Guidelines for cadaver dissection in education and research of clinical medicine (The Japan Surgical Society and The Japanese Association of Anatomists).

"Not only must CST or similar activities be conducted in compliance with the conditions set out above (Table ), they must also comply with the legal and ethical procedures. The burden of administrative routines on the department of anatomy may be ideally lessened by organizing an expert committee that arranges the consensus and participation of related sections and divisions in the institution.Aim and general conductThe aim of CST and related activities is to contribute to the social welfare by improving medical safety.The details of the CST protocol must be reviewed and checked by the IRB (or equivalent third-party agency) before and after implementation.Participants of CST must honor the wishes of the donor, as well as pay respectful attention in handling the cadaver through deep understanding of the ethical, thanatological, and religious beliefs of Japanese society. At least one representative from among the CST participants is required to attend the memorial service.Participants should take sufficient care to maintain a good relationship between the registered donors or their relatives and the department of anatomy nurtured through a long history of authentic anatomical education.CST must be conducted on a non-profit basis, with clear and transparent accounting. We do not necessarily prohibit charging the participants with a registration fee to join the CST project. Medical devices necessary for conducting CST can be loaned from private companies regardless of charge. Moreover, we can accommodate instruction staff from companies, such as those showing how to use medical equipment safely (Table ).Administration of donated cadavers and ICThe department of anatomy is the sole center for the registration and administration of donor and cadaver, with the record of cadaver stock well-documented.In principle, cadaver donors for CST are requested to have the IC in writing as a living will, with an explicit statement that they wished for their corpse to be used by medical (or dental) doctors for clinical education or research, such as CST.In addition, upon bequeathal of cadaver, the donor’s family should be informed of his/her living will, and their approval should be obtained. This does not apply to those with no family.The whole sequence of administrative procedures such as acceptance, returning and a set of memorial services must be the same as those for the systemic dissection in undergraduate anatomical education.Review of protocol report and disclosure after the conduct of CSTInstitutions planning to conduct CST or similar activities must have the IRB review the validity and feasibility of the protocol, and give its approval for the implementation.Before the implementation of CST, institutions are required to organize an in-house expert committee, including a member from the department of anatomy, to review the protocols with special references to the aim, methods, number of participants, and the implementation term, before submitting the protocols to the IRB.The protocol for CST or similar activities should indicate the name of the superintending faculty of the department of anatomy and the responsible person from the clinical department.The representative in charge of the implementation of CST should be a professor, an associate professor, or an equivalent medical or dental doctor in the clinical department of the institution concerned. In addition, the representative conducting the training must have an appropriate certification, such as a clinical instructor from the academic society to which he/she belongs.The representative for the implementation of CST and other persons involved in its conduct should report the details of the training (operating costs and COI), whether or not the participants have been charged, and the corresponding fee. If any supply or financial supports are received from third parties such as companies, the details of their involvement (such as the lease of equipment, support for the management costs, sending instructors) must also be reported to the expert committees or equivalent body.Expert committees or equivalent bodies in the institutions should submit a report on the contents of the implementations, including details of costs and the training programs, to the JSS CST-PC in a prescribed format. In case of any surplus or balance carried forward, the reason should be stated clearly.Should the JSS CST-PC have queries on the contents of training, operating costs, or other issues in the report, the Committee may request additional reports from the responsible person in the institution concerned. In addition, if a serious violation of the guidelines is identified, such as conducting training for commercial purposes, the Committee may issue a warning to the parties involved for their non-compliance thereto.The institutions are desirable to disclose the details of CST on their websites.Implementation of CSTCST and similar activities should not increase the routine works of the department of anatomy. Those activities should be conducted in specialized facilities in the institutions, such as in anatomy laboratories.The program should devote enough time to expressing respect and acknowledgment to the donor.Cadavers free of chemical fixation require adequate facilities and stringent management, such as frozen storage and infection control, making it mandatory to carry out CST in a suitable institution with good infection management.Liability for accidents during training and how they must be dealt with should be clarified in advance. All participants should acknowledge these before conducting CST.For promoting medical safety on a national scale, the program enables the medical doctors and dentists outside the institutions to take part in the program.Participants’ names and affiliations must be recorded."