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Body donation, anatomical donation, or body bequest is the donation of a whole body after death for research and education. There is usually no cost to donate a body to science; donation programs will often provide a stipend and/or cover the cost of cremation or burial once a donated cadaver has served its purpose and is returned to the family for interment.
For years, only medical schools accepted bodies for donation, but starting in the early 2000[ when? ] private programs (either for- or non-profits) also accept donors. [1] Depending on the program's need for body donation, some programs accept donors with different specifications.[ clarification needed ]
Any person wishing to donate their body may do so through a willed body program. The donor may be required, but not always, to make prior arrangements with the local medical school, university, or body donation program before death. Individuals may request a consent form, and will be supplied information about policies and procedures that will take place after the potential donor is deceased.
The practice is still relatively rare, and in attempts to increase these donations, many countries have instituted programs and regulations surrounding the donation of cadavers or body parts. For example, in some states within the United States and for academic-based programs, a person must make the decision to donate their remains themselves prior to death; the decision cannot be made by a power of attorney. If a person decides not to donate their whole body, or they are unable to, there are other forms of donation via which one can contribute their body to science after death, such as organ donation and tissue donation.
Hinduism, [2] Buddhism, [3] Islam, [4] Christianity [5] and Sikhism all support the idea of body donation and/or organ donation for the betterment of the world.[ citation needed ]
The decision to become a body donor is influenced by factors such as: social awareness, cultural attitudes and perceptions of body donation, cultural attitudes and perceptions of death, religion, and perceptions of the body-mind relationship. [6] Studies indicate most donors are primarily driven by altruism and their desire to aid the advancement of medical knowledge and to be useful after death. [7] Other reasons include helping future generations, expressing gratitude for life and good health or for the medical field, to avoid a funeral or to avoid waste. [7]
The offering of financial incentives as a way to increase donor numbers or as an acknowledgement for donors is generally considered to detract from the act of donation and serve as a deterrent. [8] However, a US study showing a positive correlation between body donation numbers and funeral cover cost savings offered as compensation suggests that, in reality, the added incentive could be a persuasive factor for donors. [9]
Bodies donated to any organization are used for scientific research and medical training. Bodies are used to teach medical students anatomy, but they are also used to improve and create new medical technologies. Many programs that accept body donations have specific research affiliations, these can be viewed by looking at each programs website. These can include cancer research, Alzheimer's research, and research into improving surgeries. [10]
Some programs accept whole bodies but distribute different body parts based on need. This ensures a maximum benefit from each donation. These programs can assist with research as shown above, technical training, or improvement/research of medical devices. [11]
After bodies are accepted for donation, a timeframe of six months to three years is expected before the donor's body will be returned to the family. This takes into account embalming, research, and the number of bodies the program has access to at the time. [12]
Body disposal and donation are regulated by the Bestattungsgesetze (funeral laws) of the states. In Germany, the right to autonomy extends beyond death, as a result of which the instructions given by a deceased during their lifetime must be respected when dealing with their body. A body donation can only take place if the deceased signed a declaration of last will in their lifetime, stating the intention of donating their body to an anatomical institute. Relatives of the deceased can neither give permission nor deny body donation against said declaration, the institute however may deny the body. Denial of the body may occur if it carries infectious diseases, has had organs or body parts removed for donation or surgery, is gravely injured or otherwise unfit for teaching, if the body is located too far away from the institute or for reasons of storage capacity. Most institutes require an advance fee to be deposited to pay for funeral costs. [13]
In 1948, the Anatomy Act was passed in all of India's states. This allows bodies to be donated by the donor and bodies to be claimed for medical and research use if there is no claim to one's body within a 48-hour timeframe. [14] Similar to the US, India also has specific guidelines for accepting bodies for donations. Donations that are not deemed suitable include bodies with HIV/AIDS, hepatitis (A, B, and C), donated organs, extreme BMI, or skin diseases.
