Anatomical Sciences Education MONTH 2018 Anatomical Sciences Education 0:1–8 (2018) Making the Ethical Transition in South Africa: Acquiring Human Bodies for Training in Anatomy Beverley Kramer,* Erin F. Hutchinson, Desiré M. Brits, Brendon K. Billings School of Anatomical Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa While dissection remains the method of choice for teaching human anatomy, ethical require- ments for obtaining cadavers has made the process of acquiring human bodies more strenu- ous for institutions. In Africa and at the School of Anatomical Sciences in South Africa, dependence on unclaimed bodies has been prevalent. The aim of the present study was to determine whether more rigorous application of ethical consent has altered the provenance of the cadavers in the School of Anatomical Sciences, University of the Witwatersrand. The numbers of bequeathed/donated/unclaimed cadavers received over the period 2013–2017, as well as their sex and population affinity were analyzed. The majority (96.8%) of the cadavers dissected over the period were from bequests/donations. Marginally more females than males were available. In addition, the population affinity of the cadavers had changed from a majority of South African African (unclaimed) bodies to a majority of South African White (bequest/donated) bodies. The study shows that even with ethical constraints it is possible to transition from the use of mainly unclaimed bodies to the acquisition of bequeathed/donor bodies. However, there may be challenges in relation to anatomical col- lections in the School as few of the bequest/donated cadavers remain in the School to be added to the collections. These changes also affect the demographics of the Schools’ collec- tions. Anat Sci Educ 00: 000–000. © 2018 American Association of Anatomists. Key words: gross anatomy education; cadaver acquisition; ethics; bequest program; donated bodies; unclaimed bodies; South Africa INTRODUCTION Methods of teaching human anatomy have diversified over the centuries and today include many digital and imaging modalities (Gunderman and Wilson, 2005; Hisley et al., 2008; Kotzé et al., 2012). However, most teachers of anatomy agree that the preem- inent mode of teaching human anatomy remains human dissec- tion (Aziz et al., 2002; Pawlina and Lachman, 2004; Gunderman and Wilson, 2005; Rizzolo and Stewart, 2006; Korf et al., 2008; Romero-Reverón, 2017). This too, is the preferred method of learn- ing by students (Azer and Eizenberg, 2007; Izunya et al., 2010; Mwachaka et al., 2016). Yet the provision of, and procedures for obtaining human bodies vary from country to country and even between institutions within a country (Biasutto et al., 2014a, b). In the historical past, at many medical schools and teaching institutes around the globe, the bodies of criminals and paupers were utilized for dissection. There is a sizeable and discomfort- ing body of literature on grave robbing, body snatching and other nefarious processes (Jones and Fennel, 1991; Richardson, 2001, 2004; MacDonald, 2005; Jones and Whitaker, 2009; Hildebrandt, 2011; Hulkower, 2011; Kaiser, 2013; Humphries, 2014) used to obtain human bodies in the name of human anatomy. Added to this are the heinous practices by the Nazis in Germany and its occupied territories over the period 1933– 1945 (Redies et al., 2005; Hildebrandt, 2008). In the 19 th and early part of the 20 th Century, a dependence on unclaimed bodies for dissection persisted. However, in the late part of the 20 th Century, a change in social beliefs initi- ated the act of body donations and endorsed the ethical and moral dilemmas of anatomists. The transition to making use of donated bodies not only embraced the religious and social beliefs of the individual, but also the right of the individual to choose (Ballala et al., 2011). This right is of fundamental importance as often the choice not to donate is based on fears of misuse of the body or that the body may not be treated with respect and dignity (Rokade and Gaikawad, 2012). In 1968 the “Uniform Anatomical Gift Act” (UAGA) was a turn- ing point for those who wished to donate their bodies in the United States (Ghosh, 2015). In 2008, the Trans European Pedagogic Research Group for Anatomical Sciences (TEPARG) ASE RESEARCH REPORT *Correspondence to: Professor Beverley Kramer, School of Anatomical Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa. E-mail: Beverley.kramer@wits.ac.za Received 20 March 2018; Revised 13 May 2018; Accepted 9 June 2018. Published online 00 Month 2018 in Wiley Online Library (wileyonlinelibrary.com). DOI 10.1002/ase.1814 © 2018 American Association of Anatomists