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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