This article first appeared in Issue 2 of our free digital magazine CURIOUS.
There’s a lot of loss surrounding death, but there is something to be gained when people donate their bodies to science. However, what actually happens to donor bodies? Where do they go?
To demystify the process of body donation, we spoke to head of anatomy for Brighton & Sussex Medical School in the UK, Professor Claire Smith. Having overseen the creation of the most advanced 3D model for female anatomy, and with a wealth of experience working with human cadavers, Smith is very familiar with the donation process which, as she explains, is still teaching us new things about the human body to this day.
I’ve died and donated my body to medical science, what happens now?
Claire Smith: Well, firstly, I'm really sorry that you've died. Hopefully, you've told someone in your family that this is your wish, and you've already signed a consent form to say that you want to donate your body. You have to do that when you're alive in the UK and Ireland where it's a first-person consent system, but that's not the case throughout the world. Once you’ve died, your next of kin or member of your family needs to contact your local medical school. In the UK, that's undertaken by a postcode system run by the human tissue authority.
Based on what you died from, and your medical history, the relevant authority will make a judgment on whether that body is suitable for donation. There are some diseases that we can't take because either the body doesn't embalm very well, or it poses a risk to the health and safety of those that would work on it. If the body is accepted then, they will arrange for the funeral services to transport it, usually within five days.
Do donated bodies stay whole or are they sometimes used in parts?
CS: It’s really a question of supply and demand, and it also depends on the level of consent. So, an individual can choose whether we have consent to take images, whether we have consent to retain parts. Or, the medical history might make that body more suitable for either surgical training or undergraduate medical school training. All of those factors are assessed by someone like myself, and depending on what they’re going to be used for they will either be embalmed or frozen.
Why do we need human donors?
CS: At this moment in time, we don't have anything that replicates a lot of what we anatomists do. There are amazing 3D virtual reality models out there which we do use in teaching and training. But there isn't anything that replicates the complexity of the 3D form as well as an actual human body. Also, despite having textbooks, we're all unique, and actually our doctors, dentists, and surgeons need to learn from that variation, and you can only get that from exploring human donors.
How are donated bodies used in surgical training?
CS: Donated bodies enable surgeons to practice procedures that can't be replicated on simulation models or on animal tissue. It's the really high-level and complex things, not just learning to stitch an artery or something like that.
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Surgeons also work with donors to develop new surgeries. So, they might come to us and say, “I've got a really complex case, this is what I want to do. Do you have a donor that might be suitable that I could try this procedure on?” Because it's never been done before.
How are donor bodies involved in medical students’ education?
CS: Some donor bodies are dissected by students, so they're getting really close knife-to-skin experience which enables them to explore different parts of the body. That might be medical students, healthcare students, nurses, physiotherapists, or our teams might work to create something called “prosections” where an experienced anatomist does a beautiful dissection so students can examine the spatial relationships of structures within the body.
What about research?
CS: For research, students, staff, or surgeons, might come to me and say, “Claire, every time I do this knee operation, I'm always finding this little blood vessel here. It's not in Gray’s [Anatomy, (1858), 42nd Edition, Elsevier], despite all the extensive work. Do you have 50 knees available which I could work on, dissect, and try to understand where these ligaments or arteries are going from and to?” Those sorts of investigations can lead to new knowledge ending up in textbooks.
Do unexpected things turn up in dissections?
CS: Individuals die from a whole range of things, but for many, it’s linked to the brain, heart, or lungs giving up. However, when we dissect donors, we sometimes find things they never knew they had. We can uncover natural variations, such as an artery or vein where it shouldn't be, or organs where they shouldn't be. Other times, we can find a tumour or something that never made it onto their medical records.
Why do people donate?
CS: When we asked donors (for a study) why they are interested in donating, the majority of individuals said it was an altruistic thing to give back to healthcare workers and the wider public. Recently, and for the first time, we’ve also seen a percentage of individuals who have said it was for financial reasons as for donated bodies, medical schools do cover all associated funeral costs.
If people want to donate their bodies to science, what’s the best thing to do?
CS: The top thing is to please discuss it with friends or family because there's no automatic system so the process will require someone to make a phone call to a medical school. If you're in the UK, go to the human tissue authority website and you can find a postcode finder system. If you're outside of the UK, search for your local medical school online and contact them. If they don't have a body retrieval system, they will know the nearest one that there is.