Changing medical education scenario: a wakeup call for reforms in Anatomy Act

Abstract

Background: Anatomy Act provides legal ambit to medical educationists for the acquisition of cadavers. The changing medical education scenario, socio-demographic change, and ethical concerns have necessitated an urgent review of its legal and ethical framework. Suitable amendments addressing the current disparities and deficiencies are long overdue. Methods: Anatomy Act in India is a state Act, which ensures the provision of human bodies for medical education and research. The methodology included three components namely: Comparison of various Anatomy Acts clause by clause, Feedback from anatomists, and Formulation of comprehensive model Anatomy Act. Results: Various Acts studied showed discrepancies in the purpose of the Act, roles and duties of stakeholders, regulation for body donation, the procedure to handle unclaimed bodies, disposal of dissected bodies, etc. No Act defines a donor and neither addresses the issue of transport of anatomical material. Only ten states have a clause for body donation. Acts of only six states have been amended over the last 50 years. Three states denied having an Act. The whole exercise of review of Acts, extensive feedback received from end-users, and taking into account global good practices, culminated in drafting a comprehensive model Anatomy Act founded on ethical principles. Conclusion: India, with the largest number of medical colleges, is not only at the forefront but also a hub of medical education in the Southeast Asia region. Legal reform can be a torchbearer to promote ethical and transparent practices for obtaining cadavers for other countries of the region with similar socio-demography and shall also motivate anatomic fraternity across the globe for critical analysis of their respective Anatomy Acts.

Ethics of the use of dead human bodies in anatomy teaching in India

“…In India, the Anatomy Acts are state Acts. There are discrepancies between different state Acts, which make national guidelines necessary to ensure uniformity across states [15]. A law governing the transport and transfer of cadavers and body parts is missing from all these Acts [15].…”

“…There are discrepancies between different state Acts, which make national guidelines necessary to ensure uniformity across states [15]. A law governing the transport and transfer of cadavers and body parts is missing from all these Acts [15]. Medical colleges without an existing body donation programme are dependent on the transfer of cadavers from institutes with such programmes or from government institutes that receive unclaimed bodies.…”

“…As per the law, the use of unclaimed bodies for dissection is acceptable in India. In the states of Maharashtra, Goa, Himachal Pradesh, Punjab, Sikkim, Madhya Pradesh, and Assam, there is no provision in the state Acts for an approved medical institution to refuse an unclaimed or donated body [15]. Further, if an institute already has unclaimed bodies far in excess of its need, there is no incentive for it to promote body donation.…”

Anatomy acts concerning body and organ donations across the globe: past, present and future with a special emphasis on the indian scenario

“…Also there are no inclusions of rigor or livor mortis changes within the time frame of a deceased body's procurement. The mode of proper consent by a near relative for donation of a deceased www.acbjournal.org Maximum time period within which a body has to be procured [10,15] Accountabilty of the type of person who can claim a deceased body [15,17] Accountabilty for voluntary donation of cadavers [15,17] Accountability for therapeutic use of cadavers apart from anatomical research [14,17] Funeral embalming provisions [14,17] 1 body is also not properly specified [10,12,15,16].…”

Assessment of Ethical Compliance of Handling and Usage of the Human Body in Anatomical Facilities of Ethiopian Medical Schools

“…For several years, using a human cadaver in medical education and research was classified as a crime; the act of violation of a (human) cadaver. 25 There are grounds for legal and ethical justification; namely the consent of the deceased during his/her lifetime. To overcome such violation of human body usage, legal rules governing the handling of cadavers and/or their disposal were consulted and approved.…”