How should human tissue be treated?
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In 1999 a total of 2,080
How should children’s hearts and more
than 800 organs from
children were kept at
human tissue Alder Hey Hospital along
with 400 foetuses
be treated? collected from hospitals(s)
across the region.
http://news.bbc.co.uk/1/hi/health/1136723.stm on 17.09.08
Pathologist Mother Public Legislative “Consent wasn’t an issue “It didn’t seem right that “If someone had asked “Doctors removing with the 1961 Human a heart belonging to my me, I would have organs without consent Tissue Act. Nowadays, child could be part of a consented, but without will face sentences of up people rightly expect collection like butterflies, asking me, it’s just like to three years in prison control over what or insects, something to stealing.” and unlimited fines. A happens to their body. be visited and looked at.” new Human Tissue The whole pathology Authority will license and profession has embraced inspect premises and change since the 2004 enforce a code of Human Tissue Act.” conduct.”
Research using human
Whould tissue is essential if we are to
improve our understanding
of cancer and develop more
consent be so effective cancer treatments.
important?
Professor Alex Markham, Former Chief Executive of Cancer Research UK.
http://www.hta.gov.uk/newsroom/quotes_and_endorsements.cfm on 17.09.08
The Times
Public Pathologists Health Editor Cancer Research
“I’d rather donate my “Changing working “The fear is that “The 2004 HTA could
organs to save the practices to address obtaining consent raise serious problems
lives of other people, the issue of consent will be laborious, to for medical research.
than donate to medical does mean more the point where some Had it been in place
research, it’s too paperwork, but it’s a studies become earlier the research
complicated and I don’t question of balance. impossible.” leading to the discovery
really understand what Consent issues are of the ‘cancer genes’
they do.” important to patients would not have been
and their families, so as possible, yet now
pathologists, they are people can have life
important to us.” saving tests for these
breast cancer genes.”
A patient can state their
What do you wishes about what happens
to their body after death.
From September 1st, 2006,
think about the wishes of the deceased
legally take precedence over
donation? those of the family.
Musson R. and Burnapp L. 2006. British Journal of Nursing. 15 (15): 804.
Law in England
Public poll Public Patient from May 2020
“One in six people said “In principle I’m against “The living donor sharing “You can choose to ‘opt
they would be certain to the idea of paying scheme brings hope to out’ of organ donation
donate their body, organ someone for their me and others who are after death by registering
or tissues for medical organs, but if it meant in such desperate need online. Otherwise it will
research, education or saving my daughter’s of having a new kidney. be assumed you have
transplant purposes.” life, I wouldn’t hesitate.” This and the possibility ‘opted in’ for organ
of altruistic stranger donation. Your family will
donation should help to be involved in the final
address the shortage of decision, so it is
organs available.” important to tell them
what you wish to happen.
Your faith beliefs will
always be respected.”
Without a post-mortem, it is
Wouldn’t your estimated that the cause of
death can be wrong in up to
30% of cases.
family want
to know how
you died?
http://www.nhs.uk/Conditions/Post-mortem/Pages/Why-is-it-necessary.aspx?url=Pages/What-is-it.aspx on 17.09.08
Paediatric Pathologist BBC News pathologist Public “past practices (keeping “In 1999, in Liverpool, “In my experience “I don’t want to be cut up patients organs after Annette Grimes found grieving parents are when I die, because you post mortem) were not that the baby she helped by allowing post just don’t know what’ll necessarily unlawful, but thought she’d buried mortems for their babies happen to your bits and they were increasingly at whole, 40 years earlier, and are greatly pieces.” odds with the was buried without his comforted by knowing expectations and wishes heart, lungs and the post mortem of many grieving oesophagus, which had research will help other families, a practice which been kept by the hospital families with sick is no longer acceptable. following post mortem.” children.” Consent is now required for post mortem and tissue retention.”
