Anatomy Act: The Way Forward

BEING A KEYNOTE ADDRESS DELIVERED AT THE OPENING CEREMONY OF THE 14TH ANNUAL SCIENTIFIC CONFERENCE a AND ANNUAL GENERAL MEETING (AGM) OF THE ANATOMY SOCIETY OF NIGERIA (ASN) HELD AT BABCOCK UNIVERSITY, ILISAN-REMO, OGUN STATE ON TUESDAY 8TH AUGUST, 2017

ANATOMY ACT: WHAT NEXT?


BY

RT. HON. FEMI GBAJABIAMILA

INTRODUCTION

Protocols.

Today, history is being made by the Anatomy Society of Nigeria, (ASN) having been able to secure the presence of distinguished men and women from all works of life, particularly professionals in the field of medical science and more particularly in the field of Anatomy on this great occasion of her 14th Annual Scientific Conference and Annual General Meeting (AGM). It is historical in the sense that by ordinary human assumption, when you hear adverts with regard the Annual Scientific Conference of a scientific body such as the Anatomy Society of Nigeria, what readily comes to mind is that it will most likely be a gathering of Scientists organized by scientists for the purpose of discussing strictly science. But today, we are here in a gathering put together by scientists, comprise predominantly scientists but for the purpose of discussing the legal framework for the advancement of science. In other word, it is a conference of mixed law and science. This is indeed a very welcome development for it is increasingly becoming apparent that for us to develop science and advance our technology, there has to be positive synergy among all professions. We need each other and a symbiotic relationship is essential.

THE KEY OBJECTIVE OF THIS CONFERENCE.

The Theme of this year’s conference is: “Anatomy Act: what next?” Anatomy Act means Anatomy law. It is called an Act being a Federal Legislation of universal application in Nigeria. Not many persons are aware that there is a law regulating the practice of Anatomy in Nigeria. This is partly because of the obsolete nature of the Act as it came into force on the 30th day of March, 1933. The world has taken advantage of research and technological advancement in every field of human endeavor. In this modern and ever changing world, particularly in the area of healthcare delivery, one can safely conclude that the law has become moribund and impracticable; a new law is therefore inevitable.

Before I delve into succinct analysis of the existing Act vis a vis the proposed Amendment Bill, it is important for us to refresh our memories as to what anatomy is all about and its importance in the field of medicine and by extension to mankind. Taking into cognizance that I am standing before medical and anatomy experts, please permit me to adopt the definition of Anatomy as postulated by Prof. Ayodele Desalu in his keynote address delivered during the 2015 conference as follows:

“Anatomy is the study of the structure of the body and the relationship of organs and tissues at a gross (whole organ) and microscopic level (histology) Human anatomy deals with the way parts of human from molecules to bones interact to form a functional whole. The study of anatomy is distinct from the study of physiology, although the two are often paired. While anatomy deals with the structure of an organism, physiology deals with the ways the parts function together. For example, an anatomist may study the types of cells in the cardiac conducting system and how these cells are connected, while a physiologist would look at why and how the heartbeats. Thus, anatomy and physiology are separate, but complimentary, studies of how an organism works”

From the above definition, we can then safely conclude that anatomy is the study of the structure of the human body in order to understand how each component part of human body functions. It is therefore the bedrock of medical training. Professor Desalu went on to state that anatomy is considered to be the most prominent of all biological sciences. According to him, “Anatomy is the corner stone of a doctor’s education”. In the circumstance, a field of medical science that deals with the entire structure of human body, how it functions and what happens in the event of alteration of these structure by illness or bruises, requires appropriate regulation under a sound legal framework in accordance with international best practices. This is the focus and objective of this this conference.

THE EXISTING 1933 ACT

The act contains 12 (Twelve) sections.

Section 1 is the citation of the Act or the short title. “This Act may be cited as the Anatomy Act”.

Section 2 subsection 1 provides that “it shall be lawful for the Minister of Health to grant a license to practice anatomy to the Superintendent of any school of anatomy”.

