Project of the University of Vienna in 1997. This historical research project confirmed the strong NS affiliation of Pernkopf and revealed the delivery of at least 1,377 bodies of executed persons to the Anatomical Institute of Vienna during the NS time. The possible use of these bodies as models cannot be excluded for up to half of the approximately 800 plates in the atlas. In addition tissue specimens from NS victims were found and removed from the collections of the Viennese Medical School and received a burial in a grave of honor. The Pernkopf controversy facilitated the historical and ethical analysis of the anatomical sciences in Austria and Germany during the NS regime. The continued use of the Pernkopf atlas is not only justifiable but desirable as a tool in the teaching of anatomy, history, and ethics.

While questions of ethics in body procurement have become a focus of attention in many medical schools around the world, the recent report by a medical student regarding disturbing incidences in an anatomical dissection course (Terry, ) underlines the importance of a discussion of ethical practices in anatomical education. Here thoughts on core elements of instruction are proposed which are based on the premise that both, ethical body procurement and ethical anatomical education, are the foundation for a humanism-based professional training of students in medicine. As the anatomical dissection course presents an exceptional situation for students, practical guidelines for a curriculum founded on ethical considerations are essential. They include a preparatory phase before the start of the course in which students are asked about their expectations and fears concerning anatomical dissection; an introduction to the history and ethics of anatomy; a time for reflection in the dissection room before the start of dissection; a regular opportunity for reflections on dissection in parallel to the course with students and faculty; and a memorial service for the donors organized by students for faculty, students and donor families. Finally, anatomical faculty should undergo training in ethical educational practices. Many anatomy programs have incorporated various of these ideas, while others have not done so. Guidelines for ethical anatomical practices can strengthen the foundation of a humanistic approach to medicine in future physicians and health care workers.

While time spent on anatomical education in medical school curricula has been diminishing over the last decades, the recognized role of anatomical dissection has expanded. It is perceived by many students and faculty not only as the means of learning the structure and function of the human body, but also as an opportunity for the acquisition of professional competencies such as team work, patient–doctor interaction, medical epistemology, self‐awareness, and an understanding of medical ethics. This viewpoint article proposes that this learning process can be supported effectively through studying examples from the history of anatomy, as insights from this history can help illuminate contemporary ethical issues in anatomy and medicine. Anatomical education can thus provide not only the opportunity of gaining awareness of ethical questions, but also a chance to practice these new insights within the protected environment of the laboratories, in interaction with the dead and the living. Consequently, a new role has developed for anatomists, which includes the interweaving of the scholarly exploration of the history and ethics of anatomy with the practical application of research results into a reframed concept of anatomical education. Anatomy, as a foundational discipline in the medical curriculum, can thus provide a first step on the educational path of empathetic and humane medical caregivers.

Although it is known that anatomists working in Germany during the Third Reich have used bodies of victims of the National Socialist (NS) regime for dissection and research, a comprehensive history of the anatomy in the Third Reich has not yet been written. Recent studies of the history of German anatomy departments during this time period provide material for a first outline of the subject matter. A historical review can help with the formulation of ethical foundations in modern anatomy. From the outset, the NS regime sought to reorganize German universities according to NS leadership principles and political goals. Many German academics, especially physicians and among them anatomists, followed these intentions with a voluntary "self-alignment" that encompassed their professional actions as well as their ethics. Currently, political information is available for 111 of 178 anatomists. Thirty-eight of the anatomists were dismissed for racial or political reasons, among them 10 chairmen of anatomy, whereas 35 of the anatomists were politically active members of one of the NS organizations. Over 70% of the chairmen of anatomical departments in the time period from 1941 to 1944 were members of NS organizations. Anatomists, as so many other physicians and academics, belonged both, to the group of victims of the regime, i.e., those being dismissed from their positions for racial and political reasons, and to the group of supporters and sometimes active perpetrators of NS policies.