Some leaders have donated their bodies for medical research, such as communist leader Jyoti Basu [15] and Jana Sangh leader Nanaji Deshmukh. [16] Nowadays, many people in India donate their bodies after death by signing a pledge form with two accompanying witness signatures. [17]
Only the legal next-of-kin of the deceased can provide the necessary consent for donation if the donor did not provide it to the specific accepting program prior to death.[ citation needed ] Body donation is not regulated through licensure and inspection by the federal government and most states.[ citation needed ]
Body brokers (or non-transplant tissue banks) engage in the acquisition of cadavers, often via offers of free cremation, and then subsequently process the cadaver and resell body parts in a largely unregulated national market. [18] [19]
The legal right for an individual to choose body donation is governed by the Uniform Anatomical Gift Act, which has been largely adopted by most states. Laws relating to the transportation and disposition of human bodies currently apply, regardless of the recent House Bill introduced.[ citation needed ]
The American Association of Tissue Banks (AATB) provides accreditation to non-transplant tissue bank research and education programs to establish that the level of medical, technical, and administrative performance meets or exceeds the standards set by the AATB. Whole body donation and non-transplant tissue banking remains an industry with limited regulation, and while it is not a legal requirement, accreditation allows for individuals choosing to donate their body to medical research or education programs to choose a program with the highest quality standards.[ citation needed ]
The American Medical Education and Research Association (AMERA) is a peer-recognized national accrediting body in the United States that provides accreditation to organizations using standards developed solely for non-transplant organizations. This includes whole body donor organizations, university anatomical programs, bio-repository programs, and end users of human tissue. AMERA encourages the industry to become accredited and involved in establishing standards that are relevant to non-clinical tissue organizations.[ citation needed ]
Many medical programs in the United States now hold student-led memorial services for the donated bodies. This is to show respect for the donors and their families, and to shine a positive light on the process of body donation. [20]
There are many private body donation programs in the US. Each of these private programs accepts bodies from certain surrounding areas. Most programs also have guidelines for bodies they will and will not accept. Generally, programs will not accept bodies that are positive for hepatitis (A, B, and C), HIV/AIDS, history of illegal drug use, or fall within an extreme category for their BMI. The embalming process adds even more weight to a donor's body, so if they have a high BMI the programs may not take them because they cannot handle the weight of the donor after embalming. [21] If a donor has a specific disease prior to death, which is not contagious, and would like to be a part of a program's study, they may contact that research program specifically.[ citation needed ]
Body donation in the UK is governed by the Human Tissue Authority (HTA) under the auspices of the Human Tissue Act 2004. The HTA licenses and inspects establishments, such as medical schools, which teach anatomy using donated bodies. Under the Human Tissue Act, written consent must be given prior to death; consent cannot be given by anyone else after death. [22] The minimum age to consent to donate one's body in the UK is 17.[ citation needed ]
The Human Tissue Authority provides information to donors about where they can donate and answers many prevalent questions related to tissue donation on their website. The HTA provides the links to each establishment's information, but each establishment has its own guidelines for body donation. The HTA also provides the tools to find donation sites local to the person wishing to donate their body or tissues.[ citation needed ]
Although most establishments accept most donations, donors who have had an autopsy may be declined from a program. Certain programs also may decline bodies of donors who have died abroad. [23]
Organ donation is the process when a person authorizes an organ of their own to be removed and transplanted to another person, legally, either by consent while the donor is alive, through a legal authorization for deceased donation made prior to death, or for deceased donations through the authorization by the legal next of kin.
Body Worlds is a traveling exposition of dissected human bodies, animals, and other anatomical structures of the body that have been preserved through the process of plastination. Gunther von Hagens developed the preservation process which "unite[s] subtle anatomy and modern polymer chemistry", in the late 1970s.
Organ transplantation is a medical procedure in which an organ is removed from one body and placed in the body of a recipient, to replace a damaged or missing organ. The donor and recipient may be at the same location, or organs may be transported from a donor site to another location. Organs and/or tissues that are transplanted within the same person's body are called autografts. Transplants that are recently performed between two subjects of the same species are called allografts. Allografts can either be from a living or cadaveric source.
The Uniform Anatomical Gift Act (UAGA), and its periodic revisions, is one of the Uniform Acts drafted by the National Conference of Commissioners on Uniform State Laws (NCCUSL), also known as the Uniform Law Commission (ULC), in the United States with the intention of harmonizing state laws between the states.
Plastination is a technique or process used in anatomy to preserve bodies or body parts, first developed by Gunther von Hagens in 1977. The water and fat are replaced by certain plastics, yielding specimens that can be touched, do not smell or decay, and even retain most properties of the original sample.
Prior to the introduction of brain death into law in the mid to late 1970s, all organ transplants from cadaveric donors came from non-heart-beating donors (NHBDs).
Dissection is the dismembering of the body of a deceased animal or plant to study its anatomical structure. Autopsy is used in pathology and forensic medicine to determine the cause of death in humans. Less extensive dissection of plants and smaller animals preserved in a formaldehyde solution is typically carried out or demonstrated in biology and natural science classes in middle school and high school, while extensive dissections of cadavers of adults and children, both fresh and preserved are carried out by medical students in medical schools as a part of the teaching in subjects such as anatomy, pathology and forensic medicine. Consequently, dissection is typically conducted in a morgue or in an anatomy lab.
