埃塞俄比亚医学院解剖设施中人体处理和使用的伦理合规性评估。

IF 2.3 Q2 MEDICINE, GENERAL & INTERNAL Pragmatic and Observational Research Pub Date : 2021-07-12 eCollection Date: 2021-01-01 DOI:10.2147/POR.S321646
Solomon Tesfaye, Niguse Hamba, Wakjira Kebede, Mitiku Bajiro, Lemessa Debela, Tihahun Alemayehu Nigatu, Asfaw Gerbi
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引用次数: 5

摘要

背景:人体解剖学在历史上一直是医学教育的基石,它的特殊之处在于它使用保存在各种解剖设施(如停尸房、大体解剖实验室或博物馆)中的人体遗骸进行教学和研究。在为促进临床实践和研究的知识进步服务的同时,人类尸体的处理和使用,如尸体的来源、运输、储存、保存、解剖和最终处置,都应该得到最大的尊重。在埃塞俄比亚,尽管没有足够的资料说明第一次尸体解剖是何时、何地和由谁进行的,但该国许多医学院正在进行解剖。尽管在每一种解剖环境中使用人体都有道德上的必要性,但由于在包括埃塞俄比亚在内的发展中国家存在一些严重的挑战性障碍,仍然存在道德和法律上的不确定性。因此,本研究的目的是评估处理和使用人体的道德实践,以促进在不久的将来,埃塞俄比亚解剖解剖实验室和相关环境中制定和实施可接受的,尊重的和道德的指导方针。方法:选择埃塞俄比亚八所医学院的解剖设施进行多中心横断面研究。通过结构化问卷和检查表收集到的数据进行清理、预置,输入SPSS 20进行分析。内部一致性和信度采用Cronbach’s alpha测量。结果:研究结果生动地展示了人体伦理违规行为,包括解剖单位在监督尸体的采购、运输、防腐、护理和解剖实验室的解剖过程中缺乏权力,以及学生虐待尸体。结论:除了由于缺乏规范的人体使用伦理准则或政策而导致的依从性缺失外,基于依从性的专业发展也不存在。遗体来源的道德途径是通过遗体捐赠;然而,在埃塞俄比亚,解剖学教学完全依赖于无人认领的尸体。使用非道德来源的尸体进行解剖可能会对解剖学讲师、技术助理、殡仪业者和医学生产生负面的生命情绪。通过认识到死者的人性和独特性,我们通过对人体的良好实践,激发更好地提供道德和伦理练习。这项研究的结果是对埃塞俄比亚解剖学设施实践的严重谴责,我们敦促埃塞俄比亚解剖学学会发挥其作用,改变目前与人体使用的道德和法律不确定性有关的实践。
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Assessment of Ethical Compliance of Handling and Usage of the Human Body in Anatomical Facilities of Ethiopian Medical Schools.

Background: Human anatomy has historically been a cornerstone in medical education and is special in that it uses human remains kept in various anatomical facilities like a morgue, gross anatomy laboratory, or museums for instruction and research. While serving knowledge advancement facilitating clinical practice and research, human cadaver handling, and usage at all levels, such as cadaver sourcing, transportation, storage, preservation, dissection, and final disposal deserves in return the utmost respect. In Ethiopia, even though there is not enough information on when, where, and by whom the first cadaver dissection was conducted, dissection is being conducted in many of its medical schools. Despite ethical necessity surrounding human body usage in every anatomical setting, there is still ethical and legal uncertainty due to several challenging barriers which is severe in developing nations including Ethiopia. The aim of this study is, therefore, to assess ethical practices of handling and usage of the human body to promote, in the near future, formulation and implementation of acceptable, respectful, and ethical guidelines for the anatomy dissection laboratories and related settings in Ethiopia.

Methods: A multicentered cross-sectional study was used at selected anatomy facilities of eight Ethiopian medical schools. The collected data through structured questionnaires and checklists were cleaned, preset and entered in to SPSS version 20 for analysis. Internal consistency and reliability were measured by using Cronbach's alpha.

Results: The study result showed vivid human body ethical breaches that ranged from lack of power by anatomy unit to oversee the process during sourcing, transportation, embalming, caring, and dissection of cadavers in the anatomy laboratories to student's mistreatment of cadavers.

Conclusion: In addition to lack of compliance due to lack of standard ethical guidelines or policies regarding human body usage, the compliance-based professional development is also nonexistent. The ethical way of body sourcing is through body donation; however, in Ethiopia, anatomy teaching exclusively depends on unclaimed bodies. Using a body for dissection that is solely sourced unethically may generate a negative emotional sense of life for anatomy instructors, technical assistants, morticians, and medical students. We inspire better provision of moral and ethical exercise with the good practice concerning the human body through recognizing the humanity and uniqueness of the deceased person. The results of this study serve as a serious condemnation of practices in Ethiopian anatomy facilities and we urge the Anatomical Society of Ethiopia to play its part in changing the present practices related to ethical and legal uncertainty of the human body usage.

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Pragmatic and Observational Research
Pragmatic and Observational Research MEDICINE, GENERAL & INTERNAL-
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期刊介绍: Pragmatic and Observational Research is an international, peer-reviewed, open-access journal that publishes data from studies designed to closely reflect medical interventions in real-world clinical practice, providing insights beyond classical randomized controlled trials (RCTs). While RCTs maximize internal validity for cause-and-effect relationships, they often represent only specific patient groups. This journal aims to complement such studies by providing data that better mirrors real-world patients and the usage of medicines, thus informing guidelines and enhancing the applicability of research findings across diverse patient populations encountered in everyday clinical practice.
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