As the old aphorism has it, only two things are certain in life: death, and taxes. But while death may be inevitable, it does throw up a number of uncertainties - like what should be done with your body. A number of university anatomy schools globally run body donation programmes, and the practice is becoming more common on the African continent.
The University of the Witwatersrand's School of Anatomical Sciences in Johannesburg, South Africa is celebrating its centennial year. PhD student Kimberleigh Tommy sat down with lecturer Dr Brendon Billings to find out why people should consider leaving their body to science and the huge shifts in how body donation works.
Why should I consider donating my body to an anatomy school? And what will be done with it?
The study of anatomy has been the foundation for training medical and allied health sciences students for hundreds of years. Dentists, physiotherapists, occupational therapists, doctors, pharmacists, nurses and medical scientists all need to understand the structure of the human body so they have the necessary skills to do their jobs properly.
Dissection also plays an important role in introducing students to death. It provides moral and ethical training for students as well as a humanistic approach to patient care. Overall, cadaver-based teaching prepares students intellectually and emotionally to deal with the challenges they face in their future careers.
Donated bodies are strictly used for teaching and research. They first undergo a process called perfusion. Perfusion and embalming is the process of removing blood from the body and replacing the blood with a fixative (chemical cocktail) to preserve the remains and make them safe for students to dissect.
What will the students be told about me? Will they know my name?
There are ethical and legal implications involved in identifying donors, so a student or researcher will never be told your name.
When it comes to research, if more personal details are needed - like your demographics or your occupation - then the researcher signs a non-disclosure agreement which strictly prohibits the use of any personal details in the publication of the research manuscript, dissertation or thesis.
You mentioned ethics. Which guidelines are followed at the University of Witwatersand's School of Anatomical Sciences in terms of legal and ethical use of human remains for teaching and research?
At our school, the use of human cadavers for training health professional students falls under the National Health Act of the Republic of South Africa and follows the ethical guidelines of the International Federation of Associations of Anatomy.
When do I sign up and can someone donate on my behalf?
At Wits, you can register to donate your remains at any point during your lifetime or your family may donate your remains as a next of kin donor. While self-donation is preferred, quite a few of the bodies are donated by families after death. The reasons associated with a next-of-kin donation include following the wishes of the family member to financial constraints (the school does not pay for donations, but does cover the costs of cremation once research and teaching is complete).
Do I need to document my donation in a will?
Adding a codicil to a will is encouraged. However, it is not required if you complete the specific school's body donor registration form, which acts as a will or codicil indicating your wishes.
Does my family receive money for the donation?
All donations are an altruistic gift. Our school cannot pay the donor or the family any money for the donation.
Can my family still have a funeral for me if I am donating my body?
Yes. In certain instances, families have requested the embalmed remains for a memorial ceremony. After that the embalmed body is then returned to the school for teaching and research.
And once that teaching and research is done, will my remains be given back to my family? If so, when?
Return of remains to a family is optional. The donor may request for their remains to be returned to the family after dissection of the body has been completed and the remains cremated - the school pays for the cremation. Alternatively, donors could opt to donate their bodies to the school for an indefinite period of time.
Can I donate if I am an organ donor?
Yes, you can be both an organ donor and a body donor - but there are some provisos to take note of. If your organs turn out not to be suitable for donation, then we will accept the body donation. We need a full body for our particular programme; if certain organs have been removed leaving an open wound the perfusion process that's necessary to embalm corpses is compromised.
Do I need to get medical clearance or disclose any diseases like HIV?
Our school has a list of communicable diseases that will exclude an individual from donating their remains. These exclusions are provided on the body donor information sheets. You are not required to disclose your HIV status if you plan to donate your body to our school's body donor programme.
Does my cause of death matter?
Yes, it does. Motor vehicle accidents, homicides and suicides or any other case that requires an autopsy will be addressed by the state mortuary services and not the school. In such instances the donated body cannot be accepted by the school.
Who processes my death certificate with South Africa's Department of Home Affairs?
We do, as the school.
So if I decide that your school's programme is the one I'd like to donate my body to, do I have to live in Johannesburg?
The majority of donations are within 300km from Wits University, but individuals living in the broader Gauteng province may donate to the school. Exceptions can be made, if the family is willing to transport the body to an area within the distance indicated. It's worth checking geographical exclusions and requirements for other schools if you're looking to donate to another programme.
Authors: Brendon Kurt Billings - Lecturer/Curator, University of the Witwatersrand | Kimberleigh Ashley Tommy - PhD Candidate (Biological Anthropology), University of the Witwatersrand