Kidney transplant or renal transplant is the organ transplant of a kidney into a patient with end-stage kidney disease (ESRD). Kidney transplant is typically classified as deceased-donor or living-donor transplantation depending on the source of the donor organ. Living-donor kidney transplants are further characterized as genetically related (living-related) or non-related (living-unrelated) transplants, depending on whether a biological relationship exists between the donor and recipient. The first successful kidney transplant was performed in 1954 by a team including Joseph Murray, the recipient's surgeon, and Hartwell Harrison, surgeon for the donor. Murray was awarded a Nobel Prize in Physiology or Medicine in 1990 for this and other work. In 2018, an estimated 95,479 kidney transplants were performed worldwide, 36% of which came from living donors.
The Human Tissue Authority (HTA) is an executive non-departmental public body of the Department of Health and Social Care in the United Kingdom. It regulates the removal, storage, use and disposal of human bodies, organs and tissue for a number of scheduled purposes such as research, transplantation, and education and training.
Eye banks recover, prepare and deliver donated eyes for cornea transplants and research. The first successful cornea transplant was performed in 1905 and the first eye bank was founded in 1944. Currently, in the United States, eye banks provide tissue for over 80,000 cornea transplants each year to treat conditions such as keratoconus and corneal scarring. In some cases, the white of the eye (sclera) is used to surgically repair recipient eyes. Unlike other organs and tissues, corneas are in adequate supply for transplants in the United States, and excess tissue is exported internationally, where there are shortages in many countries, due to greater demand and a less-developed eye banking infrastructure.
The Australian Organ Donor Register (AODR) is a government register, recording individuals who have agreed to donate organs and tissues in the event of their death. The register is operated by the Organ and Tissue Authority (OTA) and Services Australia through Medicare.
A tissue bank is an establishment that collects and recovers human cadaver tissue for the purposes of medical research, education and allograft transplantation. A tissue bank may also refer to a location where biomedical tissue is stored under cryogenic conditions and is generally used in a more clinical sense.
Organ trade is the trading of human organs, tissues, or other body products, usually for transplantation. According to the World Health Organization (WHO), organ trade is a commercial transplantation where there is a profit, or transplantations that occur outside of national medical systems. There is a global need or demand for healthy body parts for transplantation, which exceeds the numbers available.
The American Association of Tissue Banks (AATB) is a nonprofit transplant trade organization that is dedicated to ensuring that human tissues intended for transplantation are safe and free of infectious disease, of uniform high quality, and available in quantities sufficient to meet national needs. AATB is located in McLean, Virginia. It was founded in 1976 and consists of 1,100 members.
Transplantable organs and tissues may refer to both organs and tissues that are relatively often transplanted, as well as organs and tissues which are relatively seldom transplanted. In addition to this it may also refer to possible-transplants which are still in the experimental stage.
A beating heart cadaver is a body that is pronounced dead in all medical and legal definitions, connected to a medical ventilator, and retains cardio-pulmonary functions. This keeps the organs of the body, including the heart, functioning and alive. As a result, the period of time in which the organs may be used for transplantation is extended. The heart contains pacemaker cells that will cause it to continue beating even when a patient is brain-dead. Other organs in the body do not have this capability and need the brain to be functioning to send signals to the organs to carry out their functions. A beating heart cadaver requires a ventilator to provide oxygen to its blood, but the heart will continue to beat on its own even in the absence of brain activity. This allows organs to be preserved for a longer period of time in the case of a transplant or donation. A small number of cases in recent years indicate that it can also be implemented for a brain-dead pregnant woman to reach the full term of her pregnancy. There is an advantage to beating heart cadaver organ donation because doctors are able to see the vitals of the organs and tell if they are stable and functioning before transplanting to an ailing patient.
MOHAN Foundation is a not-for-profit, registered non-government charity organisation in India that works in the field of deceased organ donation and transplantation. MOHAN is an acronym for Multi Organ Harvesting Aid Network.
Organ donation is when a person gives their organs after they die to someone in need of new organs. Transplantation is the process of transplanting the organs donated into another person. This process extends the life expectancy of a person suffering from organ failure. The number of patients requiring organ transplants outweighs the number of donor organs available.
The current law in Ireland requires a potential donor to opt in to becoming an organ donor. However, it is ultimately up to their family to make the decision whether or not the person can donate their organs after they die.
Organ donation in India is regulated by the Transplantation of Human Organs and Tissues Act, 1994. The law allows both deceased and living donors to donate their organs. It also identifies brain death as a form of death. The National Organ and Tissue Transplant Organisation (NOTTO) functions as the apex body for activities of relating to procurement, allotment and distribution of organs in the country.