KOCHI: While cadaver donation has become a topic of discussion after the deaths of CPM leaders Sitaram Yechury and M M Lawrence, experts emphasise the importance of raising awareness about donating bodies to medical colleges for educational purposes.
In Kerala, several known persons, such as assistant film director Anil Xavier, CPM central committee member M C Josephine, and writer and politician Simon Britto, donated their bodies for medical education. More recently, Anil’s family also pledged to donate their bodies.
A cadaver is necessary for first-year medical students to learn human anatomy. According to the Medical Council of India, the ratio of cadaver to students is one to 10.
However, lack of knowledge and proper guidelines, as well as controversies hinder cadaver donation, resulting in shortage at medical colleges.
According to Dr Kumari T K, a professor with the Department of Anatomy at Azeezia Medical College in Kollam, the number of people who come forward willing to donate their bodies for medical studies after death has been increasing.
“Nowadays, more people are willing to donate their bodies after death for medical studies. Some people enquire about the procedure for donation and submit a letter of consent. The public is now more aware of the importance of donating their bodies for medical studies and its impact on future doctors. It is a good change,” she said.
The government medical colleges in Kalamassery and Alappuzha received 20 and 18 cadavers, respectively, last year.
Dr Kumari said more cadavers are required at the medical colleges for the students. “Medicine or anatomy cannot be learnt through theories.
Cadaver dissection is a must for first-year medical students. They need to understand the human anatomy. The public needs to be educated about the importance of donating cadavers for medical studies,” she said.
A cadaver can be used for medical studies for 10 to 15 years. “The cadaver we receive is preserved in formalin. There are other procedures as well. The body will not be identified after that. The human cadaveric dissection has a crucial role in learning the anatomy of humans in the first year of medicine.
The specimen can be used for study purposes for around 10 to 15 years. The body will be cremated after that,” said a professor who wishes to stay anonymous. The Kerala Anatomy Act also allows hospitals to take possession of an unclaimed body if there are no legal or procedural restrictions.
Religious factor
What prevents most people, especially the family and relatives of the deceased persons, from donating their bodies for medical studies is their religious beliefs. The recent controversy that arose after the death of CPM leader Lawrence is an example.
Rejeesh Rehman, who donated the body of his father C M Abdu Rahman for medical studies, said even though the person would wish to donate the body, the family and relatives would be reluctant.
“Most of the time, the person might have wished to donate his or her body to medical colleges. However, the family gives more priority to the emotional aspect. The children and relatives may wish to organise the funeral as per religious beliefs and hence may not allow to donate the body,” he said.
E A Jalil, the founding member of Punarjani, an NGO aimed at creating awareness about organ donation and cadaver donation based in Malappuram, said there are religious and emotional factors that prevent people from donating bodies.
“There are situations when, even if the person has signed a willingness certificate, the relatives do not allow donation. The family’s emotional attachment to the person and their belief are major reasons for it,” he said.
To avoid arguments, the state government, in the Kerala Anatomy Act, has made it mandatory to write a letter expressing consent to use the body for the purpose of conducting anatomical examination and dissection.
“Now, a rule has been brought to avoid arguments and confusion after a person’s death. Two witnesses are mandatory to witness the signing procedure. The person who wishes to donate their bodies to medical colleges needs to discuss their willingness with the family,” said Jalil.
Sharing his personal experience, Rejeesh said, for him, fulfilling his father’s last wish gave him satisfaction.
“My family also supported me, as my father had told this to other relatives too. In case of confusion, a family should discuss to come to a conclusion,” said Rejeesh.
Awareness
Rejeesh said more awareness should be created among the public.
Jalil said creating awareness among the public is important. “We need to have qualified doctors with knowledge and experience. Thus, cadaver donation is significant in medical studies. Education and change in the mindset of the public have encouraged people to donate bodies. The public should consider this a social responsibility and should come forward to help the next generations,” he said.
“Awareness classes among the young generations can help in that sense,” added the professor.
Need for revisions
According to the 1957 Kerala Anatomy Act, only hospitals established or maintained by the government, any municipal council, or other local authority can receive cadavers, and following the growing demand, in 2008, the Department of Medical Education issued an order allowing government institutions to supply the same to teaching institutions under the Anatomy Act.
According to Jalil, the rules and regulations about cadaver donations should be revised according to the changing scenario.
“Earlier, only government medical colleges were allowed to receive the bodies, and the private institutions had to travel to the colleges for a cadaver. Also, the government colleges could provide them if there was an excess. It would lead to unethical practices in the field. Now these conditions have been changed. Such revisions should be brought,” Jalil said, adding that the rule was brought in when there were only five or six government medical colleges in the state.
“We have many private medical colleges and thousands of students joining medical sciences every year. These colleges had to purchase cadavers or the students had to travel to government hospitals to witness the procedure and learn human anatomy. Private colleges can receive a body only if the willing person specifies the name of the college. There should not be any disparity between government medical colleges and private medical colleges,” he said.
Seena Bhaskar, wife of Simon Britto, whose body was donated to a government medical college, said a proper guideline needs to be prepared.
“When it comes to receiving the body from the families, there should be a guideline. Also, once after the studies, it should be cremated respectfully. Such changes should be brought into the system,” she said.
Procedure To donate a cadaver
Willingness to donate body should be written on a stamp paper worth Rs 200, or two stamp papers of Rs 100 each, or four of Rs 50
The stamp paper(s) should carry signatures of spouse, relatives or children
Two witnesses, who are not relatives of the donor, must sign the form, and copies of their identity cards should be submitted along with the stamp paper(s)
Passport size photos, Aadhaar copies of the willing person and close relatives
The family members of the person should be aware of the registration
Letter from panchayat, municipality or corporation on an official letter pad with the officer’s sign and seal, mentioning the person’s ward/division, and willingness to donate his/her body
A copy should be kept at the person’s house, and the original should be brought to the medical college and kept in the department
(Source: Department of Anatomy, Government Medical College, Ernakulam)