Human Tissue: Ethical Issues
Ethical principles
13.5 Any clarification of the legal and regulatory framework for the use of human tissue must be based on appropriate ethical principles. The basis for the recommendations that follow is the ethical review presented in Chapter 6. The fundamental ethical considerations are as follows:
1 uses of human tissue which injure in that they destroy, damage or degrade are unacceptable because such uses show lack of respect for human beings and their bodies. However, when action that would otherwise count as injury is undertaken for therapy, it is legitimate;
2 it is ethically acceptable to make use of human tissue for medical treatment, and for medical training, for fundamental and applied research and for other purposes that may contribute indirectly to medical treatment;
3 these uses of human tissue are only ethically permissible when the tissue has been removed with the consent of those whose tissue is used or, where that is not possible, by procedures that give equivalent protection;
4 there are strong arguments against the commercial acquisition and supply of human tissue for medical and scientific purposes, however acceptable those purposes may be in themselves.
13.6When it comes to putting those ethical considerations into practice, our principal conclusion has been that they can and should be reflected in the procedures used to organise and regulate the removal, storage and further use of human tissue. Our recommendations are designed to build on existing legal and professional regulation to produce a coherent framework for ensuring the appropriate use of human tissue. One example of how the basis of such a framework has been laid is the existing requirement that only appropriately qualified professionals, accountable as such, may remove human tissue. Existing professional requirements extend, beyond the removal of tissue, to its storage and many of its further uses. Our recommendations on the acceptable organisation of the acquisition, supply and further use of human tissue accordingly emphasise and build on widely recognised professional responsibilities. From these accepted professional responsibilities, and following the thinking of the Polkinghorne Committee in its guidance on the research use of fetuses and fetal material, we develop the role of what we term medical intermediaries.
13.7We have argued that human tissue should be acquired and supplied through non-commercial procedures. Further uses of human tissue, however, include some which can lead to the development of products that may be used as commodities; some of these products may be patentable, although the extent to which inventions derived from human tissue are, or should be, patentable is still a matter of debate. There must, therefore, be intermediaries to control the relations between the non-commercial acquisition and supply of human tissue on the one hand, and the commercial organisations which may create and distribute products derived from human tissue on the other hand. The role of these medical intermediaries in the acceptable organisation of the acquisition, supply and further use of human tissue is discussed below in Sections II and III.