The deputies took up the bodies – Kommersant

The State Duma Committee on Health Protection intends to develop a clear legislative mechanism for the transfer of unclaimed bodies to educational institutions for the training of doctors. United Russia deputy, surgeon Badma Bashankaev said that “the former tradition of teaching” students on cadaveric material is now almost impossible, since “saturation of universities with it” has ended. Universities subordinate to the Ministry of Health claim that “there is no shortage of biomaterial for educational and scientific purposes.” However, doctors admit that there are problems with the transfer of bodies “on the ground”.

In March, Kommersant talked about the unexpected consequences of foreign sanctions. Russian private projects that train doctors in applied anatomy on bodies (cadaver courses) have encountered a shortage of cadaveric material. The main supplier – the United States – stopped selling bodies to Russia. In May, it became known that public educational institutions also had problems in this area. Last week, the State Duma hosted a round table “Legislative regulation of post-mortem activities. Problems and solutions”. It was held by the President of the NMIC them. Dmitry Rogachev Alexander Rumyantsev and deputy, surgeon Badma Bashankaev. According to Mr. Bashankaev, teachers of the departments of anatomy of medical universities turned to him with “an urgent question”. “The former tradition and science of teaching students on cadaver material is now almost impossible. There is simply nothing to teach students on,” Badma Bashankaev explained.

However, he stressed, it is not about sanctions. Referring to the statistics obtained from 40 universities and institutes, Mr. Bashankaev said: “saturation with cadaveric material” has long ended – in some universities five years ago, and in others all 20. “This is due to fear of the security forces and, possibly, due to reading the law in the wrong way. Therefore, we are working. Within 30 days there will be a resolution,” the deputy assured. Because I don’t see surgery, I don’t see teaching anatomy without cadaver material. Electronic tables and paper atlases are great, but nothing can replace the study of tactile skills, namely topographic anatomy on a cadaver.”

Medical schools interviewed by Kommersant deny the existence of a problem. Samara, Kazan, Volgograd state medical universities subordinate to the Ministry of Health reported that there is no shortage of biomaterial for educational and scientific purposes. Thus, the Samara university has its own cadaver center, on the basis of which surgical residents are trained and additional professional education programs for doctors are implemented. In Volgograd, classes for students are held directly at the bases of the pathoanatomical departments. “A well-established procedure and regulatory platform exists and, what is especially important, has been adequately working since the times of the USSR. The medical personnel training system in our country has a number of advantages, including the possibility of teaching students in the “anatomical theater”,” said Svetlana Kalashnikova, head of the department of anatomy at the Volg State Medical University.

However, Deputy Chairman of the State Duma Health Committee Sergei Leonov (LDPR) argues that there is a problem and it is “the most acute for medical universities in our country.” Difficulties, the deputy says, arose when government decree No. 750 was adopted in 2012. The document says that the conditions for the transfer of an unclaimed body, organs and human tissues are the request of the receiving organization and written permission issued by “the person or body that ordered the forensic medical examination of the unclaimed body.” According to Sergey Leonov, it all comes down to the fact that the document must contain the signature of a specific official, but in practice no one wants to take responsibility: “Suddenly a relative appears, and they say to him: “Sorry, he is at the university in a bath with formalin” “. As a result, says Mr. Leonov, universities receive one or two bodies in ten years, when “at least one per year” is needed. And even the material that can be obtained does not always meet the requirements: “The corpse can be transferred if relatives are not found within 14 days. But during this time, irreversible processes occur that do not allow for high-quality embalming.”

The head of the KinesioCourse educational project, rehabilitation doctor Mikhail Kasatkin, says that the mechanism for voluntary transfer of the body to science also works inefficiently. Art. 68 of the Law “On the Basics of Protecting the Health of Citizens” regulates that the body, organs and tissues of a deceased person can be used for medical, scientific and educational purposes if there is a written declaration of will of the person made during his lifetime and notarized. “After the physical death of a person, such a declaration comes into force. But if relatives decide to hold a funeral without following his will, few people can prevent this,” says Mr. Kasatkin. And if relatives are ready to fulfill the desire of the deceased, then it is necessary to have the consent of relatives, a death certificate and a conclusion of a forensic expert on the cause of death. There must also be transfer certificates – from the medical institution to which the body was first sent, to the address of the medical university. “The law and additional regulations exist, but there is no local organization. That is, the pathoanatomical departments do not want to do this, and universities do not have special conditions and qualified staff of people who will control this process,” Mikhail Kasatkin sums up.

In his opinion, “from the point of view of the growth of our society above itself,” it is worth explaining to the population that it is normal to bequeath their bodies to science. It is also necessary to create a department that would work with the body of the deceased, “as it is done abroad”: “In the USA or Mexico, only the foot or hand of a person who decided to bequeath himself to science remains in the territory of residence, everything else is sent to the one who bought the body . And accordingly, the organization responsible for this ensures the legal process, plus helps the family to hold a farewell, more often this is cremation. It is these bodies that are bought by both private Russian organizations and state-owned ones – hospitals and universities.

Mikhail Kasatkin clarifies that the supply of foreign cadavers to Russia has now recovered due to parallel imports, usually through Turkey. However, the price has increased several times. As a result, the number of such educational courses has decreased, and their cost has increased significantly, the expert says, and they have become available to an even smaller number of physicians.

Natalia Kostarnova