Sub section 2 of section 2 states that the license shall be deemed to authorize the practice of anatomy in such school by any teacher or medical practitioner employed therein or by any student attending a course of study at such school when working under the supervision of such superintendent, teacher or Medical Practitioner. I want to believe that the above provision is hanging as the section did not make provisions for the basis of the grant of the license. But under section 12 of the Act, the Act provides that the Minister may make regulations for regulating the issue of and prescribing the form of licenses and certificates issued under the provisions of this Act. Such unlimited and unfettered powers to the Minister may portend danger to the development of Anatomy in a country where almost everything is politicized. In the present day global practice, there must be some laid down criteria by a body set up by law to regulate anatomy in a society. Such body also must be vested with the power to grant license to any person who meets the criteria or requirements and not the Minister.

Section 3 provides for an Executor or any one in lawful possession of any deceased person (not an undertaker) to make such deceased available for anatomical examination unless, to the knowledge of such executor or other person, such deceased person shall have expressed his desire, either in writing at any time during his life or verbally in the presence of two or more witnesses during the illness whereof he died, that his body after death might not under- go such examination, or unless the surviving husband or wife or any known relative of the deceased person shall require the body to be interred without such examination.

While I have no issues with this provision, the proviso to section 4 makes little sense of the entire sections 3 and 4. Section 4 provides as follows:

“If any person either in writing at any time during his life, or verbally in the presence of two or more witnesses during the illness whereof he died, shall direct that his body after death be examined anatomically, or shall nominate the superintendent of any school of anatomy, who is licensed under the provisions of this Act to examine bodies anatomically, to make such examination, and if, before the burial of the body of such person, such direction or nomination shall be made known to the person having lawful possession of the dead body, then such last mentioned person shall direct such examination to be made, and in case of any such nomination as aforesaid, shall request and permit any person so authorised and nominated as aforesaid to make such examination unless the surviving husband or wife or any known relative of the deceased person shall require the body to be interred without such examination”

The above provision appeared to be flowing in the right direction until the proviso that “…unless the surviving husband or wife or any known relative of the deceased person shall require the body to be interred without such examination”. It is my position that the deceased would have been aware that he has a wife/husband or other close relatives before making the declaration that his body be made available for anatomical examination when he is no more. Inserting a caveat that a wife or husband or close relatives has the power to require the body to be interred without such examination in total disregard of the express wish of the deceased person is an injustice to the living and the dead. That proviso should be jettisoned. The above can be described as a Will (whether in writing or not), which is the last Will and Testament of a man, while Section 4 is simply requiring an autopsy.

The proviso also impedes medical research, consider the converse – what if the deceased expressly says no examination but relatives ask for it?

Sections 5, 6, 7 and 8 make provisions for conditions to be satisfied before a body is removed from the place where the person died for anatomical examination and the requirements when the body is received for examination. Again while ordinarily, i don’t have any issue here, section 11 renders these provision hollow. It provides thus:

“Any person who contravenes any of the provisions of this Act shall be deemed to have committed an offence and on being convicted thereof shall be liable to imprisonment for a term not exceeding three months or to a fine not exceeding one hundred naira or to both such fine and imprisonment.”

=N= 100 not enough deterrence.

THE PROPOSED BILL UNDER REVIEW

The Bill contains18 sections. The Bill is cited in section 1 as ANATOMY ACT, 2016 (AS AMENDED) while section 18 (the last section) is the definition section. As a layman, I think the intention of the legal draftsmen is laudable as it tends to bring the Bill in conformity with global standard.

Section 2 establishes the Anatomy Council of Nigeria (ACN).

