Scalpels and Standards: What Students Consider Ethical, Unethical, and Ethically Challenging in the Anatomy Lab.

Background: Human dissection in medical education presents an ethically complex terrain shaped by institutional norms, peer culture, and personal values. While formal codes and donor protections have evolved, little is known about how students themselves define and interpret ethical conduct in the gross anatomy lab. This qualitative study explored medical students' perceptions of ethical behavior during dissection. Methods: Twenty students from all four years of medical school at a single U.S. institution participated in one-on-one, semi-structured interviews. Transcripts were analyzed inductively using open coding to identify recurring themes. Credibility was enhanced through analyst triangulation, reflexive dialogue, and use of illustrative quotes. Results: Three overarching themes emerged: (1) Ethical practices were linked to faculty role-modeling, peer and self-monitoring, and mindfulness during dissection; (2) Unethical practices included inappropriate jokes, careless handling of donor bodies, and unprofessional behavior; and (3) Ethically challenging situations involved uncertainty about donor consent, tension between objectification and personification of the body, and unspoken norms discouraging emotional expression. These dynamics often went unaddressed by formal instruction or policy, leaving students to navigate them independently. Conclusions: Students engage with dissection not only as a technical task but also as a moral experience. While institutional rules and professional standards are necessary, they are often insufficient on their own to help students smoothly navigate the ethical and emotional complexities of the anatomy lab. Anatomy education should incorporate structured opportunities for ethical and emotional reflection, reinforce transparency around body donation, and foster a culture that validates emotional responses. These practices may better support professional identity formation and align ethical conduct with students' lived experiences.