Anat Cell Biol.  2021 Dec;54(4):489-500. 10.5115/acb.21.096.

The creation of a body donation program at Federal University of Juiz de Fora in Brazil: academic importance, challenges and donor profile

• Fernandes de Oliveira AG
• Gonçalves AF
• Soares JN
• Neto Salgado LH
• Santana BS
• Passos MV
• Oliveira Reis JLd
• Arantes GC
• Sarmento Campos LF
• Carvalho MS
• Furtado da Gama LC
• Rezende AB

• KMID: 2523579
• DOI: http://doi.org/10.5115/acb.21.096

Abstract

Dissection and human specimens study remain the gold standard method for teaching anatomy. Due to the increasing health science courses in Brazil, the traditional way of obtaining bodies for scientific purposes, the unclaimed ones, became insufficient. In addition, this source is no longer ethically appropriate according to anatomists. In order to maintain the teaching quality, the Federal University of Juiz de Fora (UFJF) in Brazil, inspired by successful initiatives around the world, created a body donation program; Sempre Vivo. Besides the bureaucratic difficulty faced during its regulation, the implementation of a body donation program requires special attention regarding the religiosity, culture and uniqueness of the city's inhabitants. Informing people can demystify the process, avoid prejudice and increase the number of donors. In this way, an outreach project was designed to publicize Sempre Vivo and raise public awareness. In the first six years, Sempre Vivo reached the mark of 64 registered donors and seven bodies received. The donor’s profile corresponds to female (70.3%), 57 years of age, retired (50.8%), spiritist (53.1%) and with 12 years or more of formal education (90.6%). Considering that the UFJF has not received unclaimed bodies for ten years, the program was considered satisfactory up to this level and, in the future, it may be the exclusive source of anatomical specimens. The description of the creation and the publicizing of Sempre Vivo, the overcome challenges, as well as the donors’ profile, may encourage and facilitate the foundation of similar programs in Brazil and abroad.

Keyword

Body donation; Donors; Anatomy; Health education

Figure

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  Fig. 1 Sempre Vivo information leaflet. (A) Cover: logo capturing the concept of donation associated with a publicity slogan: “Give life to knowledge, donate your body to study” and how to get in touch with the Department of Anatomy. (B) Inside: information about body donation.

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  Fig. 2 Flowchart of Sempre Vivo since the donor’s access to the program going through the registration procedures until receiving the body.

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  Fig. 3 Sempre Vivo donors profile, regarding (A) how the donor came to know the program; (B) educational level; (C) religious beliefs and faith.

Reference

References

1. Ahmed K, Rowland S, Patel V, Khan RS, Ashrafian H, Davies DC, Darzi A, Athanasiou T, Paraskeva PA. 2010; Is the structure of anatomy curriculum adequate for safe medical practice? Surgeon. 8:318–24. DOI: 10.1016/j.surge.2010.06.005. PMID: 20950770.

2. Riederer BM. 2016; Body donations today and tomorrow: what is best practice and why? Clin Anat. 29:11–8. DOI: 10.1002/ca.22641. PMID: 26475613.

3. Farrokhi A, Soleymaninejad M, Ghorbanlou M, Fallah R, Nejatbakhsh R. 2017; Applied anatomy, today's requirement for clinical medicine courses. Anat Cell Biol. 50:175–9. DOI: 10.5115/acb.2017.50.3.175. PMID: 29043095. PMCID: PMC5639171.

4. Bisht B, Hope A, Paul MK. 2019; From papyrus leaves to bioprinting and virtual reality: history and innovation in anatomy. Anat Cell Biol. 52:226–35. DOI: 10.5115/acb.18.213. PMID: 31598350. PMCID: PMC6773896.

5. Elizondo-Omaña RE, López SG. 2008; The development of clinical reasoning skills: a major objective of the anatomy course. Anat Sci Educ. 1:267–8. DOI: 10.1002/ase.57. PMID: 19109857.

6. Böckers A, Jerg-Bretzke L, Lamp C, Brinkmann A, Traue HC, Böckers TM. 2010; The gross anatomy course: an analysis of its importance. Anat Sci Educ. 3:3–11. DOI: 10.1002/ase.132. PMID: 20058224.

