Religious Concerns About COVID-19 Vaccines: From Abortion to Religious Freedom.

In the midst of the debate about vaccines against COVID-19 and vaccine mandates, there are a surprisingly large number of concerns coming from some churches centring on the dependence of some of the vaccines on historic abortions and limitations of freedom of choice. Although the ethical significance of separation between historic abortions and the vaccines has been widely accepted by most religious authorities, the pandemic has led to renewed concern by some. The emergence of vaccine mandates, with their potential negative impact on church attendance, has led some to oppose anything that would limit freedom of choice. Within this opposition is a medley of other messages, such as lack of trust in experts and human rights violations. Some regard vaccine passports as a form of 'medical apartheid' or 'therapeutic totalitarianism', coercing people's conscience. A countervailing perspective is provided by most church organizations that take a far more communitarian view based upon Jesus' teachings, identification with the poor and marginalized, and public health considerations. These Christians place far greater store on science as a gift from God, medical science as a means of transforming societies for good, and the potential of vaccines to control a rampant pandemic. Flexibility in imposing vaccine mandates is essential with onus placed on protecting the vulnerable, the community, and directed by the biblical precept of love for one's neighbour.

From undergraduate to postgraduate uses of the dead human body: consequential ethical shift.

The dependence of surgical training programmes on the supply of bodies by for-profit organisations places them at serious ethical risk. These risks, with their commodification of the bodies used in the programme, are outlined. It is concluded that this is not a satisfactory model for the trainees' subsequent interaction with living patients and that a code of practice is required.

Confucianism and organ donation: moral duties from xiao (filial piety) to ren (humaneness).

There exists a serious shortage of organs for transplantation in China, more so than in most Western countries. Confucianism has been commonly used as the cultural and ethical reason to explain the reluctance of Chinese and other East-Asian people to donate organs for medical purposes. It is asserted that the Confucian emphasis on xiao (filial piety) requires individuals to ensure body intactness at death. However, based on the original texts of classical Confucianism and other primary materials, we refute this popular view. We base our position on the related Confucian norms of filial piety and ren (humaneness, humanity or benevolence), the tension between differentiated love and universal love, and belief in the goodness of human nature. In light of this, we argue that the Confucian ethical outlook actually calls for organ donation at an individual level, and supports an opt-out (presumed consent) system at the level of social policy. Furthermore, because the popular view is based on a number of dominant but misleading modes of thinking about cultural differences, our revisionist account of Confucian moral duties regarding organ donation has implications for developing a more adequate transcultural and global bioethics. These will be discussed and expanded upon.

Consensus guidelines for the uniform reporting of study ethics in anatomical research within the framework of the anatomical quality assurance (AQUA) checklist.

Unambiguous reporting of a study's compliance with ethical guidelines in anatomical research is imperative. As such, clear, universal, and uniform reporting guidelines for study ethics are essential. In 2016, the International Evidence-Based Anatomy Working group in collaboration with international partners established reporting guidelines for anatomical studies, the Anatomical Quality Assurance (AQUA) Checklist. In this elaboration of the AQUA Checklist, consensus guidelines for reporting study ethics in anatomical studies are provided with in the framework of the AQUA Checklist. The new guidelines are aimed to be applicable to research across the spectrum of the anatomical sciences, including studies on both living and deceased donors. The authors hope the established guidelines will improve ethical compliance and reporting in anatomical research. Clin. Anat. 31:521-524, 2018. © 2018 Wiley Periodicals, Inc.

Does Confucianism allow for body donation?

Confucianism has been widely perceived as a major moral and cultural obstacle to the donation of bodies for anatomical purposes. The rationale for this is the Confucian stress on xiao (filial piety), whereby individuals' bodies are to be intact at death. In the view of many, the result is a prohibition on the donation of bodies to anatomy departments for the purpose of dissection. The role of dissection throughout the development of anatomy within a Confucian context is traced, and in contemporary China the establishment of donation programs and the appearance of memorial monuments is noted. In reassessing Confucian attitudes, the stress laid on a particular interpretation of filial piety is questioned, and an attempt is made to balance this with the Confucian emphasis on a moral duty to those outside one's immediate family. The authors argue that the fundamental Confucian norm ren (humaneness or benevolence) allows for body donation as people have a moral duty to help others. Moreover, the other central Confucian value, li (rites), offers important insights on how body donation should be performed as a communal activity, particularly the necessity of developing ethically and culturally appropriate rituals for body donation. In seeking to learn from this from a Western perspective, it is contended that in all societies the voluntary donation of bodies is a deeply human activity that is to reflect the characteristics of the community within which it takes place. This is in large part because it has educational and personal repercussions for students. Anat Sci Educ 11: 525-531. © 2018 American Association of Anatomists.

