In 2008, members of the TEPARG provided first insights into the legal and ethical framework governing body donation in Europe. In 2012, a first update followed. This paper is now the second update on this topic and tries to extend the available information to many mor European contries. For this second update, we have asked authors from all European countries to contribute their national perspectives. By this inquiry, we got many contributions compiled in this paper. When we did not get a personal contribution, one of us (EB) searched the internet for relevant information. Perspectives on the legal and ethical framework governing body donation in Europe. We still see that a clear and rigorous legal framework is still unavailable in several countries. We found national regulations in 18 out of 39 countries; two others have at least federal laws. Several countries accept not only donated bodies but also utilise unclaimed bodies. These findings can guide policymakers in reviewing and updating existing laws and regulations related to body donation and anatomical studies. 

The Legal and Ethical Framework Governing Body Donation in Europe - 2nd update on Current Practice.

In the field of medicine, anatomy is considered one of the most important subjects to be studied in college, even for clinicians. Learning from cadaveric specimens is considered an important part of the medical experience. The current study consisted of a questionnaire given to Year 1 and Year 2 medical students. This study was performed to assess using a questionnaire whether students were capable of continuing studying Anatomy during the COVID-19 period. The study consisted of 102 students in Years 1 and 2 of the Faculty of Medicine of Alexandria University in Egypt. It included Year 1 Students (mean age 18.6 ± 1.1 years old; 21 males and 36 females), and Year 2 Students (mean age 20.4 ± 1.0 years old; 22 males and 23 females). The survey consisted of three sections. The first section consisted of four questions on the demographic data of the participating students. The second section consisted of 10 questions concerning their satisfaction with the tutorials and presented by the Department of Anatomy. Answers to the questionnaire were in the form of a Likert scale (with 1 = strongly disagree to 5 = strongly agree). The students disagreed with the fact that they found difficulty in time management, represented by a mean score of 2.23 ± 1.14. That is to say, the students were capable of managing their time well. Here also, the difference between Year 1 and Year 2 students was significant (p = 0.028), which is an indicator that Year 2 students found more difficulty in time management. Most students agreed (mean score of 3.48 ± 1.07) that they were able to handle online learning and the transition between the systems was acceptable. Students were also convinced and agreed that the methods used by the college limited the spread of COVID-19 (mean score of 3.81 ± 1.04). Allowing assignments and projects increased the interaction between the students and the staff members. Education must continue during the COVID-19 period, based on their responses and opinions in the questionnaire. Online learning proved to be effective in teaching medical students during the COVID-19 pandemic. 

https://doi.org/10.1016/j.aanat.2022.151973

Evaluation of the effectiveness of online education in anatomy for medical students during the COVID-19 pandemic

Cadaver dissection has always played a fundamental role in medical education. However, especially in Italy, the topic of body donation has remained partially unknown for years. The current study analyses graphic medicine as a new possible communication tool, evaluating and reflecting, with second‐year students enrolled in the International School of Medicine and Surgery at the University of Bologna, about its potentialities for body donation awareness‐raising in both the scientific community and the general population. For the first time in an Italian University, two graphic medicine workshops were organized focusing on human anatomy and body donation. Seminars were positively evaluated by students using a four items Likert‐scale question: mean 3.54 (± SD 0.73) for the Likert question about the experiences of the workshops; 3.88 (± 0.33) for the Likert question regarding the use of graphic medicine in body donation awareness campaigns among the general population; 3.59 (± 0.65) for the Likert question regarding the use of graphic medicine in body donation awareness campaigns among the scientific community. Furthermore, the open‐ended questions included in the anonymous questionnaire were analyzed using the constructivist grounded qualitative analysis, whence various themes emerged. Finally, five graphic medicine projects about body donation were created by students, proving their interest in testing this method to promote body donation, focusing the attention on different communicative aspects. Considering the results of this pilot study, the co‐creative collaborative use of graphic medicine could be evaluated as an additional strategy to increase body donation awareness‐raising in Italy and beyond, especially in the non‐experts' community.