Sections 3 and 4 provide for the powers, duties and responsibilities of the Council which include the training and teaching of Anatomy in Nigeria, granting of license to practice anatomy to individual registered Anatomists, granting of license to practice anatomy to the Departments and Laboratories of Anatomy amongst others.
Section 5 provides for membership of the Council. Section 7 provides for the duties of the Registrar and Secretary to the Council. Section 9 provides for finances of the Council.
The sections highlighted above are sections that appear deserving of further comments. If this Bill is an amending Bill, it will still be cited as ANATOMY ACT 1933 (as amended). If it is a repeal and re-enactment Bill, it should be cited as ANATOMY ACT 2016.
The Anatomy Council of Nigeria (ACN) established under section 2 of the Bill and sections 3 and 4 are major breakthrough towards moving the study and practice of Anatomy to the next level in Nigeria. However I will suggest that the duties of the Council should expressly include the regulation of private mortuaries in private hospitals in Nigeria. Since anatomy as earlier defined is the body and structure of man dead or alive.
On membership of the Council under section 5, the provisions will be redrafted when the Bill is officially before the National Assembly to clear any perceived ambiguity. I am particularly worried about section 5 (iii) which provides for ten other members of the Council, five of whom must be representatives of Registered Associations of Anatomy and five others appointed by the Minister. It is my humble opinion that the ANATOMY COUNCIL OF NIGERIA is a professional body and the powers of the Minister must be reduced as much as possible. In the circumstance, five members appointed by the Minister appear to me very excessive. We must be mindful that under our laws, the Minister of health may not have a background in Health.
In the same vein, the Anatomy Society of Nigeria (ASN) may have to take a second look at section 7 (iii) under Duties of the Registrar and Secretary to the Council to ascertain the true intention of that provision. It provides that it shall be lawful for the Registrar to grant a license to practice Anatomy to an Anatomist or Anatomy Technician.

Section 4(iv) provides that a license granted as aforesaid shall be deemed to authorize the practice of Anatomy in Departments and Laboratories of Anatomy by any Anatomist therein and by any student who is attending a course of study at such Departments and Laboratories when working under the supervision of Anatomist(s). Is it the Council that has power to grant license or the Registrar? If the intention is that the Council shall grant as provided in section 4 and the Registrar issues the certificate of grant, it must be expressly worded in that manner before a Registrar ascribe to himself a power that does not belong to him. Ambiguity in any statute/law must be reduced to the barest minimum if not completely removed.
While sections 10 to 17 contains regulatory provisions generally, it is surprising that the Bill does not make provisions for penalty for violations. This may just be an oversight.

WHAT NEXT?
As earlier stated, this Bill is laudable in many respect. Anatomy has been practiced for a long time without any legal framework. Permit me to say so because to me, the 1933 Act is moribund and one will not expect Anatomy to move to the next level without a proper and modern legal regulatory framework. The Anatomy Society of Nigeria has done serious work in a bid to back the study and practice of anatomy with a legal framework. These efforts deserve special mention and commendation.
Having come up with a proposed Bill, what is next is for this Bill to be officially sponsored on the floor of the House of Representatives. What next? Anatomy in Nigeria should have a legal backing? What next? The study and practice of anatomy in Nigeria should have global recognition. And what next? Nigeria should have an ANATOMY ACT that will herald the study and practice of anatomy into a new dawn. What next? Professionals in the field of medicine in general and anatomy in particular should begin to take a more than cursory interest in the field of medicine and its research. They should liaise continuously with the Government as major stakeholders particularly in the area of funding during yearly budget cycles. Medical science is perhaps the most important discipline of human endeavour, but yet may be one of the most expensive. A legal framework cannot exist in a vacuum. The research and development of anatomy and medicine must be funded, hospitals and research centers must be fully equipped and funded for the law to be practicalized and have life not just as a piece of legislation on paper but as a breathing document.
RECOMMENDATION AND CONCLUSION
In this paper I have attempted to highlight the key objective of this conference; which is primarily to amend the Anatomy Act 1933. However, having considered the existing Act of 1933, I will recommend a complete repeal of the Act and enactment of a new Anatomy Act. In other word, the proposed Bill should be a repeal and re-enactment Bill. It is my belief that anatomy is too important in the field of medicine to be handled with levity. I agree with Professor Desalu’s position that “Anatomy is the corner stone of a doctor’s education”. It must be given the attention it deserves by all stakeholders because a well-structured and a well-regulated study and practice of anatomy will go a long way in resolving many of the healthcare challenges in Nigeria.
*Distinguished guests, ladies and gentlemen, my contribution to this all important task is an undertaking to sponsor the Bill.*
I wish you all a fruitful and very rewarding conference.

Personally, I think is high time something significant is done towards getting Anatomist their rightful place in Nigeria's healthcare service. I hope the current ongoing conference will yield great result to this effect.