Further considerations on the international transfer of donated bodies: The environmental impact

A recent article1 in this journal highlights important ethical concerns surrounding the international transfer of donated human bodies for anatomical education and research. The authors underscore the complexity of cross-border body donation practices, drawing attention to issues of transparency, informed consent, and the potential for concealed for-profit operations. Central to their argument is the requirement for a social license to operate, particularly when donated bodies are sent to institutions in other countries. Such a license, however, should be understood as bidirectional, encompassing both the community in which donation occurs and the society in which the body is ultimately used. Genuine social license depends upon transparency and collective awareness of the full range of implications associated with these practices. It is within this broader framework of accountability that one further implication demands explicit consideration: the environmental impact of international body transfer, which this letter seeks to bring to the forefront of the discussion. Although the environmental impact of anatomical practices in research and education remains underexplored,2 empirical evidence is beginning to emerge, especially concerning the long-distance transfer of donated human bodies. A recent life-cycle assessment study conducted in Italy provides empirical insight into this issue.3 Using the IPCC 100-year Global Warming Potential methodology and Ecoinvent emission factors, the authors quantified the carbon footprint—one measurable component of the broader environmental impact—associated with transport. They calculated that local ground transport (mean distance ~201 km) generated approximately 14 ± 11.84 kg CO2e/body. In contrast, international procurement involving 500 km of refrigerated truck transport and a 7500 km intercontinental cargo flight resulted in an estimated 450.375 kg CO2e/body for transport alone—a more than 30-fold increase relative to local sourcing. Although transportation is not the sole contributor to the total environmental footprint of anatomical practice—ventilation, refrigeration, embalming chemicals, and consumables also contribute substantially—the transport differential between local and international sourcing is striking. Importantly, the study did not include additional emissions related to the potential return of remains to families, which is common in some US programs; therefore, the environmental burden of international transfer may be underestimated.3 This environmental consideration does not negate the realities of donor shortages in some regions. Rather, it strengthens the case for developing robust, transparent, and community-supported local donation programs. Social license—discussed as a prerequisite for ethical international transfer1—may also apply to environmental accountability. Communities who support body donation programs may reasonably expect that such programs operate in ways that minimize unnecessary ecological harm. Furthermore, prioritizing local donation aligns with the principles of reduction and reuse. Reducing long-distance transportation lowers carbon emissions and maximizing the educational and research utilization of each donated body improves resource efficiency. Environmental stewardship thus complements, rather than competes with, ethical and educational priorities. In conclusion, the international transfer of donated bodies should be examined not only through ethical and legal lenses but also through the framework of environmental sustainability. The donated human body remains indispensable to medical education and research. However, when equivalent educational outcomes can be achieved through locally sourced donations, the substantial carbon burden of intercontinental transport warrants serious consideration. Promoting transparent, community-supported local body donation programs may therefore represent not only an ethical imperative but also an environmentally responsible one. In the context of the global climate crisis, practices surrounding body donation should strive to advance anatomical sciences education without imposing unnecessary environmental harm. Goran Štrkalj: Conceptualization; investigation; methodology; writing – original draft; writing – review and editing; project administration. Goran Štrkalj, PhD, SFHEA, is a professor of anatomy at the University of New South Wales in Sydney, Australia. He teaches anatomy and biological anthropology to science and medical students. His main research interests are in anatomical sciences education, human biodiversity, and history of science.