Maintaining the anonymity of cadavers in medical education: Historic relic or educational and ethical necessity?

Throughout the modern history of anatomical dissection by medical and other health science students, cadavers have been anonymized. This has meant that students have been provided with limited, if any, information on the identities or medical histories of those they are dissecting. While there was little way around this when the bodies were unclaimed, this need not be the case when the bodies have been donated. However, with a few exceptions, no efforts have been made to change this model. Recent attempts to move anatomy teaching in a more humanistic direction, by emphasizing the cadaver as the students' first patient and with the growth of commemoration services following the dissecting process, raise the question of whether cadavers should continue to be anonymized. In laying a basis for discussion of this matter, we outline what appear to be the virtues of anonymity, and the form that alternatives to anonymity might take. The options identified are nonidentification, low information; nonidentification, moderate information; and identification, full information. The virtues and drawbacks of each of these possibilities are assessed by analyzing their value for students, and also for donors and their families. Policy issues raised by alternatives are also considered. This article provides a basis for continued discussion and suggestions for further research in this area. Anat Sci Educ 10: 87-97. © 2016 American Association of Anatomists.

The use of animal tissues alongside human tissue: Cultural and ethical considerations.

Teaching and research facilities often use cadaveric material alongside animal tissues, although there appear to be differences in the way we handle, treat, and dispose of human cadaveric material compared to animal tissue. This study sought to analyze cultural and ethical considerations and provides policy recommendations on the use of animal tissues alongside human tissue. The status of human and animal remains and the respect because of human and animal tissues were compared and analyzed from ethical, legal, and cultural perspectives. The use of animal organs and tissues is carried out within the context of understanding human anatomy and function. Consequently, the interests of human donors are to be pre-eminent in any policies that are enunciated, so that if any donors find the presence of animal remains unacceptable, the latter should not be employed. The major differences appear to lie in differences in our perceptions of their respective intrinsic and instrumental values. Animals are considered to have lesser intrinsic value and greater instrumental value than humans. These differences stem from the role played by culture and ethical considerations, and are manifested in the resulting legal frameworks. In light of this discussion, six policy recommendations are proposed, encompassing the nature of consent, respect for animal tissues as well as human remains, and appropriate separation of both sets of tissues in preparation and display.

Is the decline of human anatomy hazardous to medical education/profession?--A review.

PURPOSE: The continuous decrease in teaching time, the artificially created scarcity of competent anatomical faculties and a reduced allocation of resources have brought about the decline of anatomy in medical education. As a result of this, anatomical knowledge and the standard of medical education have fallen with consequences including safety in clinical practice. The aim of the present study is to analyze this declining phase of anatomy and its impact on medical education and to consider corrective measures. METHODS: This article expresses comparative viewpoints based on a review of the literature. RESULTS: Anatomy enables doctors to master the language of medical science so they can communicate with patients, the public and fellow doctors and diagnose and treat diseases successfully in all medical fields. No medical specialist or expert can master their field without adequate knowledge of human anatomy. The shrinkage of anatomical schedules, inadequate faculties and declining allocation of resources is therefore unfortunate. These factors produce stress in both student and faculty creating gaps in anatomical knowledge that means insufficient skill is developed to practice medicine safely. CONCLUSION: This decline is hazardous not only to the medical profession but also to society. Reforms consisting of balanced rescheduling of medical curricula and optimum resource allocation have been proposed to improve the standard of education of doctors.

Human body donation programs in Sri Lanka: Buddhist perspectives.

Considerable attention is being given to the availability of bodies for anatomical education. This raises the question of the manner in which they are obtained, that is, whether they are unclaimed or donated. With increasing emphasis upon the ethical desirability of using body bequests, the spotlight tends to be focused on those countries with factors that militate against donations. However, little attention has been paid to cultures where donations are readily available. One such country is Sri Lanka where the majority of the Buddhist population follows Theravada Buddhism. Within this context, the expectation is that donations will be given selflessly without expecting anything in return. This is because donation of one's body has blessings for a better outcome now and in the afterlife. The ceremonies to honor donors are outlined, including details of the "Pirith Ceremony." The relevance for other cultures of these features of body donation is discussed paying especial attention to the meaning of altruism and consent, and justification for the anonymization of cadavers. The degree to which anatomy is integrated into the surrounding culture also emerges as significant.

