Ethical considerations

Tampere Surgical Education Centre is an international, non-profit institution, run by a public Pirkanmaa Hospital District. TSEC has a responsibly to follow and further develop its high ethical standards set by the national authorities. The education is conducted by showing respect for human dignity and legal protection of the deceased.

Our permit to operate has been granted by Valvira, National Supervisory Authority for Welfare and Heath. The National Advisory Board on Social Welfare and Health Care Ethics ETENE has given a positive statement of our operation. Permissions include the educational use of cadavers, but not research or development. Therefore, all medical device used during education must have a marketing permit. Partners in cooperation, who would like to use our services, can apply for their own research permit from Valvira, if needed.

A specialist doctor, Medical Advisor, is responsible for the medical and ethical quality, legal matters and agreements of TSEC. A steering group, which assembles at least twice a year, has been established to follow up and promote production of services and different forms of collaboration.

Medical objectives

TSEC aims to improve operative skills and patient safety in Pirkanmaa region, Finland and Northern Europe. Minimizing risks related to surgical procedures by training improve the results and patient satisfactory in the long run.

In spite of advanced models, skills labs and virtual simulators, there is a need to practice surgical procedures in realistic environment. Major part of surgeon’s operative skills is non-technical, involving e.g. situation awareness, decision making, leadership, communication and team work. These skills can best be trained in OR simulating environment. Procedural teaching also makes it easier to discern anatomy and enables the actual feel of tissue handling, which optimally corresponds to a real surgery situation.

Also the other health care professional, participating in patient’s pre- and perioperative treatment, need practice. During an emergency, there is no time for sharing duties. The whole team should be working together following scheduled course of action, which can be trained during a cadaver session in TSEC.

Medical implants remain in patient for years. Therefore, it is of importance to practice their use with no risks for application errors by the users. The incorrect or unskillful use of medical device may lead to unexpected and unmanageable complications. TSEC offers safe and controlled environment to practice the use of implants and equipment without such risks.

Where do the cadavers come from?

The medical and forensic autopsies of Pirkanmaa Hospital District and some other regions are centralized to the same O building. The surgical education is integrated to the process of determination of the cause of death. The cadavers used in training have mainly been subjected to forensic autopsy, and the education takes place within a few days from it. In some instances, the deceased can also be used before autopsy, provided that the training does not hinder the determination of the cause of death. In that case, the organizer must give a detailed list of procedures planned to be practiced before the event. The forensic examiner then evaluates, whether the training can be carried out without causing any harm to the autopsy.

One cannot will his corpse to TSEC. If a person wants his corpse to be used in surgical education, a note in the patient records or living will is enough. It is advisable to tell about it to one’s relatives, too.

Faculty of Medicine and Life Sciences, University of Tampere accepts donated bodies. In that case, they are used for the anatomy training of the medical students. For further information, contact Professor Seppo Parkkila (seppo.parkkila(at)uta.fi).

Guidelines for the cadaver use

The operational permit of TSEC allows the use of cadavers in surgical education, when

  • there are justified medical reasons and the type of procedure is allowed by Valvira
  • one can assume, that the deceased would not have opposed the use
  • the appearance of the deceased is not substantially altered
  • the education will not hinder the determination of the cause of death or organ transplantation
  • the education will not delay the handover to the bereaved and the burial.

All cadavers are treated respectfully as our patients. No body parts are used in our institute. TSEC’s medical staff prepares the cadavers for training, and they are draped as in OR to protect their identity, leaving only the surgical site bare. Only procedures agreed in advance can be performed during the educational event. All incisions must be carefully closed by suturing. Photographing is not allowed in order to protect the legal rights of the deceased. All trainees are required to sign the Assurance of confidentiality of Pirkanmaa Hospital District and comply with the TSEC guidelines. Professionalism is expected from all users and visitors.