Life stories important to medical studies
In a recent bioethics talk, University of Otago medical academic Dr Katherine Hall suggested possible changes to body bequest programmes for medical research. Reporter John Gibb spoke to Dr Hall, and asked university anatomy department head Prof Neil Gemm
UNIVERSITY of Otago medical academic Dr Katherine Hall has suggested that people who bequest their bodies for medical research should also be able to pass on more information about their lives.
Dr Hall, a senior lecturer in the general practice and rural health department, referred to a more than 350yearold medical text during a recent university bioethics talk.
The medical text was the only known anatomy work of German medical scholar Johann Remmelin, called the Catoptrum Microcosmicum or Kleiner Weltspiegel (‘‘Mirror into a Small World’’), first published in 1613.
The edition held in the university health sciences library is a 1667 DutchLatin translation, and is one of only nine known remaining in the world.
Dr Hall is keen to raise awareness about the rich resources of old medical books held at this library and the university central library.
And she says there have been moves within anatomy internationally to debate whether the ‘‘strict anonymity of body donation’’ should continue.
In one US medical school programme, students were ‘‘aware of their cadaver’s history’’ and also met and celebrated that person’s life with surviving relatives.
In her talk, Dr Hall asked people to imagine that when medical students started their anatomy course they received a ‘‘dossier’’ about the donated body.
The dossier would contain whatever the donor might like to pass on, and could include ‘‘a letter of congratulations on reaching medical school and his or her hope the student will do well’’.
Mementoes of the donor’s life or a description of how that life was lived could also be passed on.
Students would not have to read the dossier, but she hoped that over the one or two years of an anatomy course they would ‘‘in their own time, access the information’’.
Learning more about the donor’s life would enable students to ‘‘start to integrate what they read with how they feel as they read and dissect’’ and ‘‘take the first steps along a journey of patientcentred medicine’’.
The Remmelin text showed details of the human body in a rich context, including biblical elements, and offered a ‘‘complex background of images, metaphors and sayings reflecting a reader’s place in the world’’.
But anatomical text books used in medical student training since the mid19th century presented body parts, often against a white background, in a somewhat detached way, without human context.
‘‘Perhaps for a student training to be a medical scientist or anatomist this is sufficient, but we are training these students to be doctors, and for medicine, especially general practice which accounts for the vast majority of medical encounters, context is everything.’’
‘‘People will present with the same or similar conditions but understanding their lives, and the patient’s subjective values, tailors and refines medical advice, management and treatment; it is the basis for patientcentred medicine.’’
There was a need ‘‘to integrate the emotions not only of our patients but of ourselves in response to the patient as part of our teaching and learning as students’’, she said.
Otago anatomy head Prof Neil Gemmell said some specific information about the donor’s state of health, cause of death and other information could be made known to medical students, but their identity was not.
‘‘This is important to protect all parties involved, the donors, the students, staff and the relatives of those who have donated their bodies.’’
❛important to connect the students with the lives of our donors and their families — it likely does make them better doctors❜
There were ‘‘genuine privacy concerns’’ that might result from students knowing the identity of their donors.
But Prof Gemmell agreed it was ‘‘important to connect the students with the lives of our donors and their families — it likely does make them better doctors’’.
This recognition already took place at an annual Otago thanksgiving service where ‘‘‘we celebrate the lives of these unbelievably generous people, learn about them and their reasons for donating to the programme’’.
‘‘During this service we share the stories of our donors, through the reading of thoughts penned by the donors themselves or their families.’’
Students also shared their experience of learning from these ‘‘special individuals’’, and the service enabled students to ‘‘connect to our donors and their families’’.
Otago medical students never knew the identity of the body they learned from, but the service enabled them to ‘‘link their experiences in the dissecting room to the lives of those people that donated’’, he said.