Elaine Edwards reports on a generous contribution to the advance of medicine
Around 80 people a year in Ireland opt to make a final, selfless contribution to society: instead of undergoing burial or cremation after death, they donate their bodies to one of the five medical colleges for research and to train medical students.
It is an option many might not be aware of and one, perhaps, considered a slightly macabre choice - yet it has immeasurable benefits for medicine, for research into diseases and for the development of new surgical techniques.
For all the fantastic developments in computer-aided training, where medicine is concerned, there is no substitute for the three dimensions of a human body in all the natural intricacy of its design, but used also in its ultimate frailty as a learning tool.
Siobhán Ward, senior technician at the Department of Anatomy in Trinity College Dublin says there is no single significant category of person who chooses to leave their body for research. It seems to attract male and female in roughly equal numbers. And it is a choice, perhaps surprisingly given the initial denial of a full funeral service, taken equally by those who adhere to religious beliefs and by those who have none.
"Some may have particular medical problems that require treatment or surgery and this makes them think about the benefits research into their health difficulties could bring for medicine. Others just think they would like to do it because it's a good thing to do," says Ward.
Anyone who decides to donate their body is encouraged to discuss the matter with their family.
"We have found that sometimes families don't really know how to respond when their mother or father say they want to donate their body to Trinity. But in 99 per cent of cases, the family will support their decision."
Trinity receives about 10 or 12 bodies a year and the length of time it keeps them depends, essentially, on supply.
The other medical colleges also receive between 10 and 20 bodies a year. At least one, the Royal College of Surgeons in IrelandI, says that if this number were to double it would be delighted, again because the work and training it can do is limited by availability.
Prof John Fraher, head of anatomy at UCC, says the benefit to the medical colleges of such a donation is extremely valuable.
"You might say that people can use computers for this, but you can't because you have to feel, you have to touch and you have to see and to have the image of the three-dimensional body in your mind.
"It's genuine altruism for the good of humanity and they [ the donors] often express the view that they want their bodies to be of value for education, to ultimately improve the quality of the health service provided. It's a very generous thing for the donor to do, but it's even more generous in a way for the family because of the delay between donation and burial, because there isn't completion in the death, as it were."
Prof Clive Lee, head of anatomy at the RCSI, also acknowledges this aspect of the donor scheme.
"There is delayed closure and that's something we're very conscious of. We ask the donors to discuss it with their families and we give them a copy of our booklet and our donation form and they leave that with their executor. If the family aren't happy, then we respect their wish."
Those who leave their bodies want assurances that their remains will be treated with due respect by the medical students who are so lucky to benefit from their gift. All of the colleges ensure that new students are carefully briefed about the person and about their decision to leave their body to science.
"At the beginning of the year we tell the students how lucky they are that these people, who are really their first patients, have donated their remains and that they have a great opportunity to learn at first hand the three-dimensional geography of the body," says Prof Lee.
"Because thereafter they will be looking at the anatomy of people's chests or abdomens, they will be looking at CTs and this is the time to see it in three dimensions so that they can understand it better."
Apart from the benefits for students learning anatomy, work on the bodies can also yield benefits for research in any number of areas, including heart disease and neurological conditions. Research has also been done on the properties of vascular tissue and on micro-damage in bone from osteoporosis.
The colleges acknowledge their donors through memorial services, books of remembrance and even through specially commissioned sculptures, such as "The Flame" by the late Alexandra Wejchert, which stands proudly in the grounds of UCC's anatomy department.
Ultimately, the donor's body is released back to the family for burial or cremation according to the donor's wishes, generally with the assistance of the colleges's own undertakers. The RCSI held its ecumenical memorial service in January and many families who met the students remarked upon how beneficial and moving the experience had been, says Prof Lee.
"It's our chance to say thank you to them and they realise they're not the only people who have done it. Our students, when they qualify and are out in the clinical world, they all value the fact that they were able to see real anatomy. That stands them in good stead for their entire clinical career."
Contacts:
Trinity College Dublin, Department of Anatomy: 01-6081182
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UCD, Department of Human Anatomy: 01-7167253/7167274
[ www.ucd.ie/anatomy/Opens in new window ]
UCC, Department of Anatomy: 021-4902246
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RCSI: 01-4022260
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NUI Galway, Department of Anatomy: 091-750305