Graphic medicine meets human anatomy: The potential role of comics in raising whole body donation awareness in Italy and beyond. A pilot study

Recent Italian legislation (Law No. 10/2020) establishes the legal, ethical and technical requirements governing how individuals can donate their bodies or tissues post‐mortem for study, training, and scientific research purposes. A ministerial working group has recently approved some of the law's implementing rules relating to technical issues. The rules for implementing the new legislation, retrieved from the legal databases and translated into English, are discussed. For the first time in Italy, the law establishes compulsory requirements and minimum characteristics—in terms of logistics, safety, availability of staff, space, and equipment—for institutions to be recognized as reference centers for the conservation and use of bodies and tissues donated post‐mortem for study, training and scientific research purposes. This makes it possible to standardize the features of such reference centers nationwide, and to coordinate their activities and potential future development, while ensuring basic operational efficiency and workplace safety, the provision of adequate facilities, buildings and equipment, and staff training. The law and its implementing rules discussed here are the first to establish criteria and compulsory requirements for centers receiving body and tissue donations in Italy. This is a step forward for the whole anatomy community, providing practical guidelines for body donation programs and related facilities in other countries too.

Reference centers for tissue and body donations: Compulsory requirements in Italy

Cadaver surgical training (CST), which ensures medical safety by improving the skills of surgeons, is popular overseas. However, training involves ethical issues given the use of cadavers. In 2012, the Japan Surgical Society and the Japanese Association of Anatomists compiled and opened the "Guidelines for Cadaver Dissection in Education and Research of Clinical Medicine (Guideline 2012)" to the public. This has allowed Japan to conduct CST or research under the regulations of Postmortem Examination and Corpse Preservation Act and the Body Donation Act. However, its dissemination has been sluggish. The Clinical Anatomy Lab (CAL), established in 2010 at Chiba University, is a facility for conducting CST and research. In the 11 years since its inception, 250 programs have been implemented. Orthopedics had the most implemented in the clinical field, with 120 (48%), followed by emergency and critical care medicine with 27 (10.8%), and neurological surgery with 27 (10. 8%). Based on the purpose of the training, the most common objective for the programs (approximately 83%) was education. Further, the highest number of programs was recorded in 2018 (34) and participants in 2017 (631). The implementation of CST requires more than just guiding surgeons to a dissection practice room. There are several methods of preserving cadavers to make them suitable for CST. For various surgical simulations, an operating table is more suitable than a dissection table. The current paper provides information on how to implement CST in universities that have so far only worked on anatomy education for medical students. 

/pdf/updates-on-cadaver-surgical-training-in-japan-a-systematic-3f5zyoyf.pdf

Updates on cadaver surgical training in Japan: a systematic facility at Chiba University

In Italy, recent legislation (Law No. 10/2020) has tuned regulations concerning the donation of one's postmortem body and tissues for study, training, and scientific research purposes. This study discusses several specific issues to optimise the applicability and effectiveness of such an important, novel regulatory setting. Some of these unsolved issues may involve the grantees of teaching and training activities, the role of academic anatomical institutes, the role of family members in the donation process, the universal time limit indicated for any donation, the handling of corpses, and the limited body donation and its subordination to the donation of organs and tissues. Critical issues arise concerning the learners, the type of training and teaching activities that can be planned, the position of academic anatomy institutes, the role of family members in the donation process, the time frame of the donation process, the eligibility of partial donation, or the simultaneous donation of organs and tissues to patients awaiting transplantation. In particular, a universal time limit for donations (i.e., one year) makes it impossible to plan the long-term use of specific body parts, which could be effectively preserved for the advanced teaching and training of medical students and surgeons. The abovementioned conditions lead to the limited use of corpses, thus resulting in the inefficiency of the whole system of body donation. Overall, the donors' scope for the donation of their body could be best honoured by a more flexible and tuneable approach that can be used on a case-by-case basis. Furthermore, it is deemed necessary to closely monitor the events scheduled for corpses in public nonacademic institutions or private enterprises. This paper presents useful insights from Italian anatomists with the hope of providing inspiration for drafting the regulations. In conclusion, this paper focuses on the critical issues derived from the recently introduced Italian law on the donation and use of the body after death and provides suggestions to lawmakers for future implementations.

/pdf/the-italian-law-on-body-donation-a-position-paper-of-the-4pplx4mnbn.pdf

The Italian law on body donation: A position paper of the Italian College of Anatomists

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The Italian law on body donation: A position paper of the Italian College of Anatomists