Services of thanksgiving at the end of gross anatomy courses: a unique task for anatomists?

The anatomist plays a critical role in the initiation of a balanced attitude to death and dying in the training of medical students (Druce and Johnson, 1994; Nnodim, 1996; Marks et al., 1997). In the course of medical education, anatomists are the earliest to be confronted with problems such as death anxiety of students (Dickinson et al., 1997). Despite the increased use of electronic media, cadaver-based anatomy still plays a central role in undergraduate medical education (Aziz and McKenzie, 1999). Dyer and Thorndike (2000) have summarized recently the evolving purpose of human dissection in medical education. There are several strategies to cope with the problems related to dissection (Tschernig et al., 2000), which are most important at the beginning of the course. At the end of the anatomy course, many students obviously feel thankful to the body donors (Marks et al., 1997). In most faculties (in Germany), a memorial/thanksgiving service is organized to fulfill this need. As we could not find any systematic evaluation on this subject, we sent out a questionnaire to the departments of anatomy of all medical faculties in Germany. We report our findings to stimulate discussion on this type of service, its importance for the students, and its relevance for anatomists. All 36 departments of anatomy responded: 81% stated that they organized such ceremonies, of which 36% had been doing so for longer than 15 years and 25% between 1 and 10 years. The others gave no details. Various names were used, e.g., remembrance ceremony (41%), memorial service (35%), service of thanksgiving (4%), or other terms. The locations included churches (48%), cemeteries (24%), cemetery chapels (17%), lecture halls (7%), and the chapel of the university hospital (3%). Those responsible for the organization were the department of anatomy (59%), medical students (52%), a professor of anatomy (44%), and clergy (38%) (multiple answers possible). The Protestant church was involved in the organization of services in 93% and the Catholic church in 90%. This high level of participation of clergy was surprising, as active involvement in churches is decreasing in Germany, and only 22% of the body donors had asked for a memorial service for their relatives and friends at the department of anatomy preceding preservation. The ceremonies were announced by multiple means: at the anatomical institute (86%), to relatives of body donors (76%), within the university (45%), to student congregations (24%), outside the university (21%), and in the local newspaper (17%). The number of participants varied greatly, partly due to the different numbers of students enrolled at each faculty. The participants were mostly students (some services more than 400), and relatives, student tutors, and anatomists (Table 1). The contributions by the students were of particular interest and document their sincere attitude: students reported including music (83%), readings (69%), sermons (59%), prayers (45%), and/or other things, such as wreaths (15%). Anatomists are confronted with the important duty of dealing with the emotional reactions of medical students to death, dying, and dissection of a human corpse at the beginning of the medical curriculum (Tschernig et al., 2000). Our survey documents the role of anatomists in initiating and/or coordinating a ceremony for the body donors as a token of thanksgiving of the students and anatomists. One can argue whether the term “memorial service” is adequate, as it seems to suggest the loss of a relative or friend. The main attitude of the students is obviously that they feel responsibility and are thankful to the body donors who have helped to enable their adequate training to become a doctor. Anatomists should discuss this topic within their own departments and with the students and learn from each others experiences, not only within their own country but also from the situation in other countries with different historical and cultural backgrounds.