Two British hospitals revealed
What should you they had given heart tissue,
removed from children
be given in return during live operations, to a
pharmaceutical company for
for donating your research.
tissue? Shortly after, both hospitals
received cash donations from
the company involved.
http://news.bbc.co.uk/1/hi/health/1136723.stm on 17.09.08Researcher Pathologist Legal expert* Member of
the public
“Treatment of disease is “For tissue used in “Donation means gift, “I think donating tissue
constantly improving, transplantation collected and a gift is given should be for altruistic
and many of the in the mortuary, if it can without expectation of reasons like helping
developments are based be used to help others reward, whether of research on new
on the findings from and it’s not costing money or money's treatments, and not be
research on human bereaved anything, so worth. However, the about personal financial
tissue. Thus each patient why should they be paid? potential donor is gain for you or for your
benefits from those For research, pathologists entitled to make their family.”
patients who donated cannot store tissue for own decision about
tissue in the past. I think very long; blood is whether to donate, and
patients should have a usually destroyed in less to sufficient information
guarantee that all than a week, solid tissue to help them make that
research will be ethical in a month. So, if it can be decision. They are
and lawful and should used to help others entitled to know that
be able to find out what where’s the harm in their tissue will be used
research their tissue was giving it away and it's not properly and only for the
used for and what it costing the bereaved purposes for which they
discovered. BUT I think anything, why should are donating.”
payment for each they be paid?”
*Lawyer point of view provided by Dr
sample would hamper Ruth Stirton, Senior Lecturer in
the ongoing progress of Healthcare Law, University of Sussex
research, and so should
not be offered.”The family play a key role in
Whose the donation process. The
role of the family should be
to help establish the decision
consent of the individual with regard
to donation.
counts?
Source: Human Tissue Authority Code F: Donation of organs and tissue for transplantation 2020.Patient rights activist British Medical Pathologist Legislative
Association
“If someone breaks into “The BMA would prefer a “To remove tissue… “To be able to give
your house and takes system where upon their without the agreement consent for his or her
your belongings, it is death, patients consent of the patient would own tissue, a patient
called stealing. But if to organ donation is be an assault on the must be 16 years of age
someone takes tissues assumed unless specific individual and be or above. Under the age
from your body, it is objections have been punishable under other of 16 a patients parent
called medical research.” made.” criminal legislation.” or other legal guardian
can give or withhold
consent.”Human tissue is ‘material,
What does other than gametes, which
consists of or includes human
cells’. This Act does not apply to
‘human tissue’ ‘hair and nail from the body of
a living person’. HTA 2004
mean? However, […] the legislation
makes no distinction between
the heart from a dead child and
the urine from a living
individual.
J.C.E. Underwood. 2006. The impact on histopathology practice of new
human tissue legislation in the UK. Histopathology. 49: 221-228. p.222.Public Poll Public Pathologist Mother “responses to the “I’m happy to donate “organs such as the “It didn’t seem right question “when I say everything in my body heart and the brain that a heart belonging ‘human tissue’, what to medical science, evoke stronger feelings to my child could be springs to mind? Are: except my brain.” than do parathyroid part of a collection like bones, brain cells, DNA, glands and lymph butterflies, or insects, eggs, embryos, eyes, nodes.” something to be visited flesh, genetics, limbs, and looked at.” marrow, muscle, organs, skeleton, skin, soft tissue, sperm, and stem cells.”
Charles Byrne (1761-1783) the
Pathology: Irish Giant, made his living at
Freak Shows in 18th Century
Britain. Aware that anatomists
Dubious past wanted his body for research, his
will stated he wanted to be
or ground- buried at sea in an iron coffin.
Three years after his death, the
famous anatomist, John Hunter,
breaking displayed Byrne’s skeleton in his
teaching museum, to much
progress? acclaim – but against Byrnes
expressed wishes.
R. Semple. 2007. The Hunterian Museum.Medical Historian Legislative Public Pathologist “John Hunter was a great “The first legislation to “I can’t believe anyone “This kind of thing, whilst man of his time, whose explicitly require consent would do something like awful, was a product of actions, wile morally for use and display of this, it’s barbaric and its time and without it we dubious with hindsight, human tissue came into totally disgusting”. would not have the did advance medical place in 2004.” benefits of modern knowledge.” medicine.”
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