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Cadaver Inquiry Stirs Concerns at Medical Schools

Some fear UCLA probe may hurt other programs' ability to procure bodies.

March 11, 2004|Rebecca Trounson and Lisa Richardson | Times Staff Writers

With the suspension of UCLA's willed body program amid scandal, professors and administrators at other medical schools said Wednesday that they feared the fallout might spread, potentially affecting their own ability to educate students and attract donations.

Under the best of circumstances, "the majority of people are sort of inherently disinclined" to leave their bodies to science, said Allan Basbaum, who heads the department of anatomy at the UC San Francisco medical school. "This certainly doesn't help."

The UCLA School of Medicine announced this week that it would indefinitely suspend, and perhaps permanently close, its body-donor program because of a growing scandal over the allegedly illegal sale of hundreds of cadavers.

The director of the program and an associate have been placed on leave amid suspicion that they sold bodies for personal gain.

Administrators and professors at other medical schools said they were concerned, even though they had seen no immediate effect on their programs. Potential donors were continuing to call to express interest, they said.

At Stanford University, the medical school's willed body program receives donations of 100 to 125 bodies each year, said Lawrence Mathers, chief of the school's anatomy division, which oversees the program. At any time, the school maintains an inventory of 75 to 100 bodies for use in training medical students and research.

"This is all built on trust and a sense of doing something positive for the betterment of science and society," Mathers said, adding that the university had recently updated and formalized its procedures on willed bodies. "If that image is tarnished, it can only hurt."

But he and others said eliminating or restricting such programs would pose serious challenges to medical training. And they said they hoped UCLA's problems, no matter how serious, would not accelerate a move in some medical schools away from the use of cadavers for education and research.

The scandal comes as a few medical schools, including UC San Francisco, are eliminating dissection as a requirement for becoming a doctor. Instead, they are using computer simulations of the body and other alternatives.

But many anatomists consider this technology a poor substitute for the experience of exploring a real cadaver. Those schools that have scaled back dissection still rely on donated bodies to create prosections, professionally dissected samples that are used in teaching. Surgeons also visit the anatomy lab to practice new techniques on corpses.

Working on a cadaver is crucial to a physician's training, both medical and emotional, said Maria Saboia, vice dean for medical education at UC San Diego. The school receives about 200 donated bodies each year, she said.

"Would you like your doctor to do something on you if they've only done it to a computer?" Saboia asked. Cadavers "give people skills, not just in using their hands, but it is a part of the acculturation to becoming a physician -- being there with your hands, your eyes, everything. You face death. You learn from this gift to help the living."

Mathers at Stanford agreed. "We have years and years of evaluation data from our students, which overwhelmingly say that the dissection experience is far and away the most valuable part of the education in anatomy they receive," he said.

The crisis at UCLA has troubled him and many others in the field, Mathers said. "All of us share the initial emotional response to this; mistakes certainly appear to have been made. But it shouldn't, in my view, have anything to say about the value of studying human remains in medical education. It's just too important."

At UC San Francisco, Basbaum said the university receives donations of about 300 bodies a year, using them for education and research in its medical and dental schools and sending some to other institutions throughout Northern California.

Basbaum said that, even though UCSF has eliminated dissection as a requirement, the use of donated bodies remains critically important to the school's teaching and research. "There has to be a balance, and anybody who says we can do without cadavers is dreaming. It's not replaced by a cold image or picture, no matter how good the artist is."

Basbaum said he anticipated that the UCLA problems would lead to new rules and attempts at greater safeguards for willed body programs throughout the UC system.

Already, the university's systemwide auditor has asked for audits of the programs at all five UC medical schools, he noted.

Tightened controls are fine, he said. But he worries that a larger bureaucracy and more hoops to jump through may discourage some potential donors. "What we don't want to do is make it that much more difficult for people to donate their bodies to science," he said. "This is not an easy thing to do."

Bioethicist Michael Shapiro, a professor of law at USC, said that, while wrongdoing in the UCLA program should be corrected, a permanent closing would cause more harm than good.

"The best move all around would be for UCLA to say 'We're on this 24-7, we've already repaired the program, we've got different people in place, please be assured we're going to be hyper-vigilant," Shapiro said. That approach maintains the supply of cadavers, "but you don't completely crash your program."

He also called for a sense of balance in assessing the wrongful behavior at UCLA.

"It's not nice to have the bodies of your loved ones messed around with, but they didn't kill your loved one. Someone is making money they shouldn't make, but the enterprise itself is worthwhile.

"No one is being kidnapped off the street for body parts; nobody's gotten killed; this isn't 'Coma,' he said, referring to the Robin Cook novel and movie in which a hospital harvests the organs of its patients to sell on the black market.

The UCLA scandal should be put in context, Shapiro said. "It's not that it's nothing. But let's have some perspective."

Times staff writer Alan Zarembo contributed to this report.

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