Doctors get OK to use human heads for anatomical studies

In a country where the idea of donating body parts for medical and educational purposes is still considered a sensitive issue, Indonesian neurosurgeons expressed relief after receiving a green light from Muslim representatives and medical ethics experts to use human heads (yes, just the heads) for anatomical studies.

"Such practices have been performed years ago in countries like the United States or Japan. We already have bylaw 18/1981 on anatomical cadaver surgery but there is still the cultural problem," Agus Purwadianto, secretary of the Medical Ethics Council, told a press conference at the Siloam Gleneagles Hospital in Karawaci, Tangerang.

"Our society still cannot not accept the idea of separating body parts, moreover a head, particularly if it is a dead relative, even though it is for medical studies," he added.

The press conference was held to coincide with the hospital's hands-on surgical anatomy workshop for around 40 local and foreign neurosurgeons last weekend.

The Rp 1-billion, skull-based surgical approach workshop was held to help prepare the hospital to host the 2004 Asian Neurosurgery Congress, which will be participated in by 500 neurosurgeons worldwide.

Both director of Muslim organization Madania Komaruddin Hidayat and the country's largest Muslim organization Nahdlatul Ulama (NU)'s legal division head Masdar Sarid stressed that since there were no objections expressed in the Koran, it could in principle be allowed because it may help to save lives and was for the good of mankind.

However, Masdar said that he would still discuss the issue further with other NU leaders.

In the first workshop held in the country, the hospital received 12 head specimens from Bandung and the United States for the participants.

Two of the specimens were sent from the United States for which the hospital's counterpart Japan-based Fujita Health University had to spend US$15,000 plus another Rp 4 million (US$451.5) fee to get them out of the airport.

"Both specimens will be returned to the United States and will be rejoined with their remains for proper burial," said president of the Asian Conference of Neurological Surgeons (ACNS) Eka J. Wahjoepramono.

He emphasized that donating one's body or body parts after death was still a controversial issue in Indonesia, let alone to surgically remove the head for anatomical studies.

Another speaker, Kahdar Wiriadisastra, chairman of the Association of Indonesian Neurosurgery Specialists (PERSPEBSI), also said hospital's here only grant permission to use an unidentified corpse after at least 48 hours, to allow time for the family (if any) to claim the body.

He said that after 48 hours, the specimen was no longer ideal for (brain) anatomical study.

Eka explained that the ideal specimens were bodies which were decapitated within six hours after death. In this condition, the head can be preserved to maintain a condition as consistent as possible with the head of the living person. These specimens are also injected with dye to identify veins and arteries. Veins are dyed blue and arteries red.

"A mastery in detailed anatomical knowledge and experience in the delicate handling of the highly complicated human brain is needed before (brain) surgeons handle a patient," he said, describing the intricate skull-based surgery that requires at least 10 hours to perform.

And in the long run, these restrictions can hamper neuro- surgical development in the country because it is impossible for local brain surgeons to receive proper training due to problems in obtaining ideal specimens locally, said Jakarta chapter of the Indonesian Doctors Association (IDI) Prijo Sidipratomo.

The experts said the availability of head specimens would benefit medical students, brain surgeons and other experts for the advancement of medical technology in neuroscience in the country as well as the public in general.

"If we can get more specimens, we can hold trainings here without having to spend millions of rupiah to import them or send local surgeons abroad for training," Prijo said.

-- Maria Endah Hulupi