Guidelines for anatomical examination
These Guidelines were drawn up by the Professional Guidelines and Practices (Anatomy) Committee. Members of the Committee are drawn from the Anatomical Society of Great Britain & Ireland, the British Association of Clinical Anatomists and the Institute of Anatomical Scientists. The Guidelines are informed by the legal framework of the Human Tissues Act, but are separate from any guidance issued by the HTA.
1. Reasonable belief
It is not unlawful to start preparing a body in order to proceed to timely preservation and storage, if (a) the DI/DP (or bequeathal secretary designated by DI/PD) has seen a copy of the signed and witnessed bequest consent form or last will, clearly indicating the donor’s wishes, and (b) has good reason to believe that there is a signed Medical Certificate of the Cause of Death, MCCD, or is in possession of the number of the certificate. Anatomical examination cannot begin until the appropriate consent form and MCCD are in place and the death has been registered (green disposal form obtained from Registrar).
2. Defining a ‘part’
Although the Human Tissue Act does not provide a definition of ‘parts’, if consent has been given for a cadaver to be used for anatomical examination with retention of ‘parts’, good practice is that at the end of 3 years (or before), a minimum of 2/3 of the body mass of the individual should be sent for cremation / burial, accompanied by the green disposal form.
3. Disposal of ‘parts’
Retained cadaveric parts not accompanied by a green form are usually disposed of in hospital or commercial incinerators, depending upon local circumstances. A Service Level Agreement between the institution disposing of the parts and the contractor, outlining appropriate procedures, should be in place. Good practice is that the parts should be incinerated in a designated human tissue burn and there should be a ‘Duty of Care’ visit to the incinerator at least once a year (ideally all deliveries of parts to the incinerator should be attended). The suitability of packaging should be determined by the amount and nature of the parts and the distance they are to be transported, e.g. bagged or bagged and placed inside drums. A list of the contents of each consignment and the part numbers within should accompany the consignment and a copy should be retained by the DI on the individual’s record/file and kept for a minimum period of 5 years from the date of disposal.
4. Images in the Dissecting Room
Images may be used for medical education, research and clinical audit without consent providing that the donors cannot be identified. Although the Human Tissue Act is silent on the taking and use of images, good practice is to request consent. Images to be used in the dissecting room or ‘secure’ practicals can directly reflect the material in the dissecting room. No individual should be identifiable in images for use in other circumstances. Images should not be uploaded onto the internet, from which they may be downloaded and inappropriate use made of them. Local practice(s) for uploading images onto an intranet must be appropriate and secure. A record should be kept of electronic images taken of cadaveric material, to whom they have been disseminated and for what purpose: good practice is to use an appropriate, standardised form for this purpose. All use of images from licensed establishments must be agreed and sanctioned by the DI.
5. Access to the Dissecting Room
When a dissecting room contains visible specimens (wet body parts), access should be restricted to the following groups of individuals: registered students with a justifiable reason for requiring access; all healthcare professionals attending courses; others, such as medical artists and police can be admitted at the discretion of the DI. Any other category of visitor should normally only be admitted to an 'empty’ dissecting room, i.e. a room either stripped of wet cadaveric material, or where such material is covered. When maintenance staff require access, cadaveric material should be covered. Whilst in the dissection room all students and visitors should be supervised by the DI, a PD or a member of staff designated by the DI/PD.
6. Handling and storage of cadaveric specimens (retained ‘parts’)
Specimens must be treated with respect at all times. Human parts should be clearly labelled with their unique identifier. When in store tank/buckets/cold rooms etc), specimens may be grouped together/ placed on top of/in contact with each other). While being transported, parts should be covered and secure and transport through public areas should be avoided when possible. When being used for teaching, specimens should not be in contact with each other unless it is specifically necessary.
7. Use of non-human material at licensed establishments
Human and non-human animal parts should be stored separately: each part should be clearly labelled with its unique identifier. When being used in a class for comparative purposes, human and non-human animal parts should normally be placed on separate trays on separate tables: it is acknowledged that there may be times during a class when this separation is not appropriate).
8. Charging for bodies
It is not appropriate to make a charge for cadavers freely given for Anatomical Examination under the Human Tissue Act. However, it is reasonable to apply a charge to cover the costs of embalming bodies, preparing retained parts for use in other establishments and transport etc. These charges should reflect the costs involved.
Date: 26th March 2009