7. Kim DH, Shin DH, Hwang YI. 2019; Effects of alternate dissection on anatomy learning. Anat Cell Biol. 52:69–75. DOI: 10.5115/acb.2019.52.1.69. PMID: 30984454. PMCID: PMC6449586.

8. Maghin F, Conti A. 2020; Body donation in Italy: an important breakthrough with the new law. Anat Sci Educ. 13:800–3. DOI: 10.1002/ase.2001. PMID: 32640114.

9. Dissabandara LO, Nirthanan SN, Khoo TK, Tedman R. 2015; Role of cadaveric dissections in modern medical curricula: a study on student perceptions. Anat Cell Biol. 48:205–12. DOI: 10.5115/acb.2015.48.3.205. PMID: 26417481. PMCID: PMC4582164.

10. Greene SJ, Rosen L. 2021; Tracking medical student emotionality in relation to whole body dissection and donation. Clin Anat. 34:128–42. DOI: 10.1002/ca.23676. PMID: 32889750.

11. Ghosh SK. 2015; Human cadaveric dissection: a historical account from ancient Greece to the modern era. Anat Cell Biol. 48:153–69. DOI: 10.5115/acb.2015.48.3.153. PMID: 26417475. PMCID: PMC4582158.

12. Olejaz M, Hoeyer K. 2016; Meet the donors: a qualitative analysis of what donation means to Danish whole body donors. Eur J Anat. 20:19–29.

13. Orsini E, Quaranta M, Ratti S, Mariani GA, Mongiorgi S, Billi AM, Manzoli L. 2021; The whole body donation program at the university of Bologna: a report based on the experience of one of the oldest university in Western world. Ann Anat. 234:151660. DOI: 10.1016/j.aanat.2020.151660. PMID: 33340651.

14. Cho MJ, Hwang YI. 2013; Students' perception of anatomy education at a Korean medical college with respect to time and contents. Anat Cell Biol. 46:157–62. DOI: 10.5115/acb.2013.46.2.157. PMID: 23869263. PMCID: PMC3713280.

15. Arráez-Aybar LA, Bueno-López JL, Moxham BJ. 2014; Anatomists' views on human body dissection and donation: an international survey. Ann Anat. 196:376–86. DOI: 10.1016/j.aanat.2014.06.004. PMID: 25048843.

16. Hildebrandt S. 2016; Thoughts on practical core elements of an ethical anatomical education. Clin Anat. 29:37–45. DOI: 10.1002/ca.22645. PMID: 26474826.

17. Ghosh SK. 2017; Paying respect to human cadavers: we owe this to the first teacher in anatomy. Ann Anat. 211:129–34. DOI: 10.1016/j.aanat.2017.02.004. PMID: 28279760.

18. Melo EN, Pinheiro JT. 2010; Legal procedures and protocols for use of cadavers in anatomy courses in Pernambuco, Brazil. Rev Bras Educ Med. 34:315–23. DOI: 10.1590/S0100-55022010000200018.

19. da Rocha AO, Tormes DA, Lehmann N, Schwab RS, Canto RT. 2013; The body donation program at the Federal University of Health Sciences of Porto Alegre: a successful experience in Brazil. Anat Sci Educ. 6:199–204. DOI: 10.1002/ase.1335. PMID: 23184541.

20. Jones DG. 2016; Searching for good practice recommendations on body donation across diverse cultures. Clin Anat. 29:55–9. DOI: 10.1002/ca.22648. PMID: 26475228.

21. International Federation of Associations of Anatomists (IFAA). 2012; Recommendations of good practice for the donation and study of human bodies and tissues for anatomical examination. Plexus. 2012:4–5.

22. Jones DG, Whitaker MI. 2012; Anatomy's use of unclaimed bodies: reasons against continued dependence on an ethically dubious practice. Clin Anat. 25:246–54. DOI: 10.1002/ca.21223. PMID: 21800367.

23. Habicht JL, Kiessling C, Winkelmann A. 2018; Bodies for anatomy education in medical schools: an overview of the sources of cadavers worldwide. Acad Med. 93:1293–300. DOI: 10.1097/ACM.0000000000002227. PMID: 29561275. PMCID: PMC6112846.

