An Ethical Dilemma: A cross-sectional and longitudinal qualitative study of how donor dissection influences medical students' perceptions of ethics

Donor dissection as anatomy pedagogy remains debated. While short-term anatomy knowledge gains may not be impacted by dissection, studies suggest that student anxiety levels are. Although donor dissection may impact professional development such as teamwork, studies exploring what else students learn from dissection are limited. A potentially rich lens to explore the role of donors in dissection may be medical ethics. To improve the knowledge base related to anatomy education and medical ethics, we evaluated the longitudinal impacts of donor dissection on medical students’ perception of ethics.Following ethics approval, a longitudinal qualitative study was undertaken at an Australian university where student responses to online discussion forums and interviews were analysed using framework analysis.Five themes related to ethics in anatomical education were identified: 1. Dignity, 2. Beneficence, 3. Consent, 4. Justification for versus the necessity of dissection and 5. Dichotomy of objectification and personification. The dominant themes of students’ ethical perceptions changed with time, with a shift from a focus on aspects of the donor as a person, toward the utility of the donor in anatomy education. The impact of donor dissection on students’ perceptions of ethics is complex. The longitudinal approach presented here suggests a strong impact of donor dissection on priming students’ focus on medical ethics, but this changing over time. This research suggests that donor dissection has impacts on students beyond simple anatomical knowledge acquisition and advocates for formal integration of medical ethics with anatomy education.