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The Limits Of Medicine

Cadavers as teachers: the dissecting room experience in Thailand

BMJ 2004; 329 doi: (Published 16 December 2004) Cite this as: BMJ 2004;329:1455

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  1. Andreas Winkelmann, assistant lecturer (,
  2. Fritz H Güldner, full professor2
  1. 1 Institute of Cell Biology and Neurobiology, Centre for Anatomy, Charité University Hospital, D-10098 Berlin, Germany
  2. 2 Section Anatomy, Department of Basic Medical Sciences, Faculty of Medicine, University of the West Indies, Mona Campus, Kingston 7, Jamaica
  1. Correspondence to: A Winkelmann
  • Accepted 7 September 2004

Thailand's approach to body donors offers a good model for resolving the ethical difficulties associated with student dissection

Anatomical dissection is a time honoured part of medical education. Nevertheless, just as the use of human tissue for research has become controversial,1 the use of human cadavers for teaching purposes is surrounded by ethical uncertainties.24 McLachlan and colleagues cited ethical problems as one of their reasons for abandoning anatomical dissection altogether in the newly founded Peninsula Medical School in Plymouth.5

At the heart of such uncertainties lies the ambiguous status of the cadaver, which carries at the same time personal and material qualities. This ambiguity is not easily resolved, which explains why the dissecting room experience can be frightening and fascinating. In this paper, we look to Thailand for a refreshing view on this issue. On the basis of personal experience, mainly from working at Naresuan University in Phitsanulok, central Thailand, we describe how a Thai medical school handles anatomical dissection quite differently from what we (as Europeans) were accustomed to. Although our findings can be largely generalised to the whole of Thailand, we cannot speak for other Buddhist countries.

Source of bodies

In Thailand, which remained an independent kingdom throughout the colonial period, Western medicine was introduced in the middle of the 19th century, mainly by American missionaries.6 7 Use of anatomical dissection for teaching was introduced around 1900. Today, gross anatomy is taught in a preclinical dissection course for second year medical students. Dissection technique and students' proficiency levels are no different from Western standards.

Cadavers are acquired through unremunerated voluntary donation. Like most Western countries, Thailand used to use unclaimed bodies for anatomical dissection, which resulted in a shortage of cadavers until about 30 years ago. Today, it no longer has any shortage of willing …

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