24. Simão TRP, Miglino MA, da Silva JB, McManus C, Liberti EA. 2016; Implementation of a program of voluntary body donation for anatomical study in the University of São Paulo, Brazil. Int J Morphol. 34:1494–501. DOI: 10.4067/S0717-95022016000400051.

25. Cornwall J, Poppelwell Z, McManus R. 2018; "Why did you really do it?" A mixed-method analysis of the factors underpinning motivations to register as a body donor. Anat Sci Educ. 11:623–31. DOI: 10.1002/ase.1796. PMID: 29762910.

26. Gürses İA, Coşkun O, Öztürk A. 2018; Current status of cadaver sources in Turkey and a wake-up call for Turkish anatomists. Anat Sci Educ. 11:155–65. DOI: 10.1002/ase.1713. PMID: 28657659.

27. Park HJ, Ahn H, Ki E, Lee JS, Choi Y, Hu KS, Chun YM, Kim HJ. 2021; Body donation trends in Yonsei University: a statistical analysis of donor records. Anat Cell Biol. 54:59–64. DOI: 10.5115/acb.20.261. PMID: 33424016. PMCID: PMC8017449.

28. Prakash , Prabhu LV, Rai R, D'Costa S, Jiji PJ, Singh G. 2007; Cadavers as teachers in medical education: knowledge is the ultimate gift of body donors. Singapore Med J. 48:186–9. PMID: 17344998.

29. Larner SP, Mcquone B, Schober JM, Loukas M, Terrell M. 2015; Perceptions of the living dead: an assessment of knowledge and opinions about whole body donation, its process, and willingness to become cadaveric donors in Pennsylvania. Clin Anat. 28:442–8. DOI: 10.1002/ca.22516. PMID: 25727324.

30. Brazilian Civil Code. 2002. Law no 10.406 [Internet]. Brazilian Civil Code;Brasília: Available from: http://www.planalto.gov.br/ccivil_03/leis/2002/l10406.htm. cited 2020 Jul 15.

31. Garment A, Lederer S, Rogers N, Boult L. 2007; Let the dead teach the living: the rise of body bequeathal in 20th-century America. Acad Med. 82:1000–5. DOI: 10.1097/ACM.0b013e318149e986. PMID: 17895666.

32. Stott D. 2008; Not enough bodies. BMJ. 336:0801004. DOI: 10.1136/sbmj.0801004.

33. Wingfield HA. 2018; Body donation today: a critical comparison of two current practices, and moving into the future. Clin Anat. 31:86–9. DOI: 10.1002/ca.23010. PMID: 29086440.

34. Instituto Brasileiro de Geografia e Estatística. 2010. Demographic census [Internet]. Instituto Brasileiro de Geografia e Estatística;Rio de Janeiro: Available from: https://www.ibge.gov.br/estatisticas/sociais/educacao/9662-censo-demografico-2010.html?t=destaques. cited 2020 Jul 15.

35. U.S. News & World Report. 2021. Best global universities in Brazil [Internet]. U.S. News & World Report;New York: Available from: https://www.usnews.com/education/best-global-universities/brazil. cited 2021 Jul 10.

36. Cornwall J, Perry GF, Louw G, Stringer MD. 2012; Who donates their body to science? An international, multicenter, prospective study. Anat Sci Educ. 5:208–16. DOI: 10.1002/ase.1278. PMID: 22508582.

37. da Rocha AO, de Campos D, Farina MA, Pacini GS, Girotto MC, Hilbig A. 2017; Using body donor demographics to assist the implementation of donation programs in Brazil. Anat Sci Educ. 10:475–86. DOI: 10.1002/ase.1687. PMID: 28264142.

38. Harvard Medical School. 2021. Anatomical gift program [Internet]. Harvard Medical School;Boston: Available from: https://meded.hms.harvard.edu/anatomical-gift-program. cited 2021 Jan 30.

39. Caplan I, DeCamp M. 2019; Of discomfort and disagreement: unclaimed bodies in anatomy laboratories at United States Medical Schools. Anat Sci Educ. 12:360–9. DOI: 10.1002/ase.1853. PMID: 30586224.

40. Jones DG, King MR. 2017; Maintaining the anonymity of cadavers in medical education: historic relic or educational and ethical necessity? Anat Sci Educ. 10:87–97. DOI: 10.1002/ase.1618. PMID: 27123986.

