Human Tissue: Ethical and Legal Issues
Hospital Inquiries
Hospital Inquiries
Two high-profile inquiries focussed on instances of improper retention of organs:
- Bristol Inquiry (2001)
- Alder Hey Inquiry (2001)
Bristol Inquiry
A public inquiry was set up to investigate children’s heart surgery at Bristol Royal Infirmary in October 1998. During this it emerged that it had been commonplace for hearts, removed from children during post-mortem examination, to be retained. In many cases this appears to have taken place without parental consent or even knowledge. This revelation caused much public concern.
Professor Ian Kennedy, Chairman of the Nuffield Council, chaired the Inquiry. The Inquiry published an Interim Report, Removal and retention of human material, in May 2000. This then became Annex C of the final report, which was published in July 2001. Recommendations in the Interim Report included:
- Emphasis on the respect for the dead child and parental concerns when considering the removal, retention, use and disposal of human material
- Medical benefits of retaining tissues should be balanced with informed co-operation of the parents
- An increasing use of alternative means for education and research, for example three-dimensional modelling and other technology, because of the emotional concerns of using human material
- Wider questions concerning the establishment and maintenance of tissue banks and commercialisation of tissue should receive urgent consideration, with a view to establishing an appropriate regulatory system
The Report suggested two options for the future – either having a Code of Practice or new legislation with necessary related provisions.
For more information: http://www.bristol-inquiry.org.uk
Alder Hey Inquiry
It was discovered that it had been common practice to retain organs without parental knowledge and agreement Alder Hey Children’s Hospital in Liverpool. Separate research collections of children’s hearts and other organs had been accumulated over several decades.
Additionally, between 1988 and 1995, Professor van Velzen, then Professor of Fetal and Infant Pathology was responsible for the removal of all organs from all babies and children at post-mortem and their storage for intended research, without parental knowledge or agreement. In the majority of cases, these organs were never put to any useful research purpose.
A public inquiry was held, to investigate the removal, retention and disposal of human organs and tissues. The resulting Redfern report was published in January 2001 and recommended:
- Establishment of serious incident procedures to prevent future mishandling of the organ retention issue
- Medical and pathology records should be reviewed and updated and an audit trail should be developed and put in place
- New management standards to prevent a repeat of the van Velzen years
- The Human Tissue Act 1961 should be amended to provide a test of fully informed consent
- Once fully informed consent is obtained for research purposes, the researchers are entitled to remain in possession of the material retained while research continues.
- Local ethics committees should be given a supervisory role to police approved research.
The report also included specific recommendations for clinicians, coroners, pathologists and bereavement advisers.
For more information: http: //www.rlcinquiry.org.uk/
Last Updated Tue, 8 August 2006