Whole-body donations are an invaluable resource for medical education and development. Most people in Sweden who wish to donate their bodies can do so and thereby benefit medical education and science.
Despite major advances in terms of technical and digital development, there remains a large need for whole-body donations to medical education and development. Sophisticated computer simulation and high-tech imaging technologies cannot replace the added value offered by teaching using donated bodies. These studies also provide us with important information and knowledge regarding differences between individuals, age groups and genders.
Approximately 80 whole body donations take place in Sweden each year, all of which advance medical teaching and development. The recipients of these donations are the teaching departments at universities in Umeå, Uppsala, Linköping and Gothenburg, as well as Karolinska Institutet (KI) in Stockholm. From an international perspective, Sweden has a relatively low frequency of donation. One reason for this may be that people in general know very little about whole body donation. If more people chose to become donors, this would contribute to improved teaching, research and healthcare.
How donated bodies are used
At Karolinska Institutet, most donated bodies are used in anatomy lessons for medical students and, to a lesser extent, for prospective dentists, physiotherapists and, in rare cases, other healthcare professionals. For many students, anatomy courses early in their studies are also their first encounter with a deceased person, something that links to discussion, reflection and targeted teaching regarding medical ethics and professionalism.
Another important area of use is in anatomical training and advancement for specialists at advanced level, especially for surgeons. In Sweden, this is less common as the number of donations is inadequate for this purpose. Whole-body donations are also important to research and development, for example to develop surgical methods and obtaining knowledge in fields where animal experiments are insufficient.
At KI, however, donated bodies are currently only used in first-cycle education and not for research or the training of specialists.
Almost everyone can donate their body
The vast majority of people in Sweden who are between 18 and 95 years of age can donate their body to medical education and development if they so wish. A donor consents to having their remains handled by the anatomy unit at the Department of Neuroscience, Karolinska Institutet.
It is important that, prior to reaching the decision to donate their body, the prospective donor has been given thorough consideration to the matter and has no reservations about entering the donation agreement. This is often expressed as a desire to “benefit medical science”.
A prerequisite for any donation is that, after the donation, the body may be handled freely at the KI anatomy unit. Among other things, this means that there cannot be any restrictions attached of a religious or existential nature regarding the normal use of a deceased person under such circumstances. Some diseases, obesity, injuries or other changes to the body can prevent the body from being suitable for donation or to be handled by the anatomy unit.
For many donors, their decision provides a sense of meaning, an ability to contribute to a better understanding of the human body for the benefit of future generations. This attitude must naturally be met with a serious and respectful code of ethics on the part of the organisation receiving the body, and all those associated with it. The donor has placed great trust in the medical faculty and provided an invaluable resource in the form of their donation. A decision that creates a duty on the part of the recipient of the donation.
If possible, include your family in the decision.
Even if it is a fully personal decision to enter into a whole body donation agreement, it could be wise to inform close relatives or alike about the decision and its implications. Not least to prevent any uncertainty regarding the donation or differences of opinion about how the body should be handled after death.
Ensuring the donor’s rights and suitability
The donation agreement ("donationsavtal" in Swedish) is a contract between the donor and the receiving anatomy unit at the Department of Neuroscience, Karolinska Institutet. It is only the donor who can enter such an agreement about their body. Relatives of the deceased cannot donate the body after death.
The donation agreement document, with the donor’s signature, is completed and sent to the anatomy unit. There, a decision is made as to whether the donation can be accepted and whether the wishes and reservations stated by the donor on the form are possible to fulfil. If this is the case, the donation agreement will be signed by a donation administrator or unit manager. The donation agreement will be archived at the anatomy unit at KI, and a copy of it will be returned to the donor together with a donor's card. Only then is the proposed donation valid.
The donor is responsible for ensuring that the agreement is stored somewhere known to their next of kin, as well as for informing any healthcare provider about the decision.
The donation agreement includes information about funeral wishes. It is important that the form is completed as thoroughly and clearly as possible, and that the donor contacts the anatomy unit should any changes need to be made to the donation agreement.
The donor can discontinue the agreement at any time without giving a reason. Contact the anatomy unit by post, e-mail or telephone. Contact information is available further down the page. Please also note that the anatomy unit can discontinue the agreement, should the body for some reason prove to be unsuitable for donation after death.
Organ donors and whole-body donors
In certain cases, an individual may be interested in two different types of donation; the donation of organs for life-saving transplants and whole-body donation for medical teaching and development purposes. If so, the individual in question may be both registered as an organ donor and have entered into a whole-body donor agreement.
In practice, it is impossible to first be an organ donor and then be accepted as a whole-body donor. The basic attitude of the medical profession in cases where both a life-saving transplant and a while body donation are possible, is that a life-saving transplantation must take precedence.
Those with an interest in both types of donation can therefore register as an organ donor and also enter into a whole body donor agreement. The circumstances surrounding their death will then decide which type of donation they will make.
What happens after a donor has died?
The anatomy unit at KI should be contacted as soon as possible after the death, either by a relative or healthcare official. A check will then be made that the donation can still go ahead. Among other things, this involves checking that the attending doctor has been able to confirm cause of death without an autopsy (an autopsy makes donation impossible), that the person did not carry or die from an infectious disease or that the body is not damaged in some other way. If the next of kin does not wish to proceed with the donation, it will not take place, irrespective of the donor’s wishes.
If the donor is still suitable, their body will be transported from the morgue to KI’s anatomy unit. Once there, the body will be embalmed and then used for teaching purposes. After approximately one to two years, the body will be cremated – if the agreement does not state anything else – and returned to the family for burial. However, a symbolic funeral service has normally already been held a couple of weeks after death.
About donor anonymity
The donor’s identity is strictly protected throughout the donation process. The donation agreement is stored under high security and is only available to a few authorised individuals. On arrival at the anatomy department, the standard ID bracelet on the deceased is replaced with a neutral code or serial number. All staff and students who come into contact with the donor have a strict duty of confidentiality, both with regard to any aspect that may identify an individual and observations made of the donor.
If an image is taken of the body, for example a photograph, no distinguishing features, tattoos or other characteristics that may be linked to the donor’s identity may be included. The donor’s complete anonymity during handling at the anatomy department also makes it impossible to obtain any records or findings regarding the individual's medical condition.
A whole-body donation is a charitable act. No cash reimbursement is made during the donor’s lifetime. However, a completed whole-body donation does relieve the deceased’s estate of certain costs.
The university’s financial undertaking applies within Sweden and covers:
- Transportation costs for the deceased body from the morgue to the anatomy unit at KI, and from KI to the crematory or cemetery.
- Fees to the funeral contractor.
- Costs for coffin and burial urn of basic model
- Costs for cremation and final interment of ashes/remains at a cemetery in Sweden.
The family is entirely at liberty to make additional payments, for example for a more expensive coffin over and above the most basic model, announcements, flowers or officiation. The costs of any memorial service are not met by the university. If a donor has signed funeral insurance, this should primarily cover the costs, while the university is responsible for any excess amount. Please note that KI cannot administrate burials or final interment of ashes/remains at any other location than a cemetery in Sweden. For information about for example scattering the ashes at sea, contact the County Administrative Board (Länsstyrelsen).
For questions about about whole-body donations:
+46 (0)8-33 68 55 | firstname.lastname@example.org
Helkroppsdonation, undervisningsavdelningen neurovetenskap (BZ)
Berzelius väg 3
SE-171 65 SOLNA
Johan Södergren, Autopsy Technician, Director