41. Champney TH, Hildebrandt S, Gareth Jones D, Winkelmann A. 2019; BODIES R US: ethical views on the commercialization of the dead in medical education and research. Anat Sci Educ. 12:317–25. DOI: 10.1002/ase.1809. PMID: 30240149.

42. Bolt S, Venbrux E, Eisinga R, Kuks JB, Veening JG, Gerrits PO. 2010; Motivation for body donation to science: more than an altruistic act. Ann Anat. 192:70–4. DOI: 10.1016/j.aanat.2010.02.002. PMID: 20188530.

43. McClea K, Stringer MD. 2010; The profile of body donors at the Otago School of Medical Sciences--has it changed? N Z Med J. 123:9–17. PMID: 20389313.

44. Bajor G, Likus W, Kuszewski P, Kostro K, Łoś A, Kłakus P. 2015; "Mortui vivos docent" or who gives his body to science? The analysis of the personal questionnaires of Polish donors in the Conscious Body Donation Program. PLoS One. 10:e0121061. DOI: 10.1371/journal.pone.0121061. PMID: 25790303. PMCID: PMC4366327.

45. Cornwall J, Stringer MD. 2009; The wider importance of cadavers: educational and research diversity from a body bequest program. Anat Sci Educ. 2:234–7. DOI: 10.1002/ase.103. PMID: 19728368.

46. Subasinghe SK, Jones DG. 2015; Human body donation programs in Sri Lanka: Buddhist perspectives. Anat Sci Educ. 8:484–9. DOI: 10.1002/ase.1525. PMID: 25689145.

47. Jedrzejewski B, Ritter D. 2016; A demographic exploration of whole body donors at the Alpert Medical School of Brown University. R I Med J (2013). 99:37–9. PMID: 26827086.

48. Woolf SH, Schoomaker H. 2019; Life expectancy and mortality rates in the United States, 1959-2017. JAMA. 322:1996–2016. DOI: 10.1001/jama.2019.16932. PMID: 31769830. PMCID: PMC7146991.

49. Lagwinski M, Bernard JC, Keyser ML, Dluzen DE. 1998; Survey of cadaveric donor application files: 1978-1993. Clin Anat. 11:253–62. DOI: 10.1002/(SICI)1098-2353(1998)11:4<253::AID-CA6>3.0.CO;2-S. PMID: 9652541.

50. Techataweewan N, Panthongviriyakul C, Toomsan Y, Mothong W, Kanla P, Chaichun A, Amarttayakong P, Tayles N. 2018; Human body donation in Thailand: Donors at Khon Kaen University. Ann Anat. 216:142–51. DOI: 10.1016/j.aanat.2017.11.004. PMID: 29274383.

51. Conesa C, Ríos Zambudio A, Ramírez P, Canteras M, Rodríguez MM, Parrilla P. 2004; Influence of different sources of information on attitude toward organ donation: a factor analysis. Transplant Proc. 36:1245–8. DOI: 10.1016/j.transproceed.2004.05.056. PMID: 15251303.

52. World Health Organization. 2018. Life expectancy and healthy life expectancy data by WHO region [Internet]. World Health Organization;Geneva: Available from: https://apps.who.int/gho/data/view.main.SDG2016LEXREGv?lang=en. cited 2020 Jul 15.

53. Gürses İA, Ertaş A, Gürtekin B, Coşkun O, Üzel M, Gayretli Ö, Demirci MS. 2019; Profile and motivations of registered whole-body donors in Turkey: Istanbul University Experience. Anat Sci Educ. 12:370–85. DOI: 10.1002/ase.1849. PMID: 30548175.

54. Gunderman RB. 2008; Giving ourselves: the ethics of anatomical donation. Anat Sci Educ. 1:217–9. DOI: 10.1002/ase.39. PMID: 19177414.

55. Park JT, Jang Y, Park MS, Pae C, Park J, Hu KS, Park JS, Han SH, Koh KS, Kim HJ. 2011; The trend of body donation for education based on Korean social and religious culture. Anat Sci Educ. 4:33–8. DOI: 10.1002/ase.198. PMID: 21265035.