Earlier this month we caught up with the director of RSU Institute of Anatomy and Anthropology (Anatomical Theatre) Professor Māra Pilmane to talk about the subjects of training prospective physicians and 21st century’s morals and ethics.
What changes, if any, has the anatomical theatre experienced lately?
As you see, the anatomical theatre is undergoing reconstruction. This is already the third, however the most fundamental reconstruction undergone since the 80ies of the previous century. The improvements are comprehensive – paved inner yard, created students’ area and practically complete reconstruction of the entire building. We gladly tolerate the inconvenience, since we expect that the anatomical theatre will become a castle – a masterpiece it has probably never been! The deepest gratitude for that, without flattering, should be expressed to the university’s rector, Department of Infrastructure and everyone involved in the construction work.
In addition to that we are looking forward to the arrival of the museum. The former horse stall building in the yard will be turned into RSU museum which will also become the holder of the anatomical exposition, the former Jēkabs Prīmanis Museum of Anatomy. Hitherto it was under the administration of the Museum of the History of Medicine and today it is officially coming back home, as far as this was our collection. The way things go is fantastic and I am really satisfied about that. The anatomical theatre will now host two museums – a branch of Jēkabs Prīmanis Museum of Anatomy which will be incorporated into RSU museum and the collection or exposition of our Institute of Anatomy and Anthropology from which we can take preparations and tissues more freely than, for example, from some state museum.
My heart starts missing a beat even imagining how beautiful it will be! I think that we, the entire university, have long deserved it!
We have introduced modern technologies in the study process. Last year we purchased a modern virtual 3-dimensional dissecting table which has stirred much interest not only in Latvia but even Europe-wide. Our colleagues from Tartu and Vilnius have come to see it and now are acquiring identical devices for themselves.
It is a unique acquisition, the operating table allows for dissection of real life human bodies of both genders in electronic form, perform various cuts, rotate the image etc. The table contains 600 diverse clinical cases with x-ray images, back preparation and structure repetition modes.
At present it is even hard to think of something we do not have! Our anatomical theatre has everything! We desire an anatomical hologram programme, however as for today no such programme is available in the world – it is still in the process of elaboration.
What is preoccupying your mind as the New Year approaches?
I think we have to intensify the discussion on ethics with general public and, definitely, with students. This is the century of ethics! Students should keep this in mind as soon as they step over anatomical theatre’s doorstep. This is a place where death helps the living. Death should be honoured and respected, treated with due care, as far as the anatomical theatre displays bodies of deceased.
It is prohibited to take photos in the anatomical theatre and this is not a kind of oddity introduced by us. People who have donated their bodies to science and medicine would not be happy to know that the pictures of their bodies are posted on social networks and commented upon. It is a morally wrong and deeply unethical conduct!
If it is hard to understand, I have to remind that this is a violation which can lead to exclusion from the university. We have to show due respect to those who have given a thought of prospective medical practitioners who could learn from them.
Study materials offered by the anatomical theatre should be handled with care. It is also not allowed to obtain anatomical materials in illegitimate manner – an occasional practice in the years of Soviet rule. A true medical practitioner is not one with a skull at home, this, forgive me for saying, is a medieval perception and it is quite a surprise that no criminal proceedings have been initiated against them. There are two locations for dead tissues: graveyard or anatomical theatre.
I would like to make use of the occasion and address all colleagues who have come into human bones or skull from the times missing ethical consciousness and to bring them back to the anatomical theatre. We will accept and register these articles who will afterwards officially serve for educating future medical practitioners. The second option, of course, is to wait for the police to arrive and explain the situation to them. There is also the third one – which, I would not deem to be entirely official – to bury the skull singlehandedly. Let us respect the fact that no possession of deceased person’s tissues is allowed!
The rules of the anatomical theatre are binding upon everyone entering the theatre. Another thing to be respected is that following entry of the anatomical theatre you have to take your hat off. It has to be remembered that in Latvia men pay tribute to deceased by taking their hats off. This is an integral part of our culture. Herewith we give due respect to the dead.
As you already mentioned, modern technologies are introduced into the study process, but is it possible to acquire anatomy without natural materials?
The cycle of believing that medicine can be acquired by virtual anatomy and plastic modules only, has closed. It was clearly and loudly admitted already during the annual congress of the International Federation of Associations of Anatomists in 2008 that we colleagues have been wrong, thinking that human anatomy can be mastered by looking at plastic models and now we return to prosection. This path back to where we started has been taken by the world’s largest universities for medicine. We are glad that RSU anatomical theatre has never given up on prosection. Thus, we have always been current.
We have been facing a number of unexperienced and at times embarrassing issues lately....
For example a person devotes his body to anatomical study and commits suicide afterwards. Such situations make us contemplate on the following: donation of one’s body to medicine is a generous and charitable gesture without any monetary reward. This is a mature decision, commonly not taken overnight, there are cases when people call the anatomical theatre to discuss this issue.
Suicide corpses present a truly severe moral and ethical dilemma and we are forced to think of where the gesture of charity has vanished, considering that a person committing suicide is unable to demonstrate charity towards himself. This consideration seriously hinders us from accepting the body. Moreover, every suicide is first investigated by the police and therefore we practically always refuse to accept the body.
Another moral and ethical issue which has gained topicality in the last few years is that relatives address the anatomical theatre with the willingness to donate the body of a person to medicine while the person is still alive. I have to think of where our society is heading to. What are the reasons behind it? Could it be because of financial considerations – no funeral arrangements, death allowance received… I would fear if I have hit the target! Anatomical theatre is not a kind of service which accepts bodies of deceased in case the relatives cannot afford to bury them. Such cases confuse us. We treat the bodies of deceased with deep respect and are grateful to persons who have donated their bodies to medicine; however, there is room for the question on whether it indeed has been a gesture of charity. What have been the underlying reasons for making this choice? Maybe this is the area of authority of police? What has happened to deeply ethical issues faced by the society? We ourselves have no answer to these questions.
The age of social networking unfortunately has thrown open the gate of permissiveness, despite that, no moral and ethical norms have been abolished! Every prospective medical practitioner should remember this!
Where and when RSU medical students can access natural and artificial bones, skulls etc. for proper acquisition of anatomy?
The laboratory of anatomy where every student can work with artificial and natural materials by presenting his/her student’s card is opened not only on working days but also on Saturday. Students take the materials they need, find a cosy place for acquiring knowledge, study them and return the materials to the laboratory the same day. The old problems with availability of materials are a history, at present all materials are freely accessible to students. In case you intend to visit us on Saturday, we would advise to apply in advance, as far as the availability of technical staff is limited and we have to first serve the students who have applied their needs beforehand. Commonly there are no problems with this procedure which has been accepted by local and also foreign students.