It was a government promise after the Paris-Descartes scandal. In application of the bioethics law adopted in June 2021, the new rules for the conditions of body donation to science were published on April 28 in a decree in the Official Journal. Several notable changes are shaking up the old regulations, such as the cost of transporting the body to the reception center (previously paid by the family of the deceased) and the systematic establishment of an ethics committee. in these establishments.
But the text aims above all to be more transparent by laying down a clear legal framework, after the revelation of the affair of the “temple of French anatomy”. Supporting images, the express had revealed in November 2019 that putrefied remains were piled up in a dilapidated room at the University of Paris-Descartes. A blackened arm eaten away by a mouse, moldy faces, blood flowing along a clogged pipe… The photos taken between 2016 and 2018 shocked the country. And asked the following question: what respect for those who have agreed to give their bodies to science? What ethics? These revelations subsequently led to four indictments in 2021, including those of the Parisian university and former president Frédéric Dardel for “attack on the integrity of a corpse”.
In France, 3,000 people donate their bodies to science after their death at some thirty centres. This bioethics law, summarized in the decree, therefore aims to restore the confidence of those who make this choice. Assure donors that, before, during and after research activities on their remains, their integrity will be respected. Release goes around this overhaul of the rules.
How do the establishments receiving donations operate?
A major novelty, the decree provides for the systematic creation, in each structure, of a “ethical, scientific and educational committee responsible for issuing an opinion on training programs and research projects requiring the use of donated bodies”. For example, if a facility manager wants to authorize the segmentation of the donor’s body (a very marginal practice nonetheless), he will have to refer to the ethics committee. Ditto for the temporary release of a body outside the establishment. “The decree formalizes the fact that these practices must remain derogatory and submitted beforehand to the ethics, scientific and educational committee of each center for body donations”emphasizes the ministry to Release.
Finally, the ministry in charge of these centers (like that of Higher Education and Research) will be responsible for authorizing, for a period of five years and on a renewable basis, any establishment that hosts these bodies. An authorization that can be suspended and withdrawn at any time if violations are observed. The ministry further states that “practicing donation centers will have to comply with these new regulations”.
How do we collect consent?
Nothing really new in this first stage of the process: consent, gratuity or even anonymity were already part of the main principles of body donation, but the text recalls its importance and clarifies the stages. After receiving documentation on the subject from the establishment authorized to receive bodies, the person who wishes to donate agrees “by a written statement in full, dated and signed by him”, indicates the decree, in application since Friday. The latter undertakes to carry a donor card at all times. But this consent is revocable at any time, under the same conditions.
No payment can otherwise be allocated to the person who consents to the donation. The donor is encouraged to inform his family or friends of his approach. The establishment, if it is ultimately unable to accept the body after the death of the donor, “this one [sera] routed to the nearest authorized establishment capable of receiving it”.
What methods of transport and reception of the bodies?
Before the entry into force of the decree, transport costs were paid by the donor or his relatives, as confirmed by the Ministry of Higher Education, which affirms that the old regulatory system was “incomplete”, since he “did not mention the care upstream of the arrival of the body at the donation centers”.
As a reminder, this other derivative of the Paris-Descartes affair: the center provided donors and their families with a shortlist of five or six funeral carriers, while several hundred were authorized to move the bodies. In an article from World, a relative testified that he had thus paid 900 euros to see his “grandmother in a black bag”, while“we wondered if the van was refrigerated”.
With the decree, the establishment having obtained the consent now takes “integrally” in charge “the costs relating to the transport of the body”. He ensures that transport operations are “completed within a maximum period of forty-eight hours from the death”. When the body arrives at the scene, the reception structure “ensure its conservation until the end of the medical teaching and research activities”. An identification number is also assigned to it for “guarantee the confidentiality of the identity of the donor”.
Medical teaching and research activities must then be carried out in a “maximum period of two years following the reception of the body”. By ensuring “the best catering possible” of the body, the establishment judges which funeral operation is the most suitable, taking into account the preference expressed by the donor or the reference person designated by him.
What are the conditions for carrying out funeral operations?
Since 1996, an article of the general code of local authorities implied that the establishment takes care of funerals according to its own organization. “In practice, the establishment most often cremated the body and scattered the ashes in the communal garden of remembrance”explains the ministry, but adds that, on a case-by-case basis, “restitution procedures could be put in place”.
Donors and their relatives now have a clear choice, the family has the opportunity to take care of the funeral. The research establishment always offers to cremate the body if necessary: in this case, the ashes are ultimately returned to the referring person or a relative. Each year, the institution also organizes a ceremony of remembrance in honor of the donors.