Transformation of a cadaver population: Analysis of a South African cadaver program, 1921–2013

Abstract

Anatomy has served as a cornerstone in the training of various allied and clinical disciplines and has traditionally been based on dissection of the human body. Thus, to pursue this method of teaching and learning, access to cadavers is of continuing importance. Over a significant period of time unclaimed cadavers have performed an essential role in the teaching of anatomy in South Africa and in Africa. As recent cadaver numbers were declining at the School of Anatomical Sciences, University of the Witwatersrand, Johannesburg and difficulty in procurement was being experienced, the purpose of this study was to critically evaluate the composition of our cadaver population over time so as to provide possible strategies to arrest the decline. A retrospective, quantitative analysis of cadaver records from the School of Anatomical Sciences between 1921 and 2013 was undertaken. Analysis included a comparison of Poisson counts and Fischer's exact test. A significant decrease in the number of cadavers received during the period 2000-2013 and a slow bequest program over the same period of time has led to concerns about the sustainability of teaching anatomy through dissection. Decreases in the numbers of males and cadavers of the black population group occurred between 1990 and 2013, and of bequests from 2000 to 2013. An influence on the cadaver population from a changing political climate and change in socioeconomic status of part of the population was perceived. Changes in sex and population group of the cadavers may have a long-term effect on teaching and research.

Making the Ethical Transition in South Africa: Acquiring Human Bodies for Training in Anatomy

“…The majority of cadavers obtained in the School of Anatomical Sciences, University of the Witwatersrand over the period 2013–2017 were derived from bequeathed and donated sources. This is a major change from the predominant use of unclaimed bodies that prevailed previously in this School (Kramer and Hutchinson, ). In addition, over the period 2013–2017, the cohort also changed with respect to sex and population affinity.…”

“…In addition, over the period 2013–2017, the cohort also changed with respect to sex and population affinity. The population of cadavers was also found to be older, in that the mean age of the individuals was approximately 76 years compared to the 1950s when the mean age was 70 for males and 64 for females (Kramer and Hutchinson, ). These changes are not only of importance from an ethical perspective but also have implications for collections housed within the School.…”

“…While transformation to a situation where all the cadavers are from bequests or donors is ongoing, the observed demographic profile (sex and population affinity) of the cadavers in the School of Anatomical Sciences, University of the Witwatersrand has changed over the period of the current study. More female cadavers are available than male cadavers in the current (2013–2017) cadaver population than that described over the period 1921–2013 (males 69.7%; females 30.3%) (Kramer and Hutchinson, ). Similarly at another local institution between the years 1956‐1996, only 32% of the donors were female (Labuschagne and Mathey, ).…”

BODIES R US: Ethical Views on the Commercialization of the Dead in Medical Education and Research

“…The International Federation of Associations of Anatomists (IFAA) states that willed body donation is the “standard of ethical practice ” in anatomical education, and has encouraged countries to implement these ethically based programs (McHanwell et al, ; Jones and Whitaker, ; FICEM, ; Habicht et al, ). Nevertheless, numerous countries still rely on the use of unclaimed bodies for anatomical education, since there are not sufficient numbers of donors in their donation programs (Stimec et al, ; Kramer and Hutchinson, ; Riederer, ; Habicht et al, ).…”

Attitudes of Undergraduate South African Students towards Body Donation

“…In South Africa, bodies for both anatomical education and research are acquired through unclaimed bodies Kramer & Hutchinson (2015) and whole body donations (Riederer, 2016). Present and future health professionals and educators are stated to be generally expected to play a significant role in developing and maintaining body donation programmes (Alexander et al).…”