Where does New Zealand stand on permitting research on human embryos?

In many respects New Zealand has responded to the assisted reproductive technologies (ARTs) as positively as many comparable societies, such as Australia and the UK. Consequently, in vitro fertilisation (IVF) and pre-implantation genetic diagnosis (PGD) are widely available, as is non-commercial surrogacy utilising IVF. These developments have been made possible by the Human Assisted Reproductive Technology (HART) Act 2004, overseen by its two committees, the Advisory Committee on Assisted Reproductive Technology (ACART) and the Ethics Committee (ECART). However, New Zealand stands apart from many of these other societies by the lack of permission for scientists to conduct research using human embryos. There is no doubt this reflects strongly held viewpoints on the part of some that embryos should be protected and not exploited. Legitimate as this stance is, the resulting situation is problematic when IVF is already designated as an established procedure. This is because the development of IVF involved embryo research, and continuing improvements in procedures depend upon ongoing embryo research. While prohibition of research on human embryos gives the impression of protecting embryos, it fails to do this and also fails to enhance the health and wellbeing of children born using IVF. This situation will not be rectified until research is allowed on human embryos.

Using and respecting the dead human body: an anatomist's perspective.

In his stimulating article enquiring into what the living owe the dead, Wilkinson (2013, Clin. Anat. DOI: 10.1002/ca.22263) sought to unpack a range of ethical questions of considerable interest to anatomists. In this, he looked closely at the extent to which we are or are not to respect all the prior wishes of the deceased, and the implications of this for the role of the family in providing consent, the use of unclaimed bodies, and the public display of bodies. Some of his conclusions challenge widely encountered views by anatomists. In this response I have re-visited these topics in an attempt to ground his arguments in the experience of anatomists, by emphasizing the many intimate connections that exist between each of these areas. The following emerge as issues for further debate. I accept that the wishes of the deceased are preeminent, so that authorities should make every effort to abide by these. This reiterates the importance of body bequests over against unclaimed bodies, and provides a context for assessing the role of family consent. This has repercussions for all activities employing dead bodies, from the dissecting room to public plastination exhibitions. In determining the extent to which the wishes of the deceased are followed the input of other interested parties is a relevant consideration. An ethical assessment of the public display of bodies needs to take into account the nature of the plastination process.

I see dead people: insights from the humanities into the nature of plastinated cadavers.

Accounts from the humanities which focus on describing the nature of whole body plastinates are examined. We argue that this literature shows that plastinates do not clearly occupy standard cultural binary categories of interior or exterior, real or fake, dead or alive, bodies or persons, self or other and argue that Noël Carroll's structural framework for horrific monsters unites the various accounts of the contradictory or ambiguous nature of plastinates while also showing how plastinates differ from horrific fictional monsters. In doing so, it offers an account of the varied reactions of those responding to exhibitions of plastinated whole bodies.

Anatomy's use of unclaimed bodies: reasons against continued dependence on an ethically dubious practice.

The use of unclaimed bodies has been one of the distinguishing features of the anatomy profession since the passing of nineteenth century legislation aimed at solving the problem of grave robbing. Only in more recent years has the use of bequeathed bodies supplanted dependence upon unclaimed bodies in many (but not all) countries. We argue that this dependence has opened the profession to a range of questionable ethical practices. Starting with contraventions of the early Anatomy Acts, we trace the manner in which the legitimacy of using unclaimed bodies has exposed vulnerable groups to dissection without their consent. These groups have included the impoverished, the mentally ill, African Americans, slaves, and stigmatized groups during the Nazi era. Unfortunately, ethical constraints have not been imposed on the use of unclaimed bodies. The major public plastination exhibitions of recent years invite us to revisit these issues, even though some like Body Worlds claim to use bequeathed bodies. The widespread use of unclaimed bodies in institutional settings has lent to these public exhibitions a modicum of legitimacy that is needed even when donated bodies are employed. This is because the notion of donation has changed as demonstrated by consideration of the principles of beneficence and non-maleficence. We conclude that anatomists should cease using unclaimed bodies. Difficult as this will be in some cultures, the challenge for anatomists is to establish relationships of trust with their local communities and show how body donation can assist both the community and the profession.