Ethical issues surrounding the use of images from donated cadavers in the anatomical sciences

Abstract

Body donor programs rely on the generosity and trust of the public to facilitate the provision of cadaver resources for anatomical education and research. The uptake and adoption of emerging technologies, including those allowing the acquisition and distribution of images, are becoming more widespread, including within anatomical science education. Images of cadavers are useful for research and education, and their supply and distribution have commercial potential for textbooks and online education. It is unclear whether the utilization of images of donated cadavers are congruent with donor expectations, societal norms and boundaries of established public understanding. Presently, no global "best practices" or standards exist, nor is there a common model requiring specific image-related consent from body donors. As ongoing success of body donation programs relies upon the ethical and institutional governance of body utilization to maintain trust and a positive relationship with potential donors and the community, discussions considering the potential impact of image misuse are important. This paper discusses the subject of images of donated cadavers, commenting on images in non-specific use, education, research, and commercial applications. It explores the role and significance of such images in the context of anatomical science and society, and discusses how misuse - including unconsented use - of images has the potential to affect donor program success, suggesting that informed consent is currently necessary for all images arising from donated cadavers. Its purpose is to encourage discussion to guide responsible utilization of cadaver images, while protecting the interests of body donors and the public.

Consent in body donation

“…A donor could register at 18 years of age and die aged 108 and body parts from that donor could then be stored, displayed, and used for 100 years or more after their death, i.e., approximately two centuries after that person gave consent. Even if they were told about all the things that could possibly follow donation that were known about at the time of registration, societal and technological developments will inevitably have occurred in the period following this that enable things to be done with and to their donated bodies that they simply could not have been fully informed about with any specificity at the time that their consent was obtained (Jones, 2007;Cornwall, 2016;Cornwall et al, 2016;Márquez-Grant & Errickson, 2017;Champney et al, 2018;Gilbert et al, 2018).…”

Maintaining the anonymity of cadavers in medical education: Historic relic or educational and ethical necessity?

“…The special issue of Clinical Anatomy published in January 2016 covered a wide range of ethical issues in contemporary anatomy. Included within these are overviews of best practice in body donation (Riederer, ), the place of consent and consensus in obtaining bodies (Winkelmann, ), and essential elements of ethical anatomical education (Hildebrandt, ), Other issues examined are the use of animal tissues alongside human tissue (Kaw et al, ), for‐profit body donation companies (Champney, ), the use of images from donated cadavers (Cornwall et al, ), and the public display of cadavers (Jones, ). None of these touched on anonymity; although as outlined above, there is reference to it in the article on good practice recommendations on body donation (Jones, ).…”

Body donation and digital technology: the ethical issues

“…Digital images from donated bodies can also be distributed and shared widely with little effort, [3] or stored for long (potentially infinite) periods of time. Outside of medical imaging, most photographs are now digital, and 3D printing is also based on digitally acquired information via computer scans.…”

“…Researchers can also use imaging in conjunction with dissection to explore different aspects of gross anatomy. Students can correlate digital information with physical findings and may have a patient history to guide anatomical examination, and researchers can have access to a an information source that can be easily stored and accessed.Digital images from donated bodies can also be distributed and shared widely with little effort, [3] or stored for long (potentially infinite) periods of time. Outside of medical imaging, most photographs are now digital, and 3D printing is also based on digitally acquired information via computer scans.…”