Some people choose to have their bodies donated after their death for the advancement of medicine and education.
While such donations are declining in Hiroshima Prefecture, there is a growing need for cadavers for medical and dental students to practice anatomy skills, as well as for the training of doctors in surgical techniques as medicine becomes more advanced.
In late October, around 50 second-year students at Hiroshima University’s School of Dentistry came face to face with cadavers covered with plastic sheets. Professor Ryuji Terayama of the university's graduate school broke the ice with the students, who appeared nervous, saying, “The bodies before you are your first patients, and they are also your teachers who will tell you many things without saying a word.”
The students all offered silent prayers and picked up their scalpels.
At Hiroshima University, anatomy practice sessions are also held at the School of Medicine, including for students in its health sciences program. The university uses 60 to 70 cadavers per year, with one required for every four to eight students.
While digital teaching materials and models are also used in classes, Koji Ikegami, professor of anatomy at the university’s graduate school, said practical training significantly increases the students’ understanding of the human body.
“You can touch and feel the hardness of the blood vessels, or check the fine tissues,” he said.
Ikegami said it is also an opportunity for students to reflect on the thoughts of the donors and their families who donated the bodies in the hopes that they would be used for learning. By working with cadavers, students develop a sense of responsibility and ethics as medical professionals, he said.
The history of body donation in Japan dates back to 1955. The Shiragiku-kai, a nonprofit group that accepts registrations from people who are willing to donate their bodies after their death, was established at Tokyo University that year. The group went on to set up shop in other parts of Japan, including at Hiroshima University in 1963.
Anatomy practice at universities had involved not only donated bodies but also those of people who died in hospitals with no known relatives. But with the establishment of the body donation law in 1983, which stipulates respect for the donor’s wishes, more than 99% of cadavers used at universities nationwide are now covered by donations.
In addition to anatomy practice, Hiroshima University began a program called “cadaver surgical training” (CST) in its 2019 academic year, under which donated bodies are used by doctors to learn surgical techniques.
Since many actual surgeries involve life-or-death situations in which every second counts, surgeons often have no time to explain techniques to trainee doctors. According to Ikegami, supervising doctors say that they can teach the trainees without time constraints under CST. The program also benefits patients undergoing surgery, he said.
With the advancement of medicine, cadavers are also being used in the testing of robots and other new medical devices as well as for trialing new surgical methods.
The number of departments and doctors involved in CST at Hiroshima University is increasing every year — in the year ended March 2024, a total of 61 doctors from six departments, including orthopedics and surgery, participated in the program.
Ikegami is concerned that a declining number of body donation registrations might put constraints on training.
Akira Tasaka, the 77-year-old chairman of Hiroshima University’s Shiragiku-kai, said body donations are “gifts” to the next generation.
“If good doctors can be nurtured, they will be able to help our children and grandchildren,” he said.
Tasaka himself registered to donate his body in 2013 — a decision he said was influenced by his mother, who died in 2001 at the age of 90. In her younger days, his mother helped out at a relative's surgical clinic and expressed a desire to donate her body for the advancement of medicine.
Inspired by the fulfillment of his mother's wish after her death, Tasaka registered himself, thinking that she would have liked the idea.
“I've also started to be more careful about illnesses and accidents so that I can donate a healthy body,” he said with a laugh.
In October, Tasaka gave a talk to dental students who were about to start their practical training with cadavers.
“I hope you will improve your techniques and humanity. I am looking forward to the time (of my own donation), and I am living my life to the fullest now,” he told the students.
After the practical training sessions, the students send letters of thanks to the families of the donors, according to the university.
Letters from last year were filled with words of gratitude and determination.
One read, “I was impressed by the complexity and beauty of the human body,” while another read, “Truly, this is a profession that deals with human beings.”
One went, “I feel like I learned how to prepare myself to face patients.”
At Hiroshima University’s Kasumi Campus, where the schools of dentistry and medicine are located, a monument stands with an engraved message that reads, “For those who have donated their bodies to serve as the foundation of medicine.”
Some people come to Hiroshima University to discuss donating their bodies for such reasons as having no relatives or money for a funeral, but the university turns them down because they go against its principle of accepting bodies based on the donors’ wish to contribute to medical education and research.
Those who wish to donate their bodies to the university must first obtain the consent of their next of kin before registering with its Shiragiku-kai. The university cremates the bodies after their use in anatomy or surgery practices and returns the remains to their next of kin within a few years after a donation.
In principle, all institutions accepting such donations across the nation require a will from the donors themselves expressing their wish and consent from their next of kin, though certain universities could have additional conditions.
Dokkyo Medical University in Tochigi Prefecture has a cemetery on its grounds. The university stores at its ossuary the ashes of donors who have no one to claim them, and, after five years, buries them in the cemetery.
While Hiroshima University primarily accepts donation registrations from people who live in Hiroshima Prefecture, Dokkyo Medical University has no such geographical restriction and also accepts them from outside of Tochigi Prefecture. An official from Dokkyo said the number of donations from within the prefecture is insufficient given that there is another institution — Jichi Medical University — in the prefecture that also accepts donations.
Kanagawa Dental University, meanwhile, has concluded a partnership agreement with the city of Yokosuka in Kanagawa Prefecture, which is working to support its residents' "end of life planning." The university accepts registrations from people who have no relatives on condition that they secure in advance the agreement of a third party to claim their ashes afterward, with the city providing support for the procedure.
With your current subscription plan you can comment on stories. However, before writing your first comment, please create a display name in the Profile section of your subscriber account page.