Should Hospital Policy Require Consent for Practicing Invasive Procedures on Cadavers? The Arguments, Conclusions, and Lessons from One Ethics Committee’s Deliberations

In July 1989, nurses at a San Antonio, Texas, hospital were troubled to discover that an intern had practiced endotracheal intubation on a cadaver without prior permission from the patient or his family. The nurses reported the incident to the hospital's ethics committee. By agreeing to study the issue, the committee began two years of unexpectedly arduous deliberations. At the heart of these deliberations lay two questions: Is consent ethically necessary before practicing invasive procedures on cadavers? If so, should hospital policy explicitly require that consent? The deliberations occasionally broke into contentious debate and revealed deep-seated disagreements over such basic concepts as informed consent, families' rights, and physicians' prerogatives. But eventually the committee concluded that consent is necessary and that it should be explicitly required by hospital policy. The committee then drafted a policy articulating those conclusions and persuaded the executive committee of the hospital's medical-dental staff to adopt it....Therefore, we describe the committee's deliberations on the issue, summarize the policy drafted by the committee, and identify valuable lessons for all ethics committees.