Industry reacts to MailOnline piece about cadaver injectables courses
MailOnline has sparked debate with an article about how NHS trusts are giving cadavers away for use by private aesthetics course providers, who charge doctors, nurses and dentists up to £1,440 to practice cosmetic techniques on the bodies.
The article, which criticises the use of bodies donated to the NHS for medical research for private training courses for cosmetic treatments, has received mixed reactions from key figures in the aesthetics sector.
"Deeply concerning"
Dr Patrick Treacy felt that the article raised serious ethical questions regarding the use of donated remains and the boundaries of medical education.
"As shocking as it may sound, the revelation that bodies donated to the NHS are being used for cosmetic training purposes is deeply concerning," commented Dr Treacy. "While it's understandable that medical professionals need practical training to administer procedures like toxin and fillers safely, using donated bodies for such purposes, especially for private aesthetics courses charging significant fees, seems ethically dubious."
Dr Treacy also stated that the act of severing heads from donated bodies to teach cosmetic techniques goes beyond the bounds of what most donors would expect their bodies to be used for when they make the altruistic decision to donate their remains to medical education and research.
"Moreover, the fact that these aesthetic treatments are not available on the NHS adds another layer of complexity to the issue," he continued. It suggests that these procedures, which are often associated with cosmetic enhancement rather than medical necessity, are being prioritised over other potentially life-saving treatments that could benefit from medical education and resources."
Dr Treacy stated that the practice underscores the need for clearer guidelines and oversight regarding the use of donated bodies in medical education: "Transparency and informed consent should be paramount, ensuring that donors understand how their bodies will be used and for what purposes. Additionally, there should be scrutiny over the allocation of resources within the healthcare system to ensure that educational practices align with the broader goals of improving public health and well-being. Ultimately, while medical education is crucial for advancing healthcare practices, it must be conducted with the utmost respect for donors' wishes and ethical considerations.
"The current revelations highlight a need for reflection and reform within medical education and practice to uphold these principles."
"Helps medics deliver safer treatments"
Dr Sabika Karim attended the cadaveric anatomy course at Nottingham Hospital to which the original article refers.
"Even though botulinum toxin injections and fillers are unregulated and can unfortunately be performed by anyone in the UK, it is really important that the injectors should have a real understanding of anatomy for both safe and successful treatments," said Dr Karim. "That is why it is essential that medics (doctors, dentists and nurses) who are delivering the treatments make sure they keep up to date with their training and learning."
Dr Karim continued that learning and revising facial anatomy in 3D on cadavers not only allows a better understanding of the anatomy, but also the variation between patients: "It allows us to visualise muscles and the relationships between the muscles, so we can better deliver botulinum toxin treatments, which, in experienced hands, are not just for lines and wrinkles, but can have a profound effect on a patient, both in respect to function and aesthetic. Providers treat a whole host of conditions which could be treated in the NHS, but we treat them in clinic and take pressure off the NHS."
With respect to fillers, Dr Karim stated that learning the 3D anatomy of the arteries lowers complications and helps medics deliver safer treatments, which is invaluable as improper treatments and complications can have a negative impact on a patient's physical and mental health.
"The 3D anatomy of the blood vessels is also of utmost importance when treating complications, which I see on a regular basis in my clinic from non-medic practitioners, who do not know how to treat these complications and are not equipped to do so, which takes pressure off the NHS.
"There is no substitute for learning on cadavers and aesthetic medicine should be recognised as a medical field. All cadavers are treated with the utmost respect when we learn and I am thankful to the people and the families of the people who have so generously donated their bodies to learning, as it makes the practice of aesthetic medicine safer, and has helped change the lives of many patients, including my own, for the better."
"Essential for continuing learning"
Nurse Claudia McGloin took umbrage with a comment in the article stating that "aesthetics isn't medicine".
"Cadaver dissection is essential for our continuing education and learning. It's about patient safety at the end of the day! Any cadaver training I've ever been on was professionally organised," continued McGloin. "It was insightful and extremely beneficial. The cadavers were treated with the utmost respect. Those that donated their bodies for science and research did just that. We are talking about doctors, dentists, and nurses learning, not lays."
“Better and safer practitioners”
Dr Jenny Doyle agreed that it is a controversial subject. “When patients donate their body to science, they don't often consider all of the potential uses,” she added. “Aesthetics is very much a speciality within medicine and medical professionals within the field will be better and safer practitioners having had the opportunity to partake in cadaver training. Throughout all other areas of medicine, it is used. In some ways, given how unregulated the private market in aesthetics can be, I think it may be even more important in this sector given the lack of a formal training pathway that is needed to practice within aesthetics.”
“The need for the best training has never been more important”
Dr Anna Hemming stressed the importance of training, anatomy and managing complications, saying it provides valuable training for medical professionals to ensure safety and minimise the risk of severe complications arising: “Cadaveric training gives the best training for medically qualified doctors, dentists, and nurses to ensure the medical management of complications arising from regenerative medical treatments and corrective procedures.
“Science is evolving all the time and the need for the best training and real anatomy knowledge has never been more important. With so many rogue injectors within the aesthetic industry, it is so important that medical professionals retain their anatomy and complications training, keeping those who are properly trained and the very best in the profession able to assist those presenting with serious medical complications.”
"Ethically approved research"
Steven Gill, the Nottingham University Hospitals NHS Trust's clinical lead for the National Repository Centre, defended the supply of donated bodies for use by the aesthetic course providers.
"These bodies are highly valued and respected and are used for ethically-approved research and training of registered healthcare practitioners only," he commented to MailOnline, adding that all bodies were used in accordance with UK regulations, with the Trust making no money from the arrangement.
"All procedures are carried out by trained medical professionals, under strict guidance," Gill added. "This allows us to offer safe training to medics in a risk-free environment before embarking on clinical practice. We do not make money from the donated bodies; we only cover the costs of storage, preparation transport and ultimately a funeral."
Another aesthetics-based cadaver course is held by SkinViva Training at University Hospital Coventry and Warwickshire NHS Trust's West Midlands Surgical Training Centre.
The course, which costs participants £1,350 each, is only open to registered medical professionals like doctors, nurses, and dentists.
SkinViva Training's head of anatomy and clinic, James Ashton, defended the training to MailOnline.
"It is not aesthetics focused at all, it's focused on complications management and anatomy," he said. "They are complications that can arise from somebody having an aesthetics treatment."
Ashton also insisted that the course was not about improving safety, as opposed to teaching people how to apply the filler in the first place.
"The course is about everything to do with how to avoid complications when applying filler, so we teach about human anatomy, so where you should and shouldn't be injecting," he added. "It teaches them how to do it safely and how to manage complications should they arise."
Although Mr Ashton said he understood the 'emotional' reaction people might have to donated bodies being used for this purpose, he felt it had a net benefit to the NHS.
"If we don't teach people how to deal with them then they (injured aesthetics patients) all enter the NHS anyway," he said. "A lot of the people who are having, and enjoying, an aesthetics career also still continue to work in the NHS and will now have a solid understanding on what to do should this present in A&E or a doctors' surgery," he concluded.